Publications by authors named "Pes P"

Introduction: Early assessment of the prognosis of a patient in cardiac arrest during cardiopulmonary resuscitation is highly challenging. This study aims to evaluate the predictive outcome value of early point-of-care ultrasound (POCUS) in out-of-hospital settings.

Methods: This observational, prospective, multicentre study's primary endpoint was the positive predictive value (PPV) of POCUS cardiac standstill within the first 12 min of advanced life support (ALS) initiation in determining the absence of return of spontaneous circulation (ROSC).

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Background: Hospitalized patients with acute shortness of breath (SOB) could benefit from an enhanced focused cardiac ultrasound (eFoCUS) with Doppler measurements to reassess treatment and diagnosis.

Methods: This was a retrospective observational study performed in a medical ward. Included patients were those hospitalized for acute SOB.

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Point-of-care ultrasound (POCUS) curriculum varies among countries. However, the length of training required for physicians is still under debate. We investigated the impact of different training methods: short hands-on courses (STS), long academic training sessions (LTS), or both (mixed training [MTS]), for POCUS daily use and self-reported confidence overall and specific to specific clinical situations.

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Background Emergency tracheal intubation is routinely performed in the prehospital setting. Airway management in the prehospital setting has substantial challenges. Objective The aim of the present study was to determine risk factors predicting tracheal intubation-related complications on the prehospital field.

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Article Synopsis
  • The study aimed to evaluate evidence and create recommendations for common heart and lung uses of point-of-care ultrasound (PoCUS), reviewing 10 clinical questions in these areas.
  • The expert review group (38 international experts) assessed the evidence, requiring over 75% agreement on findings, with a consensus reached for varying levels of evidence and recommendations for each question.
  • The conclusion emphasized that these consensus recommendations can improve clinical practice and point to areas needing further research in the use of PoCUS in acute medical settings.
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Objective:  To evaluate the evidence and produce a summary and recommendations for the most common heart and lung point-of-care ultrasound (PoCUS).

Methods:  We reviewed 10 clinical domains/questions related to common heart and lung applications of PoCUS. Following review of the evidence, a summary and recommendations were produced, including assigning levels of evidence (LoE) and grading of recommendation, assessment, development, and evaluation (GRADE).

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Background And Importance: Early identification of the cause of shock is associated with better prognosis.

Objective: The aim of this study was to explore the performances of an ultrasound protocol (echoSHOCK) to diagnose the cause of shock in the emergency department (ED).

Design, Settings And Participants: This was a prospective study performed in two EDs.

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Article Synopsis
  • Trauma is a big cause of death at work, so doctors are using ultrasound to check for injuries, but it can be tricky and there are common mistakes they can make.
  • This study looked at how the seminal vesicles in guys can cause the doctors to misread ultrasound images when checking for injuries in the pelvic area.
  • A survey was sent out to doctors and radiologists to see how often they misunderstood the ultrasound pictures; the results showed a little bit of confusion, but the radiologists got it right every time.
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Background: Mobile intensive care units frequently manage unplanned out-of-hospital births (UOHB). Rewarming methods during pre-hospital management of UOHB have not yet been compared. The aim was to compare rewarming methods used during pre-hospital management in a large prospective cohort of UOHB in France.

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Article Synopsis
  • Advances in minimally invasive treatments for stone disease have significantly impacted urology, yet there's still a gap in understanding the management of residual stone fragments after percutaneous nephrolithotomy (PNL).
  • Many patients, especially those with staghorn stones, often have residual fragments post-PNL, influenced by factors like tract size and imaging methods.
  • There’s a lack of consensus on the best imaging techniques and timing for evaluating these residual fragments, and treatment options vary based on departmental resources and surgeon preferences, ranging from active monitoring to various surgical approaches.
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Background: Venous limited compression ultrasonography (VLCU) is recommended in case of suspicion of deep venous thrombosis (DVT). Current training pathways are rather long and include experiential phase. This aim of this study was to investigate the efficacy of a short training session for VLCU without experiential phase.

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Introduction: Management of out-of-hospital cardiac arrests (OHCAs) in France is performed by a particular prehospital system based on medicalisation of mobile intensive care units composed of an emergency physician and a nurse with all the required devices for advanced care. It follows the European recommendations which advocate for the use of early point-of-care focused echocardiography (EPOCE) in the prehospital setting. An ability of EPOCE may be to predict the absence of return of spontaneous circulation (ROSC) in cases of absence of cardiac motion.

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The aim of this Letter to the Editor was to respond to a comment highlighting potential statistical biases in an analysis of our recently published article. We therefore specified the method for selecting the model variables in order to limit overfitting, then we used the Firth method to control the sparse data bias, and finally for checking internal validity we used bootstrapping methods. In total, the conclusions of our model were not changed by these new analyses.

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Background: In France, while most babies are delivered at hospital, emergency medical services (EMS) weekly manage calls for unplanned out-of-hospital births. The objective of our study was to describe neonatal morbidity and mortality, defined as death or neonatal intensive care unit hospitalization at Day 7, in a prospective multicentric cohort of unplanned out-of-hospital births.

Methods: We prospectively analyzed out-of-hospital births from 25 prehospital EMS units in France.

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Introduction: Loss of pupillary light reactivity (PLR) three days after a cardiorespiratory arrest is a prognostic factor. Its predictive value upon hospital admission remains unclear. Our objective was to determine the prognostic value of the absence of PLR upon hospital admission in patients with out-of-hospital cardiac arrest.

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Background: Epigastric pain is frequent in Emergency Medicine and remains a challenging situation. Besides benign etiologies such as gastritis or uncomplicated cholelithiasis, it could reveal myocardial infarction or vascular disease. Point-of-care ultrasound (POCUS) could be performed in such situation.

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Background: Point-of-Care Ultrasound (PoCUS) is recommended by emergency medicine societies for the detection of hydronephrosis. Training of certified Emergency Physicians (EP) without prior ultrasound experience remains debated. We investigate performance of a brief training session for the detection of hydronephrosis with PoCUS performed by EP without previous ultrasound experience.

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Objective: Ensuring the availability of ultrasound devices is the initial step in implementing clinical ultrasound (CUS) in emergency services. In France in 2011, 52% of emergency departments (EDs) and only 9% of mobile intensive care stations (MICS) were equipped with ultrasound devices. The main goal of this study was to determine the movement of these rates since 2011.

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Background: To assess the performance of transcranial Doppler (TCD) in predicting neurologic worsening after mild to moderate traumatic brain injury.

Methods: The authors conducted a prospective observational study across 17 sites. TCD was performed upon admission in 356 patients (Glasgow Coma Score [GCS], 9 to 15) with mild lesions on cerebral computed tomography scan.

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