Early results of ultra-low-dose CT-scan for extremity traumas in emergency room.

Background: Ultra-low dose computed tomography (ULD-CT) was shown to be a good alternative to digital radiographs in various locations. This study aimed to assess the diagnostic sensitivity and specificity of ULD-CT versus digital radiographs in patients consulting for extremity traumas in emergency room.

Methods: Digital radiography and ULD-CT scan were performed in patients consulting at the emergency department (February-August 2018) for extremity traumas.

Magnetic needle-tracking device for ultrasound guidance of radial artery puncture: A randomized study on a simulation model.

Introduction: Ultrasound-guidance of radial artery catheter insertion improves the first attempt success and reduces the occurrence of hematomas. Needle-tracking devices optimize needle-ultrasound beam alignment by displaying in real-time the needle tip position. We compared the median time need by experienced physicians to achieve radial artery puncture using either a conventional ultrasonography device (CUD) or a magnetic needle-tracking ultrasound device (MUD) in a simulation training arm model.

Diaphragmatic excursion measurement in emergency department patients with acute dyspnea to predict mechanical ventilation use.

Introduction: Ultrasound is a feasible and reproducible method for measuring right diaphragmatic excursion (RDE) in ED patients with acute dyspnea (AD). In AD patients, the correlation between the RDE value and the need for mechanical ventilation (MV) is not known.

Materials: This was a bicentric, observational prospective study.

Global longitudinal strain changes during hemorrhagic shock: An experimental study.

Objectives: Global longitudinal strain (GLS) appears sensitive and reproducible to identify left ventricular systolic dysfunction. The main objective was to analyze the GLS changes in an anesthetized-piglet model of controlled hemorrhagic shock (HS). The secondary objective was to evaluate if GLS changes was different depending on the expansion fluid treatment with or without norepinephrine.

Out-of-hospital Times Using Helicopters Versus Ground Services for Emergency Patients.

Objective: Minimizing out-of-hospital time reduces morbidity and mortality in patients with severe trauma, acute coronary syndrome, or acute stroke. Our objective was to compare out-of-hospital times by helicopter versus ground services when the estimated time of arrival on the scene was over 20 minutes.

Methods: We proposed a retrospective observational monocentric study following 2 cohorts.

Ultrasound guidance in difficult radial artery puncture for blood gas analysis: A prospective, randomized controlled trial.

Background: Ultrasound (US) guidance has yet to prove its applicability in radial arterial blood gas analysis (ABGA) punctures. The main objective of our study was to compare the number of first-attempt successes (NFAS) for radial arterial puncture in difficult patients with or without US guidance. The Secondary aims were to compare the number of punctures (NOP), puncture time, and patient pain.

Minor Blunt Thoracic Trauma in the Emergency Department: Sensitivity and Specificity of Chest Ultralow-Dose Computed Tomography Compared With Conventional Radiography.

Study Objective: To evaluate the diagnostic performance of chest ultralow-dose computed tomography (CT) compared with chest radiograph for minor blunt thoracic trauma.

Methods: One hundred sixty patients with minor blunt thoracic trauma were evaluated first by chest radiograph and subsequently with a double-acquisition nonenhanced chest CT protocol: reference CT and ultralow-dose CT with iterative reconstruction. Two study radiologists independently assessed injuries with a structured report and subjective image quality and calculated certainty of diagnostic confidence level.

Pocket-sized ultrasound device for internal jugular puncture: A randomized study of performance on a simulation model.

Introduction: The aims of our study were to compare the performance of experienced emergency physicians for internal jugular vein puncture using a conventional ultrasound device versus a pocket-sized ultrasound in a training model.

Methods: In this single-center, prospective, randomized study, emergency physicians performed one puncture with each device in a randomized order. No emergency physicians used a pocket-sized ultrasound for central vascular catheter insertion in clinical practice.

A New Echocardiographic Tool for Cardiac Output Evaluation: An Experimental Study.

Background: The correlation between cardiac output (CO) evaluated by echocardiography and CO measured by thermodilution (COth) varies according to different studies. A new transthoracic echocardiography (TTE) tool allows automatic calculation of the subaortic velocity time index (VTIauto) and CO (COauto). The main objective was to evaluate the correlation between COth and COauto in an anesthetized, ventilated piglet hemorrhagic shock (HS) model.

Compression with a pocket-sized ultrasound device to diagnose proximal deep vein thrombosis.

Introduction: Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device (PUD). The main objective of this study was to assess the diagnostic performance of CUS made by emergency physicians (EPs) using a PUD.

Materials: This was a prospective, diagnostic test assessment, single-center study.

Assessment of five different probes for lung ultrasound in critically ill patients: A pilot study.

Introduction: The present study was aimed at comparing the diagnosis concordance of five echo probes of lung ultrasound (LUS) with CT scans in intensive care and emergency patients with acute respiratory failure.

Materials: This prospective, observational, pilot study involved 10 acute patients in whom a thoracic CT scan was performed. An expert performed an LUS reference exam using five different probes: three probes with a high-quality conventional echo machine (cardiac phased-array probe, abdominal convex probe, linear probe) and two probes (cardiac and linear) with a pocket ultrasound device (PUD).

Integration of lung ultrasound in the diagnostic reasoning in acute dyspneic patients: A prospective randomized study.

Introduction: Misdiagnosis in acute dyspneic patients (ADP) has consequences on their outcome. Lung ultrasound (LUS) is an accurate tool to improve diagnostic performance. The main goal of this study was to assess the determinants of increased diagnostic accuracy using LUS.

Tracheal extubation with suction vs. positive pressure during emergence from general anaesthesia in adults: A randomised controlled trial.

Background: After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO<92%).

Methods: Sixty-nine patients with a body mass index<30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group.

The clinical impact and prevalence of emergency point-of-care ultrasound: A prospective multicenter study.

Objective: The main objectives of our study were to evaluate the prevalence of emergency point-of-care ultrasound (POCUS) use and to assess the impact of POCUS on: diagnostic, therapeutic, patient orientation and imaging practices.

Methods: This was a one-day, prospective, observational study carried out across multiple centers. Fifty emergency departments (EDs) recorded all POCUS performed over a 24h period.

Plasmatic presepsin (sCD14-ST) concentrations in acute pyelonephritis in adult patients.

Introduction: Presepsin (sCD14-ST) is an emerging biomarker for infection. We hypothesized that presepsin could specifically increase during acute pyelonephritis and correlate with severity.

Methods: We compared presepsin values in patients with acute pyelonephritis and controls, and we assessed its capacity to predict bacteraemia and admission in patients.

Sore throat following three adult supraglottic airway devices: A randomised controlled trial.

Background: Sore throat is a common complaint after surgery. It affects patient satisfaction and can affect activity after discharge. The supraglottic airway device (SAD) offers an alternative to traditional tracheal intubation with potential benefit in preventing sore throat.

Prescription errors by emergency physicians for inpatients are associated with emergency department length of stay.

Objectives: Adverse drug events are the sixth-leading cause of death in Western countries and are also more frequent in emergency departments (EDs). In some hospitals or on some occasions, ED physicians prescribe for patients who they have admitted. These prescriptions are then followed by the wards and can persist for several days.

The impact of emergency department segmentation and nursing staffing increase on inpatient mortality and management times.

Background: The aim of our study was to investigate the impact of a new organization of our emergency department (ED) on patients' mortality and management delays.

Methods: The ED segmentation consisted of the development of a new patient care geographical layout on a pre-existing site and changing the organization of patient flow. It took place on May 10, 2012.

Diaphragmatic excursion measurement in emergency patients with acute dyspnea: toward a new diagnostic tool?

Introduction: During acute dyspnea (AD), respiratory exhaustion is mainly due to diaphragm fatigue. The primary objective was to validate interobserver reproducibility of diaphragmatic excursion (DE) in emergency department (ED) patients admitted for AD. The secondary objectives were to assess the feasibility of DE measurement and intraobserver reproducibility.