Prehospital pulse pressure and mortality of septic shock patients cared for by a mobile intensive care unit.

Background: Septic shock medical treatment relies on a bundle of care including antibiotic therapy and hemodynamic optimisation. Hemodynamic optimisation consists of fluid expansion and norepinephrine administration aiming to optimise cardiac output to reach a mean arterial pressure of 65mmHg. In the prehospital setting, direct cardiac output assessment is difficult because of the lack of invasive and non-invasive devices.

Relationship between prehospital modified Charlson Comorbidity Index and septic shock 30-day mortality.

Context: In the prehospital setting, early identification of septic shock (SS) at risk of poor outcome is mainly based on clinical vital signs alteration evaluation. The Charlson Comorbidity Index (CCI) is an in-hospital tool used for burden of co-morbidity assessment. We report the relationship between the modified prehospital CCI, and 30-day mortality of SS patients initially cared for in the prehospital setting by a mobile ICU (MICU).

Prehospital Bundle of Care Based on Antibiotic Therapy and Hemodynamic Optimization Is Associated With a 30-Day Mortality Decrease in Patients With Septic Shock.

Objectives: This study aims to investigate the association between the 30-day mortality in patients with septic shock (SS) and a prehospital bundle of care completion, antibiotic therapy administration, and hemodynamic optimization defined as a fluid expansion of at least 10 mL.kg -1 .hr -1 .

European standard internal telephone number 2222 for in-hospital emergency calls: A national survey in all French military training hospitals.

Background: In 2016, three European scientific societies called for standardization to the "2222" as a European unique phone number in case of in-hospital emergencies. This study describes the management of in-hospital emergency calls in all French military training hospitals and aims to detail their original transition, for the first time in France, to the "2222".

Methods: An electronic standardized questionnaire was emailed to heads of rapid response teams in the eight French military training hospitals.

Prehospital norepinephrine administration reduces 30-day mortality among septic shock patients.

Background: Despite differences in time of sepsis recognition, recent studies support that early initiation of norepinephrine in patients with septic shock (SS) improves outcome without an increase in adverse effects. This study aims to investigate the relationship between 30-day mortality in patients with SS and prehospital norepinephrine infusion in order to reach a mean blood pressure (MAP) > 65 mmHg at the end of the prehospital stage.

Methods: From April 06th, 2016 to December 31th, 2020, patients with SS requiring prehospital Mobile Intensive Care Unit intervention (MICU) were retrospectively analysed.

The prehospital SIGARC score to assess septic shock in-hospital, 30-day and 90-day mortality.

Background: In the pre-hospital setting the early identification of septic shock (SS) patients presenting with a high risk of poor outcome remains a daily challenge. The development of a simple score to quickly identify these patients is essential to optimize triage towards the appropriate unit: emergency department (ED) or intensive care unit (ICU). We report the association between the new SIGARC score and in-hospital, 30 and 90-day mortality of SS patients cared for in the pre-hospital setting by a mobile ICU (MICU).

Terror in Paris: Incidence and risk factors for infections related to high-energy ammunition injuries.

Background: We aimed to assess the incidence and the risk factors for secondary wound infections associated to high-energy ammunition injuries (HEAI) in the cohort of civilian casualties from the 2015 terrorist attacks in Paris.

Methods: This retrospective multi-centric study included casualties presenting at least one HEAI who underwent surgery during the first 48 h following hospital admission. HEAI-associated infection was defined as a wound infection occurring within the initial 30 days following trauma.

Prehospital hemodynamic optimisation is associated with a 30-day mortality decrease in patients with septic shock.

Introduction: Septic shock (SS) is characterized by low blood pressure resulting in organ failure and poor prognosis. Among SS treatments, in hospital studies reported a beneficial effect of early hemodynamic resuscitation on mortality rate. This study aims to investigate the relationship between prehospital hemodynamic optimisation and 30-day mortality in patients with SS.

Prehospital lactate clearance is associated with reduced mortality in patients with septic shock.

Background: Assessment of disease severity in patients with septic shock (SS) is crucial in determining optimal level of care. In both pre- and in-hospital settings, blood lactate measurement is broadly used in combination with the clinical evaluation of patients as the clinical picture alone is not sufficient for assessing disease severity and outcomes.

Methods: From 15th April 2017 to 15th April 2019, patients with SS requiring prehospital mobile Intensive Care Unit intervention (mICU) were prospectively included in this observational study.

Pre-Hospital Lactatemia Predicts 30-Day Mortality in Patients with Septic Shock-Preliminary Results from the LAPHSUS Study.

Background: Assessment of disease severity in patients with septic shock (SS) is crucial in determining optimal level of care. In both pre- and in-hospital settings, the clinical picture alone is not sufficient for assessing disease severity and outcomes. Because blood lactate level is included in the clinical criteria of SS it should be considered to improve the assessment of its severity.

Prehospital Shock Precautions on Triage (PSPoT) score to assess in-hospital mortality for septic shock.

Context: In the prehospital setting, early identification of septic shock (SS) with high risk of poor outcome is a daily issue. There is a need for a simple tool aiming to early assess outcome in order to decide delivery unit (emergency department (ED) or intensive care unit (ICU)). In France, prehospital emergencies are managed by the Service d'Aide Médicale d'Urgence (SAMU).

Impact of Prehospital Antibiotic Therapy on Septic Shock Mortality.

Septic shock (SS) is associated with high morbidity and mortality rate. Early antibiotic therapy administration in septic patients was shown to reduce mortality but its impact on mortality in a prehospital setting is still under debate. To clarify this point, we performed a retrospective analysis on patients with septic shock who received antibiotics in a prehospital setting.

Contribution of the Pre-Hospital Blood Lactate Level in the Pre-Hospital Orientation of Septic Shock: The LAPHSUS Study.

Objective: In the pre-hospital setting, the assessment of septic shock severity is essential when determining the optimal initial in-hospital level of care. As clinical signs can be faulted, there is a need for an additional component to enhance the severity assessment and to decide on in-hospital admission in the intensive care unit (ICU) or in the emergency department (ED). Point-of-care medical devices by yielding blood lactate value since the pre-hospital setting may give an easy and valuable component for the severity assessment and decision-making.

French lyophilized plasma versus normal saline for post-traumatic coagulopathy prevention and correction: PREHO-PLYO protocol for a multicenter randomized controlled clinical trial.

Background: Post-trauma bleeding induces an acute deficiency in clotting factors, which promotes bleeding and hemorrhagic shock. However, early plasma administration may reduce the severity of trauma-induced coagulopathy (TIC). Unlike fresh frozen plasma, which requires specific hospital logistics, French lyophilized plasma (FLYP) is storable at room temperature and compatible with all blood types, supporting its use in prehospital emergency care.

Maternal out-of-hospital cardiac arrest: A retrospective observational study.

Aim: Out-of-hospital cardiac arrests (OHCAs) in pregnant women are rare events. In this study, we aimed to describe a cohort of pregnant women who experienced OHCAs in a large urban area, and received treatment by the prehospital teams in a two-tiered emergency response system.

Methods: This retrospective study included pregnant women over 18 years of age who experienced OHCAs.

Skin mottling score and capillary refill time to assess mortality of septic shock since pre-hospital setting.

Objectives: The early identification of septic shock patients at high risk of poor outcome is essential to early initiate optimal treatments and to decide on hospital admission. Biomarkers are often used to evaluate the severity. In prehospital settings, the availability of biomarkers, such as lactate, is restricted.

Characteristics of Cardiac Arrest Occurring in the Workplace: A Post Hoc Analysis of the Paris Area Fire Brigade Registry.

Objectives: The aim of this study was to describe the characteristics of out-of-hospital cardiac arrest (OHCA) in different workplaces, their management, and the survival rate.

Methods: A post hoc analysis included all the OHCA cases that occurred at the workplace and were listed in the Fire Brigade of Paris database registry (2010 to 2014). Utstein-style variables, survival, and types of workplace were analyzed.

Hands-off Time during Automated Chest Compression Device Application in Out-of-Hospital Cardiac Arrest: A Case Series Report.

Introduction: During out-of-hospital cardiac arrest (OHCA), chest compression interruptions or hands-off time (HOT) affect the prognosis. Our aim was to measure HOT due to the application of an automated chest compression device (ACD) by an advanced life support team.

Materials And Methods: This was a prospective observational case series report since the introduction of a new method of installing the ACD.