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2. Prehospital trauma flowcharts — Concise and visual cognitive aids for prehospital trauma management from the French Society of Emergency Medicine (SFMU) and the French Society of Anaesthesia and Intensive Care Medicine (SFAR)

Author

Tazarourte, Karim, Ageron, François-Xavier, Avondo, Aurélie, Barnard, Edward, Bobbia, Xavier, Cesareo, Eric, Chollet-Xemard, Charlotte, Curac, Sonja, Desmettre, Thibaut, Khoury, Carlos E.L., Gauss, Tobias, Gil-Jardine, Cédric, Harris, Tim, Heidet, Matthieu, Lapostolle, Frédéric, Pradeau, Catherine, Renard, Aurélien, Sapir, David, Tourtier, Jean-Pierre, and Travers, Stéphane

Published
2022
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3. Learning from terrorist mass casualty incidents: a global survey

Author

Tallach, Rosel, Einav, Sharon, Brohi, Karim, Abayajeewa, Kirthi, Abback, Paer-Sellim, Aylwin, Chris, Batrick, Nicola, Boutonnet, Mathieu, Cheatham, Michael, Cook, Fabrice, Curac, Sonja, Davidson, Stephanie, Eason, Hilary, Fiore, Nick, Gaarder, Christine, Garusinghe, Sanjeewa, Goralnick, Eric, Grimaldi, David, Kritayakirana, Kritaya, Levraut, Jacques, Lindner, Tobias, Märdian, Sven, Padayachee, Ashley, Qureshi, Sabeena, Ramessur, Suneil, Raux, Mathieu, Ratnayake, Amila, Römer, Michael, Roy, Hobnojit, Tole, Eunice, Tose, Sheila, Fuentes, Fernando T., and Gauss, Tobias

Published
2022
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6. The Response of Emergency Departments (EDs) to the COVID-19 Pandemic: The Experience of 5 EDs in a Paris-Based Academic Hospital Trust

Author

Daniel Aiham Ghazali, Christophe Choquet, Donia Bouzid, Olivier Peyrony, Jean-Paul Fontaine, Curac Sonja, Nicolas Javaud, Patrick Plaisance, Eric Revue, Anthony Chauvin, and Enrique Casalino

Subjects
Paris, Health (social science), Leadership and Management, Health Policy, Humans, COVID-19, Trust, Emergency Service, Hospital, Care Planning, Pandemics, Hospitals
Abstract

The coronavirus disease-2019 (COVID-19) pandemic has imposed unforeseen and unprecedented constraints on emergency departments (EDs). In this study, we detail the organizational and managerial tools recently implemented among 5 academic EDs in a French region particularly affected by COVID-19 and analyze how EDs responded to the COVID-19-related disease burden during different phases of the epidemic. Initially, they focused on the early detection of suspected cases by identifying 3 predominant COVID-19 syndromes. During this diagnostic process, patients were placed in respiratory isolation (facial mask before triage) and droplet isolation (ED rooms). A 3-level strategy for triage, clinical pathways in the EDs, and the organization of hospital spaces was based on the real-time polymerase chain reaction (RT-PCR) COVID-19 positivity rate, with ED strategies adapted to the exigencies of each level. This crisis demonstrated hospitals' adaptability and capacity to mobilize in the face of new risks, with hospitals and EDs coordinating their management to reallocate resources, optimize interoperability, and rethink patient pathways. This report on their processes may assist hospitals and EDs in areas currently spared by the new variants.

Published
2022

7. Evaluation and Modelling of the Performance of an Automated SARS-CoV-2 Antigen Assay According to Sample Type, Target Population and Epidemic Trends

Author

Yin, Nicolas, Debuysschere, Cyril, Daubie, Valéry, Hildebrand, Marc, Martin, Charlotte, Curac, Sonja, Ponthieux, Fanny, Payen, Marie-Christine, Vandenberg, Olivier, Hallin, Marie, Yin, Nicolas, Debuysschere, Cyril, Daubie, Valéry, Hildebrand, Marc, Martin, Charlotte, Curac, Sonja, Ponthieux, Fanny, Payen, Marie-Christine, Vandenberg, Olivier, and Hallin, Marie

Abstract

The Lumipulse® G SARS-CoV-2 Ag assay performance was evaluated on prospectively collected saliva and nasopharyngeal swabs (NPS) of recently ill in- and outpatients and according to the estimated viral load. Performances were calculated using RT-PCR positive NPS from patients with symptoms ≤ 7 days and RT-PCR negative NPS as gold standard. In addition, non-selected positive NPS were analyzed to assess the performances on various viral loads. This assay yielded a sensitivity of 93.1% on NPS and 71.4% on saliva for recently ill patients. For NPS with a viral load > 103 RNA copies/mL, sensitivity was 96.4%. A model established on our daily routine showed fluctuations of the performances depending on the epidemic trends but an overall good negative predictive value. Lumipulse® G SARS-CoV-2 assay yielded good performance for an automated antigen detection assay on NPS. Using it for the detection of recently ill patients or to screen high-risk patients could be an interesting alternative to the more expensive RT-PCR., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2022

8. Evaluation and Modelling of the Performance of an Automated SARS-CoV-2 Antigen Assay According to Sample Type, Target Population and Epidemic Trends

Author

Yin, Nicolas, primary, Debuysschere, Cyril, additional, Daubie, Valery, additional, Hildebrand, Marc, additional, Martin, Charlotte, additional, Curac, Sonja, additional, Ponthieux, Fanny, additional, Payen, Marie-Christine, additional, Vandenberg, Olivier, additional, and Hallin, Marie, additional

Published
2022
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9. Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism

Author

Freund, Yonathan, Chauvin, Anthony, Jimenez, Sonia, Philippon, Anne-Laure, Curac, Sonja, Fémy, Florent, Gorlicki, Judith, Chouihed, Tahar, Goulet, Hélène, Montassier, Emmanuel, Dumont, Margaux, Lozano Polo, Laura, Le Borgne, Pierrick, Khellaf, Mehdi, Bouzid, Donia, Raynal, Pierre-Alexis, Abdessaied, Nizar, Laribi, Saïd, Guenezan, Jeremy, Ganansia, Olivier, Bloom, Ben, Miró, Oscar, Cachanado, Marine, Simon, Tabassome, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Barcelona, Hôpital Beaujon [AP-HP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Avicenne [AP-HP], Marqueurs cardiovasculaires en situation de stress (MASCOT (UMR_S_942 / U942)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Tenon [AP-HP], Centre hospitalier universitaire de Nantes (CHU Nantes), Universitat Autònoma de Barcelona (UAB), Les Hôpitaux Universitaires de Strasbourg (HUS), CHU Henri Mondor, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Saint-Antoine [AP-HP], Centre Hospitalier de Saint-Denis [Ile-de-France], Université de Tours (UT), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre hospitalier Saint-Joseph [Paris], Barts Health NHS Trust [London, UK], Unité de Recherche Clinique de l’Est Parisien [CHU Saint-Antoine] (URC-EST), Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts (CHNO)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Direction de la Recherche Clinique et de l'Innovation [AP-HP] (DRCI), and gravez, basile

Subjects
[SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio]
Abstract

International audience; Importance: Uncontrolled studies suggest that pulmonary embolism (PE) can be safely ruled out using the YEARS rule, a diagnostic strategy that uses varying D-dimer thresholds.Objective: To prospectively validate the safety of a strategy that combines the YEARS rule with the pulmonary embolism rule-out criteria (PERC) rule and an age-adjusted D-dimer threshold.Design, settings, and participants: A cluster-randomized, crossover, noninferiority trial in 18 emergency departments (EDs) in France and Spain. Patients (N = 1414) who had a low clinical risk of PE not excluded by the PERC rule or a subjective clinical intermediate risk of PE were included from October 2019 to June 2020, and followed up until October 2020.Interventions: Each center was randomized for the sequence of intervention periods. In the intervention period (726 patients), PE was excluded without chest imaging in patients with no YEARS criteria and a D-dimer level less than 1000 ng/mL and in patients with 1 or more YEARS criteria and a D-dimer level less than the age-adjusted threshold (500 ng/mL if age

Published
2021

10. Effect of a Diagnostic Strategy Using an Elevated and Age-Adjusted D-Dimer Threshold on Thromboembolic Events in Emergency Department Patients With Suspected Pulmonary Embolism

Author

Freund, Yonathan, primary, Chauvin, Anthony, additional, Jimenez, Sonia, additional, Philippon, Anne-Laure, additional, Curac, Sonja, additional, Fémy, Florent, additional, Gorlicki, Judith, additional, Chouihed, Tahar, additional, Goulet, Hélène, additional, Montassier, Emmanuel, additional, Dumont, Margaux, additional, Lozano Polo, Laura, additional, Le Borgne, Pierrick, additional, Khellaf, Mehdi, additional, Bouzid, Donia, additional, Raynal, Pierre-Alexis, additional, Abdessaied, Nizar, additional, Laribi, Saïd, additional, Guenezan, Jeremy, additional, Ganansia, Olivier, additional, Bloom, Ben, additional, Miró, Oscar, additional, Cachanado, Marine, additional, and Simon, Tabassome, additional

Published
2021
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13. Red Blood Cell Transfusion in the Emergency Department: An Observational Cross-Sectional Multicenter Study

Author

Peyrony, Olivier, primary, Gamelon, Danaé, additional, Brune, Romain, additional, Chauvin, Anthony, additional, Ghazali, Daniel Aiham, additional, Yordanov, Youri, additional, Arsicaud, Aude, additional, Gilleron, Pauline, additional, Curac, Sonja, additional, Richard, Marie-Caroline, additional, Feral-Pierssens, Anne-Laure, additional, Villoing, Barbara, additional, Beaune, Sébastien, additional, Goulet, Hélène, additional, Fontaine, Jean-Paul, additional, François, Anne, additional, and Pirenne, France, additional

Published
2021
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15. Analysis of Emergency Department Visits and Hospital Activity during Influenza Season, COVID-19 Epidemic, and Lockdown Periods in View of Managing a Future Disaster Risk: A Multicenter Observational Study

Author

Casalino, Enrique, primary, Choquet, Christophe, additional, Bouzid, Donia, additional, Peyrony, Olivier, additional, Curac, Sonja, additional, Revue, Eric, additional, Fontaine, Jean-Paul, additional, Plaisance, Patrick, additional, Chauvin, Anthony, additional, and Ghazali, Daniel Aiham, additional

Published
2020
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16. Impact of socioeconomic status in patients hospitalised for COVID-19 in the Greater Paris area

Author

Sesé, Lucile, primary, Nguyen, Yann, additional, Giroux Leprieur, Etienne, additional, Annesi-Maesano, Isabella, additional, Cavalin, Catherine, additional, Goupil de Bouillé, Jeanne, additional, Demestier, Louis, additional, Dhote, Robin, additional, Tandjaoui-Lambiotte, Yacine, additional, Bauvois, Adeline, additional, Pépin, Marion, additional, Curac, Sonja, additional, Beaune, Sébastien, additional, Duchemann, Boris, additional, and Nunes, Hilario, additional

Published
2020
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17. COVID-19 Preparedness Among Emergency Departments: A Cross-Sectional Study in France.

Author

Casalino, Enrique, Bouzid, Donia, Ben Hammouda, Arsalene, Wargon, Mathias, Curac, Sonja, Hellmann, Romain, Choquet, Christophe, and Ghazali, Daniel Aiham

Subjects
EMERGENCY management, COVID-19, PUBLIC health
Abstract

Objectives: The aim of this study was to evaluate hospital and emergency department (ED) preparedness in France facing the coronavirus disease 2019 (COVID-19) rapid growth epidemic-phase, and to determine the link between preparedness and responsiveness. Methods: In this cross-sectional study, from March 7 to March 11, 2020, all heads of ED departments in France were contacted to answer an electronic survey, including 23 questions. Quality, Organization, Training, Resources, Management, Interoperability, and Responsiveness were evaluated by calculating scores (10 points). Multivariate analysis of variance was used to compare scores. Spearman's correlation coefficient and multifaceted regression analysis were performed between Responsiveness and dimensions scores. Results: A total of 287 of 636 French EDs were included (45.1%). Calculated scores showed (median): Quality 5.38; Organization 6.4; Training 4.6; Resources 4.13; Management 2.38; Interoperability 4.0; Responsiveness 6.25; seasonal influenza score was 5. Significant differences between scores as a function of hospital and ED main characteristics were found. Furthermore, we found significant correlations (P < 0.01) between Responsiveness and all preparedness dimensions. Organization (adjusted-R2 0.2897), Management (aR2 0.321), and Interoperability (aR2 0.422) were significantly associated with Responsiveness. Conclusions: Preparedness in all its dimensions is low, indicating vulnerability. Preparedness and responsiveness face a certain and ongoing risk are close linked, and that Organizational, Management, and Interoperability dimensions are main determinants. [ABSTRACT FROM AUTHOR]

Published
2022
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20. A nomogram to predict the risk of unfavourable outcome in COVID-19: a retrospective cohort of 279 hospitalized patients in Paris area

Author

Nguyen, Yann, primary, Corre, Félix, additional, Honsel, Vasco, additional, Curac, Sonja, additional, Zarrouk, Virginie, additional, Burtz, Catherine Paugam, additional, Weiss, Emmanuel, additional, Moyer, Jean-Denis, additional, Gauss, Tobias, additional, Grégory, Jules, additional, Bert, Frédéric, additional, Trichet, Catherine, additional, Peoc’h, Katell, additional, Vilgrain, Valérie, additional, Rebours, Vinciane, additional, Fantin, Bruno, additional, and Galy, Adrien, additional

Published
2020
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21. Reducing pain by using venous blood gas instead of arterial blood gas (VEINART): a multicentre randomised controlled trial

Author

Chauvin, Anthony, primary, Javaud, Nicolas, additional, Ghazali, Aiham, additional, Curac, Sonja, additional, Altar, Adrien, additional, Ali, Talina, additional, Beguin, Nora, additional, Bellier, Julien, additional, Coupier, Antoine, additional, Delsarte, Laura, additional, Dreyfuss, Dora, additional, Kheirbek, Nour, additional, Oudar, Clara, additional, Stordeur, Yoann, additional, Weiss, Morgane, additional, Gaudry, Stephane, additional, Lambert, Jerome, additional, and Roux, Damien, additional

Published
2020
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22. Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia.

Author

Nuzzo, Alexandre, Guedj, Kevin, Curac, Sonja, Hercend, Claude, Bendavid, Claude, Gault, Nathalie, Tran-Dinh, Alexy, Ronot, Maxime, Nicoletti, Antonino, Bouhnik, Yoram, Castier, Yves, Corcos, Olivier, Peoc'h, Katell, The SURVI (Structure d'URgences Vasculaires Intestinales) Research Group (French Intestinal Stroke Center), Huguet, Audrey, Stefanescu, Carmen, Treton, Xavier, Joly, Francisca, Billiauws, Lore, and Hamon, Annick

Subjects
CITRULLINE, MESENTERIC ischemia, LACTATES, FATTY acid-binding proteins, DIAGNOSIS, INTESTINES, ABDOMINAL pain
Abstract

Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI—citrulline, intestinal fatty acid-binding protein (I-FABP), and d-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients—50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0–26.0) vs. 23.3 μmol/L (18.3–29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58–0.78). No statistical difference was found in plasma I-FABP and plasma d-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and d-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers. [ABSTRACT FROM AUTHOR]

Published
2021
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23. Iloprost Use in Patients with Persistent Intestinal Ischemia Unsuitable for Revascularization

Author

Nuzzo, Alexandre, primary, Soudan, Damien, additional, Billiauws, Lore, additional, Bataille, Julie, additional, Maggiori, Léon, additional, Ronot, Maxime, additional, Stocco, Jeanick, additional, Bouhnik, Yoram, additional, Castier, Yves, additional, Corcos, Olivier, additional, Nuzzo, Alexandre, additional, Stefanescu, Carmen, additional, Treton, Xavier, additional, Joly, Francisca, additional, Panis, Yves, additional, Maggiori, Leon, additional, Prost à la Denise, Justine, additional, Tribillon, Ecoline, additional, Laforêt, Anaïs, additional, Lakkis, Zaher, additional, Sibert, Annie, additional, Zappa, Magaly, additional, Garcia-Alba, Carmela, additional, Abdel-Rehim, Mohamed, additional, Vilgrain, Valérie, additional, Bertin, Caroline, additional, Kerbaol, Anne, additional, Allaham, Wassim, additional, Lagadec, Matthieu, additional, Benzimra, Julie, additional, Paugam, Catherine, additional, Weiss, Emmanuel, additional, Abback, Paer-Selim, additional, Delefosse, Didier, additional, Enriquez, Isabelle, additional, Janny, Sylvie, additional, Toussaint, Amélie, additional, Iserentant, Jules, additional, Bout, Helene, additional, Pease, Sebastian, additional, Ear, Linda Koy, additional, Pellenc, Quentin, additional, Roussel, Arnaud, additional, Cerceau, Pierre, additional, Mordant, Pierre, additional, Deblic, Romain, additional, Boulitrop, Celia, additional, Curac, Sonja, additional, Cachier, Agnès, additional, Plessier, Aurelie, additional, Rautou, Pierre-Emmanuel, additional, Valla, Dominique, additional, Soubrane, Olivier, additional, Sauvanet, Alain, additional, Dokmak, Safi, additional, Dondero, Federica, additional, Sepulveda, Ailton, additional, Farges, Olivier, additional, Aussilhou, Beatrice, additional, Palazzo, Maxime, additional, Cazals-Hatem, Dominique, additional, De Raucourt, Emmanuelle, additional, Boudaoud, Larbi, additional, Peoc'h, Katell, additional, Puy, Herve, additional, Pons-Kerjean, Nathalie, additional, Bouton, Valérie, additional, Diop, Aziz, additional, Gault, Nathalie, additional, Montravers, Philippe, additional, Augustin, Pascal, additional, and Jacob, Brice Lortat, additional

Published
2017
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27. Use of bispectral index to monitor the depth of sedation in mechanically ventilated patients in the prehospital setting.

Author

Duchateau, François-Xavier, Saunier, Monique, Larroque, Béatrice, Josseaume, Julien, Gauss, Tobias, Curac, Sonja, Wojciechowski-Bonnal, Estelle, and Mantz, Jean

Abstract

Background Sedative drug administration is a challenging aspect of the management of mechanically ventilated patients in the out-of-hospital critical care medicine. We hypothesised that the bispectral index of the EEG (BIS) could be a helpful tool in evaluating the depth of sedation in this difficult environment. The main objective of the present study was to assess the agreement of BIS with the clinical scales in the out-ofhospital setting. Methods This prospective study included mechanically ventilated patients. BIS values were blindly recorded continuously. A Ramsay score was performed every 5 min. The main judgement criterion was the correlation between BIS values and the Ramsay score. Results 72 patients were included, mostly presenting with toxic coma (36%) or neurological coma (21%). The median (IQR) BIS value was 85 (84–86) when the Ramsay score was 3, 80 (76–84) when the Ramsay score was 4, 61 (55–80) when the Ramsay score was 5 and 45 (38–60) when the Ramsay score was 6. According to Receiver operating characteristic (ROC) curves, BIS was categorised into three classes (BIS<54 corresponding to Ramsay score 6, 54≤BIS<72 for Ramsay score 5 and BIS≥73 for Ramsay score ≤4). Based on these categories, the proportion of appropriate BIS values was 67% (217/323). The concordance correlation coefficient for repeated measurements was 0.54 (0.43–0.64). The agreement between BIS and the Ramsay score is moderate. Conclusions Prehospital measured BIS values appear poorly correlated with clinical assessment of the depth of sedation. For this reason, the use of BIS to guide prehospital sedation cannot be recommended. [ABSTRACT FROM AUTHOR]

Published
2014
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28. [Untitled]

Author

Bavestrello Piccini G, Domont P, and Curac S

Abstract

Competing Interests: Les auteurs déclarent n’avoir aucun lien d’intérêts.

Published
2022

29. Use of bispectral index to monitor the depth of sedation in mechanically ventilated patients in the prehospital setting.

Author

Duchateau FX, Saunier M, Larroque B, Josseaume J, Gauss T, Curac S, Wojciechowski-Bonnal E, and Mantz J

Subjects
Adult, Aged, Emergency Medical Services statistics & numerical data, Female, Humans, Hypnotics and Sedatives, Male, Middle Aged, Monitoring, Physiologic methods, Prospective Studies, ROC Curve, Conscious Sedation, Consciousness Monitors standards, Electroencephalography methods, Respiration, Artificial
Abstract

Background: Sedative drug administration is a challenging aspect of the management of mechanically ventilated patients in the out-of-hospital critical care medicine. We hypothesised that the bispectral index of the EEG (BIS) could be a helpful tool in evaluating the depth of sedation in this difficult environment. The main objective of the present study was to assess the agreement of BIS with the clinical scales in the out-of-hospital setting., Methods: This prospective study included mechanically ventilated patients. BIS values were blindly recorded continuously. A Ramsay score was performed every 5 min. The main judgement criterion was the correlation between BIS values and the Ramsay score., Results: 72 patients were included, mostly presenting with toxic coma (36%) or neurological coma (21%). The median (IQR) BIS value was 85 (84-86) when the Ramsay score was 3, 80 (76-84) when the Ramsay score was 4, 61 (55-80) when the Ramsay score was 5 and 45 (38-60) when the Ramsay score was 6. According to Receiver operating characteristic (ROC) curves, BIS was categorised into three classes (BIS<54 corresponding to Ramsay score 6, 54≤BIS<72 for Ramsay score 5 and BIS≥73 for Ramsay score ≤4). Based on these categories, the proportion of appropriate BIS values was 67% (217/323). The concordance correlation coefficient for repeated measurements was 0.54 (0.43-0.64). The agreement between BIS and the Ramsay score is moderate., Conclusions: Prehospital measured BIS values appear poorly correlated with clinical assessment of the depth of sedation. For this reason, the use of BIS to guide prehospital sedation cannot be recommended., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Published
2014
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30. [Suicide in the elderly managed by French EMS].

Author

Curac S, Vassor I, Burnod A, Casalino E, and Duchateau FX

Subjects
Adult, Aged, Emergency Medical Services, Female, France epidemiology, Humans, Male, Middle Aged, Retrospective Studies, Suicide statistics & numerical data
Published
2014
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