Early medical care and mortality in polytrauma.

This study attempts to objectively estimate the efficiency of early medical care. It is based on the comparison of two series of multiple injured patients. Ten years separated the two groups and during this period, an Emergency Medical Aid Service (SAMU 94) was created.

Treatment in serious lower limb injuries: amputation versus preservation.

A study of patients with serious lower limb injuries is presented. With these injuries it is important to decide whether the limb should be salvaged at the risk of losing a life. Seventy-six patients are described and compared with a group of patients with similar injury severity scores but without serious lower limb injury.

Alcoholism in polytrauma.

Alcoholism is a blight which implicates numerous areas. Polytrauma requires a sometimes long and expensive hospitalization, with a mortality of approximately one in three. In 250 patients (the mean ISS is the same for patients who died, whether nonalcoholics, chronic alcoholics, or occasional drinkers), there was a significant difference between the mortality rate of two-wheeled vehicle drivers and the mortality rate of the light vehicle drivers (p less than 0.

[Treatment of severe injuries of the lower limbs. Identification of clinical criteria of severity].

The choice and timing of therapeutic methods for injuries of the lower limbs were evaluated in 60 patients. Primary amputation had to be performed in 18 of them, and conservative treatment was attempted in the others. Sixteen secondary amputations were necessary, mostly for arterial lesions.

[Deliveries outside maternity hospitals. 5-year prospective study apropos of 150 cases].

Deliveries outside of maternity hospitals in 1983 resulted in many high risk newborns. In 40% of cases it occurred in lower socio-economic groups and in 60% was due to lack of information with regards to recent progress in obstetrical care. The presence of regional emergency services (SAMU) and competent pediatric care, has allowed for rapid transport and medical intervention.

Pre hospital intensive care in multiple trauma children.

From January 1979 to December 1984, 1,272 calls, concerning injured children, aged 11 days to 15 years, justified the intervention of a Mobile Medical Emergency and Intensive Care Service, in the department of "Val-de-Marne" near Paris. Three hundred and twenty-two were very serious trauma children (25%); 45 were in cardiac arrest, and 41 died on the scene of the accident despite the intensive cares delivered by the anesthetists or pediatricians. Two hundred and eighty-one children were hospitalized in an intensive multiple trauma pediatric unit (97 cases) or in a neurosurgical pediatric unit (184 cases).

Neonatal distress. Interest of early medical care and medicalized transport.

From January 1979 to December 1981, amongst the 1200 interventions concerning neonatalogy, SAMU'94 pediatric unit was called out 1070 times for newborns less than 8 days old (i.e. 36% of the pediatric unit entire activity).

Emergency medical care in France.

Emergency Medical Aid (AMU) has existed on an organized basis in France for ten years. Considering that every call for medical assistance requires an answer the SAMU (Emergency Medical Aid Service) acts as a switchboard. Its implantation in a hospital and its powerful centralized telecommunications make it possible to adapt responses to the type of case: serious ones require sophisticated equipment, whereas non-serious ones come under a General Practitioner.

Disaster medicine training in France.

We describe the disaster medicine training program that has been developed in France by the anesthesia-reanimation specialists who provide emergency medical services. The diploma course is presented twice yearly over a two-week period to physicians of all disciplines. The 71-hour didactic program covers the background of disasters, various plans and strategies, tactics and logistics, techniques, and victim assessment and treatment.