Publications by authors named "Douillet D"
Article Synopsis
- - The PREVACT study investigated the effectiveness of immediate reversal of anticoagulation in patients on vitamin K antagonists (VKAs) who suffered mild traumatic brain injury (TBI) to see if it could lower the incidence of intracranial hemorrhage (ICH) within 24 hours of treatment.
- - In a clinical trial across 21 French emergency departments, 202 patients were randomized to either receive immediate reversal treatment or standard care, but the trial was halted early, making it difficult to draw definitive conclusions.
- - Although the results indicated a lower rate of ICH in the intervention group compared to the control group (6.1% vs. 12.1%), the difference was not statistically significant, leaving open
Background: The recreational use of nitrous oxide is becoming increasingly common among teenagers and young adults. Since 2018, the use of nitrous oxide has increased exponentially and has become a public health problem.
Case Presentation: A 23-year-old patient was referred to accident and emergency (A&E) by his general practitioner for deterioration in general condition, vomiting, diarrhea and febrile headache at 39 °C.
Article Synopsis
- The study is trying to help families make tough choices about stopping life-support in emergency rooms when patients can't talk.
- They will create a special program to help families, doctors, and nurses with these decisions and check how it affects the stress levels of the families.
- The research will take place in nine emergency departments in France and will measure how families feel after 7, 30, and 90 days, making sure everything follows ethical rules.
Introduction: Although largely used, the place of oxygen therapy and its devices in patients with acute hypoxemic respiratory failure (ARF) deserves to be clarified. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and the French Emergency Medicine Society (Société Française de Médecine d'Urgence, SFMU) organized a consensus conference on oxygen therapy in ARF (excluding acute cardiogenic pulmonary oedema and hypercapnic exacerbation of chronic obstructive diseases) in December 2023.
Methods: A committee without any conflict of interest (CoI) with the subject defined 7 generic questions and drew up a list of sub questions according to the population, intervention, comparison and outcomes (PICO) model.
The multi-staged XENON program at INFN Laboratori Nazionali del Gran Sasso aims to detect dark matter with two-phase liquid xenon time projection chambers of increasing size and sensitivity. The XENONnT experiment is the latest detector in the program, planned to be an upgrade of its predecessor XENON1T. It features an active target of 5.
View Article and Find Full Text PDFBackground And Aims: Home treatment is considered safe in acute pulmonary embolism (PE) patients selected by a validated triage tool (e.g. simplified PE severity index score or Hestia rule), but there is uncertainty regarding the applicability in underrepresented subgroups.
View Article and Find Full Text PDFIntroduction: In EDs, triage ensures that patients whose condition requires immediate care are prioritized while reducing overcrowding. Previous studies have described the manifestation of caregivers' moral judgements of patients in EDs. The equal treatment of patients in clinical practice presents a major issue.
View Article and Find Full Text PDFPurpose: The efficacy of the 1-h bundle for emergency department (ED) patients with suspected sepsis, which includes lactate measurement, blood culture, broad-spectrum antibiotics administration, administration of 30 mL/kg crystalloid fluid for hypotension or lactate ≥ 4 mmol/L, remains controversial.
Methods: We carried out a pragmatic stepped-wedge cluster-randomized trial in 23 EDs in France and Spain. Adult patients with Sepsis-3 criteria or a quick sequential organ failure assessment (SOFA) score ≥ 2 or a lactate > 2 mmol/L were eligible.
Article Synopsis
- * No significant survival advantage was found among most beta-lactam antibiotics, but the combination of meropenem and aerosolized colistin showed a reduction in mortality compared to intravenous colistin alone.
- * Although ceftolozane/tazobactam showed potential superiority for microbiological cure, ceftazidime had a higher clinical failure rate compared to other treatments, and intravenous colistin was linked to more acute kidney failure in safety assessments.
Overcrowding in the Dispatching Centre During the COVID-19 Crisis: Are Medical Students a Resource?
Disaster Med Public Health Prep
February 2024
Introduction: In February, the emergence of COronaVIrus Disease 2019 (COVID - 19) in France made it necessary to rapidly adapt emergency and SAMU services in order to take care of many infected patients. To respond to the increase in the number of calls in the dispatch centers, reinforcements were necessary on the fronts of the Medical Regulation Assistants (ARM). The aim of this study was to assess the relevance of medical students' responses to first calls exclusively concerning COVID-19.
View Article and Find Full Text PDFBackground: Prophylactic anticoagulation in emergency department patients with lower limb trauma requiring immobilisation is controversial. The Thrombosis Risk Prediction for Patients with Cast Immobilisation-TRiP(cast)-score could identify a large subgroup of patients at low risk of venous thromboembolism for whom prophylactic anticoagulation can be safely withheld. We aimed to prospectively assess the safety of withholding anticoagulation for patients with lower limb trauma at low risk of venous thromboembolism, defined by a TRiP(cast) score of less than 7.
View Article and Find Full Text PDFBackground: The HOME-CoV (Hospitalisation or Outpatient ManagEment of patients with SARS-CoV-2 infection) score is a validated list of uniquely clinical criteria indicating which patients with probable or proven COVID-19 can be treated at home. The aim of this study was to optimise the score to improve its ability to discriminate between patients who do and do not need admission.
Methods: A revised HOME-CoV score was derived using data from a previous prospective multicentre study which evaluated the original Home-CoV score.
Background: We aimed to identify patients at low risk of bloodstream infection (BSI) in the ED.
Methods: We derived and validated a prediction model to rule out BSI in the ED without the need for laboratory testing by determining variables associated with a positive blood culture (BC) and assigned points according to regression coefficients. This retrospective study included adult patients suspected of having BSI (defined by at least one BC collection) from two European ED between 1 January 2017 and 31 December 2019.
Background: Performing quality chest compressions is fundamental to the management of cardiopulmonary arrest. The aim of this study was to compare the efficacy of two hand positions: overlapping versus interlocking for performing chest compressions during cardiopulmonary arrest.
Methods: The HP2C (for Hands Position and Chest Compression) was a prospective, randomised, open-label, cross-over, single-centre study.
Article Synopsis
- - Validated clinical decision rules aimed at reducing unnecessary use of computed tomographic pulmonary angiography (CTPA) in emergency departments (EDs) for suspected pulmonary embolism (PE) were analyzed to observe changes in CTPA usage over time.
- - A retrospective study across 26 European EDs examined nearly 9,000 CTPAs performed between January 2015 and December 2019, revealing significant increases in CTPA usage and diagnosed PEs, particularly among low-risk patients.
- - The findings indicated a trend toward more frequent CTPA use and a higher diagnosis rate of PEs despite efforts to limit unnecessary imaging, highlighting the need for ongoing assessment of clinical decision rules in practice.
Background: Lung point-of-care ultrasonography (L-POCUS) is highly effective in detecting pulmonary peripheral patterns and may allow early identification of patients who are likely to develop an acute respiratory distress syndrome (ARDS). We hypothesized that L-POCUS performed within the first 48 hours of non-critical patients with suspected COVID-19 would identify those with a high-risk of worsening.
Methods: POCUSCO was a prospective, multicenter study.
Article Synopsis
- Diagnosing pulmonary embolism (PE) is hard in 2023 because its signs and symptoms are confusing and not clear.
- Many tests, like a special scan called CTPA, are done more often now, but this hasn't really helped patients feel better.
- Some new ideas are being discussed to reduce unnecessary testing, like changing the rules for which patients need certain tests, to prevent complications and risks from the extra scans.
Background: Unique blood culture (UBC) has been proposed to limit the number of venipuncture and to decrease the risk of BC contaminations (BCC) without affecting their yield. We hypothesized that a multi-faceted program based on UBC in the ICU may reduce the rate of contaminants with a similar performance for bloodstream infections (BSI) identification.
Methods: In a before and after design, we compared the proportion of BSI and BCC.