[Pharmacological and multimodal care of the adult patient with psychiatric presentation in the emergency department].

The pharmacological management of patients with psychiatric presentations, on prescription, and by nurses in emergency medicine structures is based on knowledge of a limited number of molecules and their methods of administration. This is accompanied by a relational approach and techniques to ensure the safety of the teams in the case of an agitated or very resistant patient.

[Reception of a patient suspected of having a psychiatric condition in an emergency department].

Many emergency patients have pre-existing psychiatric conditions. They may also present a symptomatology likely to evoke this type of psychiatric pathology. The way in which these patients are received and managed is of prime importance, as it determines the subsequent treatment.

Discovering the underlying typology of emergency departments.

Background: We hypothesized that monitoring the volume of activity and overall performance indicators is not sufficient to understand the underlying differences between emergency departments. We aimed to understand the underlying common characteristics of emergency departments and map their typology in order to propose adaptive solutions, that would take into account territorial specificities and manage existing resources.

Methods: We applied a multifactorial analysis based on input data at three levels; 1) the health care available in the area surrounding the emergency departments, 2) the level of medical technicality of the hospitals and 3) the profile of emergency department visits.

Follow-up of guidelines and impact on the management of suspected deep vein thrombosis in emergency departments.

Aims: To evaluate the implementation of the European Society of Cardiology (ESC) guidelines concerning the diagnostic management of deep vein thrombosis (DVT) in emergency departments (ED); and to estimate the additional financial cost and the increase in the time spent in the ED if the guidelines are not followed.

Patients And Methods: Retrospective, bi-centric study including all patients directly admitted or referred to the ED for a suspected isolated DVT, between April 1, 2019, and July 30, 2019. The diagnostic management was compared to the 2017 ESC's guidelines.

[Evaluation of a support for the analysis of electrocardiogram by emergency residents].

Aim: Electrocardiogram (ECG) is a routine examination in emergency medicine (EM), however the level of resident's interpretations is inhomogeneous and sometimes insufficient. We have developed a support to assist in the interpretation of ECG in emergency situations. Our main objective was to assess whether this new tool improved the rate of good interpretations by residents of EM departments (EMD).

Management of severe asthma exacerbation: guidelines from the Société Française de Médecine d'Urgence, the Société de Réanimation de Langue Française and the French Group for Pediatric Intensive Care and Emergencies.

Background: The French Emergency Medicine Society, the French Intensive Care Society and the Pediatric Intensive Care and Emergency Medicine French-Speaking Group edited guidelines on severe asthma exacerbation (SAE) in adult and pediatric patients.

Results: The guidelines were related to 5 areas: diagnosis, pharmacological treatment, oxygen therapy and ventilation, patients triage, specific considerations regarding pregnant women. The literature analysis and formulation of the guidelines were conducted according to the Grade of Recommendation Assessment, Development and Evaluation methodology.

Comparison of two hospitalization modes in geriatrics either directly via a hotline or after an emergency unit admission.

Unlabelled: Hospitalizations via the emergency services of the elderly represent on average 41% of the stays. The family physician is aware of the deleterious effects of using emergency rooms and know that intensive use contributes to the disorganization of these services. The provision of a telephone line, enabling doctors to have direct access to a geriatrician doctor, is a new service allowing, if necessary, direct hospitalization in geriatrics but its interest is still poorly evaluated.

Extensively drug-resistant bacteria: Which ethical issues?

Objective: The increased bacterial resistance to antibiotics has now become a public health concern. How can we preserve the well-being of patients presenting with infections caused by extensively drug-resistant bacteria (EDRBs) and that of their contacts without inducing any loss of chance of survival, all the while living together and controlling the spread of these EDRBs?

Method: Terre d'éthique, a French territorial ethics committee, was asked to reflect on this topic by the infection control unit of a French University Hospital as it raises many ethical issues.

Results: Patients are at the core of any ethical approach, and respecting their autonomy is fundamental.