Impact of a new post-emergency teleconsultation procedure on overcrowding.

Background: Saint Vincent de Paul Hospital is using a post-emergency teleconsultation solution (TELESCOPE). Target patients are discharged early, freeing up examination rooms and hospital beds, and the patient's clinical evolution is monitored by teleconsultation 24 hours after discharge. This study aims to evaluate this pioneering procedure, firstly to assess the impact of TELESCOPE on ED overcrowding, and secondarily to evaluate 72-hour post-emergency hospitalization rates, throughput times, and patient satisfaction.

[Study on the integration of emergency IPAs in Nord-Pas-de-Calais: supervisors' perspectives].

In the context of the introduction of advanced practice nurses in emergency departments (APNs), the Collège de Médecine d'Urgence du Nord-Pas-de-Calais teamed up with the Unité de Formation et de Recherche des Sciences de la Santé et du Sport at the University of Lille to conduct a survey of emergency department management teams, with the aim of gaining a better understanding of their needs. The results revealed a number of obstacles and levers to the implementation of APNs, and led to a better understanding of the patient pathways in these departments. As a result, the content of the university teaching program could be reviewed with a view to meeting the needs expressed in the field.

Bystander basic life support and survival after out-of-hospital cardiac arrest: A propensity score matching analysis.

Introduction And Objectives: In out-of-hospital cardiac arrest, early recognition, calling for emergency medical assistance, and early cardiopulmonary resuscitation are acknowledged to be the three most important components in the chain of survival. However, bystander basic life support (BLS) initiation rates remain low. The objective of the present study was to evaluate the association between bystander BLS and survival after an out-of-hospital cardiac arrest (OHCA).

The inception of a hospital-based dental emergency department in a precarious region decreases the incidence of severe cellulitis of odontogenic origin.

Introduction: Although most localized odontogenic infections can be managed successfully without complications, some can cause extensive morbidity through the onset of cervicofacial cellulitis. The management of these more severe infections generally requires emergency treatment, including surgical treatment under general anesthesia, and prolonged length of hospital stay.

Material & Methods: In this work, we assessed the impact of the provision of a hospital-based dental emergency department on the regional incidence of severe odontogenic cellulitis in a socioeconomically precarious region.

A Time-Dependent Propensity Score Matching Approach to Assess Epinephrine Use on Patients Survival Within Out-of-Hospital Cardiac Arrest Care.

Background: Epinephrine effectiveness and safety are still questioned. It is well known that the effect of epinephrine varies depending on patients' rhythm and time to injection.

Objective: We aimed to assess the association between epinephrine use during out-of-hospital cardiac arrest (OHCA) care and patient 30-day (D30) survival.

Inhaled methoxyflurane for the management of trauma related pain in patients admitted to hospital emergency departments: a randomised, double-blind placebo-controlled trial (PenASAP study).

Background: Oligo-analgesia is common in the emergency department (ED). This study aimed at reporting, when initiated by triage nurse, the superior efficacy of inhaled methoxyflurane plus standard of care (m-SoC) analgesia versus placebo plus SoC (p-SoC) for moderate-to-severe trauma-related pain in the hospital ED.

Methods: A randomised, double-blind, placebo-controlled trial was conducted at eight EDs.

Identification of a morning out-of-hospital cardiac arrest cluster of high-incidence: towards a chrono-preventive care strategy.

Rationale, Aims, And Objectives: The human body is regulated by intrinsic factors which follow a 24-hour biological clock. Implications of a circadian rhythm in the out-of-hospital cardiac arrest (OHCA) are studied but the literature is not consistent. The main objective of our study was to identify temporal cluster of high or low incidence of OHCA occurrence during a day.

Intraosseous Versus Peripheral Intravenous Access During Out-of-Hospital Cardiac Arrest: a Comparison of 30-Day Survival and Neurological Outcome in the French National Registry.

Purpose: To compare intraosseous access with peripheral venous access on adults out-of-hospital cardiac arrest (OHCA) patients' clinical outcomes.

Methods: A national retrospective multicentre study was conducted based on the French National Cardiac Arrest Registry. Comparison of patients (intraosseous vs.

Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation: A Randomized Clinical Trial.

Importance: Rocuronium and succinylcholine are often used for rapid sequence intubation, although the comparative efficacy of these paralytic agents for achieving successful intubation in an emergency setting has not been evaluated in clinical trials. Succinylcholine use has been associated with several adverse events not reported with rocuronium.

Objective: To assess the noninferiority of rocuronium vs succinylcholine for tracheal intubation in out-of-hospital emergency situations.

Intensity of care delivered by prehospital emergency medical service physicians to patients with deliberate self-poisoning: results from a 2-day cross-sectional study in France.

Emergency management of deliberate self-poisoning (DSP) by drug overdose is common in emergency medicine. There is a paucity of data about the prehospital care of these patients. The principal aim was to describe the intensity of care received by patients with DSP who were managed by prehospital emergency medical service (EMS) physicians.

Can We Define Termination Of Resuscitation Criteria In Out-Of-Hospital Hanging?

Objective: Survival rate of cardiac arrest due to hanging (H-CA) victims is low. Hence, this leads to the question of the utility of resuscitation in these patients. The objective was to investigate whether there are predictive criteria for survival with a good neurological outcome or predictive criteria for non-survival or survival with a poor neurological outcome enabling us to define the termination of resuscitation rules in these patients.

Traumatic cardiac arrest is associated with lower survival rate vs. medical cardiac arrest - Results from the French national registry.

Introduction: The survival from traumatic vs. medical out-of-hospital cardiac arrest (OHCA) are not yet well described. The objective of this study was to compare survival to hospital discharge and 30-day survival of non-matched and matched traumatic and medical OHCA cohorts.

Epidemiology of out-of-hospital cardiac arrest: A French national incidence and mid-term survival rate study.

Out-of-hospital cardiac arrest (OHCA) is considered an important public health issue but its incidence has not been examined in France. The aim of this study is to define the incidence of OHCA in France and to compare this to other neighbouring countries. Data were extracted from the French OHCA registry.

Development of an online, universal, Utstein registry-based, care practice report card to improve out-of-hospital resuscitation practices.

Rationale, Aims And Objectives: Care quality is a primary concern in health field. In France, the care practice report card (CPRC) is compulsory for practitioners. It is the first step towards the culture of excellence.

Evolution of Survival in Cardiac Arrest with Age in Elderly Patients: Is Resuscitation a Dead End?

Background: Even if age is not considered the key prognostic factor for survival in cardiac arrest (CA), some studies question whether cardiopulmonary resuscitation (CPR) in the elderly could be futile.

Objective: The aim of this study was to describe differences in out-of-hospital CA survival rates according to age stratification based on the French National CA registry (RéAC). The second objective was to analyze the differences in resuscitation interventions according to age.

Age discrimination in out-of-hospital cardiac arrest care: a case-control study.

Background: Although some studies have questioned whether cardiopulmonary resuscitation (CPR) in older people could be futile, age is not considered an essential out-of-hospital cardiac arrest (OHCA) prognostic factor. However, in the daily clinical practice of mobile medical teams (MMTs), age seems to be an important factor affecting OHCA care.

Aims: The purpose of this study was to compare OHCA care and outcomes between young patients (<65 years old) and older patients.

Impact on patient management of the implementation of a magnetic resonance imaging dedicated to neurological emergencies.

Rationale, Aims And Objectives: Neurological emergencies consumed a high amount of resources in emergency department (ED). We aimed to study the effect of the implementation of a magnetic resonance imaging (MRI) dedicated to emergencies on the management of patients admitted in ED for neurological emergencies.

Methods: We enrolled consecutive patients who underwent computed tomography and/or MRI for neurological disorders categorized as the suspicion of stroke and other reasons, over 2 periods that differed according to the priority access to computed tomography in the first period versus priority access to MRI in the second one.

Early High-Dose Erythropoietin Therapy After Out-of-Hospital Cardiac Arrest: A Multicenter, Randomized Controlled Trial.

Background: Preliminary data suggested a clinical benefit in treating out-of-hospital cardiac arrest (OHCA) patients with a high dose of erythropoietin (Epo) analogs.

Objectives: The authors aimed to evaluate the efficacy of epoetin alfa treatment on the outcome of OHCA patients in a phase 3 trial.

Methods: The authors performed a multicenter, single-blind, randomized controlled trial.

Extracorporeal Life Support in Out-of-Hospital Refractory Cardiac Arrest.

Out-of-Hospital refractory Cardiac Arrest (OHrCA) has a mortality rate between 90 and 95%. Since 2009, French medical academic societies have recommended the use of extracorporeal life support (ECLS) for OHrCA. According to these guidelines, patients were eligible for ECLS support if vital signs were still present during cardiopulmonary resuscitation (CPR), or if cardiac arrest was secondary to intoxication or hypothermia (≤32°C).

Use of emergency departments by known epileptic patients: An underestimated problem?

Background And Purpose: Seizure is a frequent reason of admission in emergency department (ED) but little is known about the proportion and the characteristics of known epileptic patients (KEPs) who used emergency services.

Methods: Over a 12-month period, we prospectively recruited adults admitted for seizure to a tertiary hospital ED. For KEPs, clinical epilepsy features and characteristics of the admission were collected.

Continuous Infusion of Ketamine for Out-of-hospital Isolated Orthopedic Injuries Secondary to Trauma: A Randomized Controlled Trial.

Abstract Objective. Although ketamine has recently been demonstrated to provide a morphine-sparing effect, no previous study reports the effect of continuous infusion of ketamine for analgesia in out-of-hospital environments. The aim of this study was to compare the effect of a continuous infusion of ketamine (IK group) vs.

Rationale, methodology, implementation, and first results of the French out-of-hospital cardiac arrest registry.

Introduction: Out-of-hospital cardiac arrest (OHCA) is an important public health issue with an estimated incidence of 50,000 cases per year in France. Community survival rates for OHCA are still low (approximately 5%). An effective, recognized way to study, assess, and improve OHCA care is to create a standard-format database.

Rivaroxaban and other non-vitamin K antagonist oral anticoagulants in the emergency treatment of thromboembolism.

Pulmonary embolism (PE) is potentially fatal and often requires emergency management. Because PE associated with shock and/or hypotension carries a high risk of sudden death, emergency clinicians must rapidly make a diagnosis and initiate appropriate therapeutic strategies, usually involving anticoagulant treatment. Traditional anticoagulants, such as heparins and vitamin K antagonists, although effective and recommended by guidelines, are associated with limitations.