[Forensic risk in emergency medicine].

Activities in the emergency departments increase in all countries for many reasons: medical, social, economic, etc. In the same time, it is logical to observe an increase in claims; this is confirmed by the insurance companies. In this review, we describe the typology of claims according to the Reason model, also named Swiss cheese model.

[The Sino-French emergency and disaster medicine training center].

French (AP-HP) and Chinese (Beijing Health Office) hospitals, with support from the French company Total, collaborated in order to improve Chinese doctors' knowledge of emergency and disaster medicine prior to the Beijing Olympic Games. A Sino-French emergency and disaster medicine training center was subsequently opened in Beijing in 2008, with the aim of providing high-level continuous medical training for Chinese specialists in emergency medicine. Teaching in the management of critical situations was based on the use of a latest-generation simulator (Sim 3G; Laerdal).

Nurses' understanding influences comprehension of patients admitted in the observation unit.

Comprehension is poor in patients admitted in the emergency observation unit. Teamwork communication gaps could contribute to patients' misunderstanding of their health condition. To determine in patients admitted in the emergency observation unit whether comprehension of diagnosis, prognosis, and management depended on nurses' comprehension, the authors conducted a prospective observational study in a busy adult emergency department of a tertiary teaching hospital in Paris over 2 months.

Bacteremia and MR-proANP changes in mild community-acquired pneumonia.

Background: Mid-regional pro-atrial natriuretic peptide (MR-proANP) increases with severity in community-acquired pneumonia (CAP). We investigated whether changes of MR-proANP correlated to bacteremia.

Methods: 392 adult patients with CAP visiting emergency department from a prospective observational multicenter study.

Prevalence of neuropathic pain in emergency patients: an observational study.

Objective: Neuropathic pain (NP) in acute conditions has been poorly investigated. A diagnostic score, the DN4 scale (DN4), has been developed to help physicians to detect and treat NP appropriately. DN4 is a 10-item questionnaire.

Midregional pro-atrial natriuretic peptide for the diagnosis of cardiac-related dyspnea according to renal function in the emergency department: a comparison with B-type natriuretic peptide (BNP) and N-terminal proBNP.

Background: Although renal dysfunction influences the threshold values of B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) in diagnosis of cardiac-related dyspnea (CRD), its effects on midregional pro-atrial natriuretic peptide (MR-proANP) threshold values are unknown. We evaluated the impact of renal function on MR-proANP concentrations and compared our results to those of BNP and NT-proBNP.

Methods: MR-proANP, BNP, and NT-proBNP concentrations were measured in blood samples collected routinely from dyspneic patients admitted to the emergency department.

Febrile neutropenia in French emergency departments: results of a prospective multicentre survey.

Introduction: Febrile neutropenia (FN) is common in cancer patients receiving myelotoxic therapy. The procedures to treat FN are well established in oncology, but it is unclear whether management is adequate in the emergency department (ED).

Methods: This prospective, multicentre, observational study was carried out in 47 French EDs for 6 months.

[New missions for emergency department].

There are more than 16 millions emergency department visits per year, 15 millions calls to SAMU and 600,000 mobile intensive care unit interventions. The knowledge of the sum of all these medical problems represents an incomparable database offering the possibility of numerous studies and programs of education. The emergency physicians do not routinely offer screening and brief intervention as part of their current clinical practice.

Blood cocaine and metabolite pharmacokinetics after cardiac arrest in a body-packer case.

Introduction: Cocaine body packing, the internal concealment of cocaine for transportation between countries, may expose to life-threatening intoxications. No data is currently available on the pharmacokinetics of cocaine and its metabolites when a packet rupture occurs in a body packer.

Case Report: We report the first pharmacokinetic data associated with a severe cocaine intoxication in a body packer, resulting in cardiac arrest.

[Misuse of psychotropic medications in a population of subjects held for custody in the city of Paris].

Objective: Identify which psychotropic medications are misused and peddled in a population of subjects held for custody in the city of Paris.

Methods: Subjects held for custody in the Medico-Legal Emergency Unit of the Paris Hôtel-Dieu hospital were examined and interrogated between March 2006 and March 2007 in order to assess their consumption of psychotropic medications.

Results: Sixty one of the 659 subjects (9.

Acute appendicitis, an unusual presentation of Streptococcus pyogenes infection.

The incidence of invasive streptococcal pyogenic infections has been on a worldwide increase. The most frequent clinical manifestations start with cutaneous septicemias. We report an unusual case of Streptococcus pyogenes-based septicemia, secondary to appendicitis with rapidly evolving peritonitis.

[Drug-facilitated crimes: prospective data collection in a forensic unit in Paris].

Introduction: Little is known about the rate of crimes that are facilitated by the administration of psychoactive products without the victim's knowledge. This study analyzes the cases collected over a two-year period in a forensic unit in Paris.

Material And Methods: The study covers the period from January 1, 2005 and December /31, 2006.

How emergency departments might alert for prehospital heat-related excess mortality?

Introduction: A major issue raised by the public health consequences of a heat wave is the difficulty of detecting its direct consequences on patient outcome, particularly because of the delay in obtaining definitive mortality results. Since emergency department (ED) activity reflects the global increase of patients' health problems during this period, the profile of patients referred to EDs might be a basis to detect an excess mortality in the catchment area. Our objective was to develop a real-time surveillance model based on ED data to detect excessive heat-related mortality as early as possible.

Prognosis of cocaine body-packers.

Objective: To study the prognosis and complications of cocaine body-packing (concealment of cocaine in the body for transportation between countries).

Design: We retrospectively reviewed the files of all cocaine body-packers hospitalized during a 4-year period in a medico-judiciary emergency unit. Subjects included in the survey were identified from the hospital databases using ICD-10 codes.