[Fibrinolysis and acute stroke in maritime search and rescue medical evacuation]. / Thrombolyse et accident vasculaire cérébral, à propos d'un cas de secours en mer.

Medical management of a female passenger with acute stroke aboard a cruise ship at the sea allowed a fast evacuation towards a stroke unit by an helicopter staffed with an emergency medical doctor. Fibrinolysis begun in a short delay after magnetic resonance imaging.

Prehospital intravenous line placement assessment in the French emergency system: a prospective study.

BACKGROUND AND OBJECTIVE: Out-of-hospital intravenous line placement is used daily. All available studies take place using paramedics, e.g. US-American emergency medical system. The aim of this study was to assess the intravenous line placement feasibility (time and success rate) in the French emergency medical system. METHODS: A prospective observational study was performed by a French out-of-hospital team during 3-month assessing the timing and success rates for intravenous line placement. All patients were enrolled at the emergency medical service of a university hospital in France. Six hundred and sixty-nine consecutive patients were included, 388 (58%) had at least one intravenous line placement in the out-of-hospital setting. RESULTS: Success rate was 76% at the first attempt and 98% at the second attempt. The overall success rate for intravenous line placement was 99.7% (only one failure), and the average successful intravenous line time was 4.4+/-2.8 min. Attempts ranged from 1 to 8. The time for intravenous line placement with blood sampling (58% of patients) is statistically longer than without (4.6+/-2.5 vs. 4.3+/-3 min, P<0.05). Seventeen of the enrolled patients were trauma patients, and 83% were non-trauma patients. Four hundred and twenty-seven intravenous lines were placed, intravenous 10% had more than one intravenous line. Seventy-one percent of the intravenous lines were used to infuse drugs, the others were security intravenous. No significant difference was noticed between trauma and non-trauma patients in regard to the success rate and the time to place the intravenous line. CONCLUSION: The out-of-hospital team was skilled at intravenous line placement (success rate=99.7%), and the time required to performed intravenous line access was short.