ABSTRACT
Introduction: In partnership with SAUVlife volunteers and SAMU 50, a remote consultation mobile unit (UMT) was deployed in the Manche department of France, targeting elderly and dependent patients where access to care is difficult due to the lack of a general practitioner and the decrease of home visits. This new vector could be an alternative to the use of emergency rooms. Method(s): We performed a monocentric retrospective observational study of the activity of the UMT from January 1 to June 30, 2021 within the SAMU 50 at the Saint-Lo Hospital. After initial medical regulation, the patients without a vital emergency could benefit from an intervention of the UMT. Result(s): The UMT intervened 681 times. At the end of the intervention, 65.6% of the patients could be left on site. The phygital unit performed 621 teleconsultations allowing 414 patients (66.7%) to remain at home and 199 patients (32%) to be transported to an emergency room. Those transported were significantly older with an average age of 71.26 years (P < 0.001). The interventions lasted an average of 1 hour and 27 minutes. Discussion(s): This experiment is new in the emergency context. This tool seems to respond to the lack of ambulatory care in the department. Its use in the context of the COVID-19 pandemic is convincing and allows for the limitation of viral transmissions through home care. However, the interventions are long and the use of the UMT can be optimized both in terms of intervention time and the number of interventions performed per day. Conclusion(s): The mobile telemedicine unit is a real contribution in the absence of general practitioners, to carry out unscheduled home visits. Even more in an epidemic context where it limits the use of emergency rooms and ultimately the transmission of infectious agents. Copyright © 2022 Elsevier Masson SAS
ABSTRACT
Recent studies proves that indoor air chemistry differs in many aspects from atmospheric one. People send up to 90 % of their life indoors being exposed to pollutants present in gas, particle and solid phase. Particle phase indoor is composed of particles emitted from various sources, among which there is an indoor source - secondary chemical reactions leading to formation of secondary organic aerosol (SOA). Lately, researchers' attentions turned towards the ultrafine particles, for there are still a lot of gaps in knowledge concerning this field of study, while there is evidence of negative influence of ultrafine particles on human health. Presented review sums up current knowledge about secondary particle formation in indoor environment and development of analytical techniques applied to study those processes. The biggest concern today is studying ROS, for their lifetime in indoor air is very short due to reactions at the very beginning of terpene oxidation process. Another interesting aspect that is recently discovered is monoterpene autooxidation process that leads to HOMs formation that in turn can influence SOA formation yield. A complex studies covering gas phase and particle phase characterization, but also toxicological studies are crucial to fully understand indoor air chemistry leading to ultrafine particle formation.