[Abdominal wall pain : the « anterior cutaneous nerve entrapment syndrom »].

Abdominal wall pain is a poorly recognized clinical problem and ofently misdiagnosed. It results in inappropriate diagnostic testing, unsatisfactory treatments and considerable costs. However, chronic abdominal wall pain can be easily diagnosed by a precise physical examination and can be rapidly and efficiently treated.

[Healthcare professionals dealing with burnout: risk factors and preventive measures].

Although sometimes called "disease of the century", the burnout doesn't inspire a lot of prevention, and is still a taboo, for most of people suffering of this malaise. The healthcare professionals represent a risky population and most of them are not aware of it. Unfortunately existing preventive measures are still badly known.

Awareness of HIV testing guidelines is low among Swiss emergency doctors: a survey of five teaching hospitals in French-speaking Switzerland.

Background: In Switzerland, 30% of HIV-infected individuals are diagnosed late. To optimize HIV testing, the Swiss Federal Office of Public Health (FOPH) updated 'Provider Induced Counseling and Testing' (PICT) recommendations in 2010. These permit doctors to test patients if HIV infection is suspected, without explicit consent or pre-test counseling; patients should nonetheless be informed that testing will be performed.

[When should a patient with malaise be referred to the emergency ward?].

General physicians (GPs) and emergency doctors are regularly called upon to deal with cases of "malaise" or sudden unforeseen feelings of debility. As highly disparaged as this designation may be, it remains commonly used in everyday life, enabling patients to express a general sensation of ill-being, accompanied by various non-specific symptoms. The lack of a preliminary case history and clinical analysis makes difficult to swiftly determine the severity of the situation, let alone its etiology.

[Public access defibrillation].

Placement of automated external defibrillators (AED) in public facilities and training of the lay persons in basic life support-defibrillation (BLS-D) was recommended by the American Heart Association for the treatment of out-of-hospital cardiac arrest (OHCA). Immediate use of AED result in increase of survival to hospital discharge. Many observation and much less randomized trials describe clinical efficacy of this approach.

[Patient waiting time at the Medical and Surgical Emergency Center at the Hôpital des Cadolles: a descriptive study].

Analyzing how much time patient are waiting in the Medical and Surgical Emergency Center (Centre médico-chirurgical des urgences, CMCU) at the Hôpital des Cadolles (Neuchâtel, Switzerland) before discharge, over a 80 days period found that overall, patients spent on average 2 h 26 in the CMCU. There was a difference between hospitalized patients (3 h 16) and discharged patients (1 h 48). The time from first encounter with a health care provider until discharge or admission was 1 h 42 on average.

[Health care organization at the time of a mass event. The example of EXPO 02--Neuchatel].

The last National Exhibition "EXPO 02" took place in Switzerland in 2002. More than 10 million people visited in within 159 days. The medical service and the "first aid" structures took pattern from other similar events in Switzerland or abroad.

["Extensive" toxicologic research in emergencies: a luxury or a necessity?].

The "undiscriminate" toxicological screening is a tool of potentially extraordinary help, allowing not only the identification of unknown and/or presumed substances in the blood or urine, but also enabling to define, the role of toxic products in a given clinical situation. In order to determine the real utility of this screening, we carried out a retrospective analysis covering the totality of these requests in the emergency unit of our hospital over a period of six months. 74 cases were collected and divided into 3 different categories (necessary, optional and useless).

[Thrombolysis or primary PCI: the gold standard in the management of acute myocardial infarction in 2003?].

Several studies published recently show the superiority of a primary percutaneous coronary intervention (I degree PCI) on thrombolysis in the treatment of acute myocardial infarction. This holds true even if PCI is delayed by 2 or 3 hours due to the secondary transfer to a hospital disposing of a cath lab. The advantage consists in a significant decrease in the number of secondary ischemia, recurrent myocardial infarction, hemorrhagic stroke and mortality.

[The outcome of "thoracic pains" in pre-hospital emergency: role of the physician of the SMUR in the triage and conveyance of patients].

The retrospective analysis of SMUR (Service Mobile Urgences Réanimation) activity in Neuchâtel from 2000 to 2001 shows that 11% of the 1250 prehospital interventions were due to "chest pain". Based upon the NACA gravity scale, a potentially serious cardiac disease was present in more than 75% of the cases. 64% of the patients were admitted to the ICU and 16% were directly transferred to an interventional cardiologic center.

[Thrombolysis of acute ischemic cerebral vascular accident: roles of the physician and the peripheral hospital].

Thrombolysis administered intravenously within 3 hours (or within 6 hours intra-arterially) after symptoms onset improves the functional outcome of acute ischemic stroke patients. In Switzerland this treatment is only performed by specialized centers. At the level of a community hospital or a general practitioner, the management is based on the appropriate selection of patients in whom thrombolysis could be indicated, followed by their immediate transfer to a reference medical center.