RESUMO
OBJECTIVES: This prospective study was conducted in three mobile emergency and intensive care units. METHODS: The patients were over 15 years of age and were not in cardiac arrest. The study was to compare practices in the three units with the guidelines drawn up by the Commission of Experts so as to define the main parameters for quality assurance. All of the patients involved were considered to have full stomachs and required rapid sequence induction. RESULTS: This procedure comply the guidelines only in 45% of cases; in the other cases succinylcholine should have been administered (mobile emergency and intensive care unit A) and the Sellick manoeuvre should have been used (mobile emergency and intensive care unit A and B). Notwithstanding, these two centres treated more traumatized patients than mobile emergency and intensive care unit C, and use of the Sellick manoeuvre in such circumstances is questionable. CONCLUSIONS: More training and greater diffusion of the protocols are required, especially with regard to doctors who intervene intermittently.
Assuntos
Ambulâncias/normas , Cuidados Críticos/normas , Medicina de Emergência/normas , Hipnóticos e Sedativos/uso terapêutico , Intubação Intratraqueal/métodos , Guias de Prática Clínica como Assunto , Ferimentos e Lesões/terapia , Adolescente , Adulto , Coleta de Dados , Feminino , França , Fidelidade a Diretrizes , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares Despolarizantes/uso terapêutico , Estudos Prospectivos , Succinilcolina/uso terapêutico , Fatores de TempoRESUMO
Chloroquine intoxication, despite therapeutic improvements, remains a potentially serious condition. We report a case of a 25-year-old patient, having ingested 10 g of chloroquine, a dose commonly considered to be lethal. Thanks to appropriate early medical treatment, this patient's outcome was favourable. To our knowledge, the literature contains no other report of survival of a patient after such an intake. This report emphasises the need to use a pre-designed medical care protocol to implement appropriate therapy as rapidly as possible.
Assuntos
Cloroquina/intoxicação , Adulto , Epinefrina/administração & dosagem , Feminino , Lavagem Gástrica , Humanos , Intoxicação/terapia , Tentativa de Suicídio , Fatores de Tempo , Resultado do TratamentoRESUMO
We report the case of two patients involved in a car crash and victims of multiple injuries. The diagnosis of bilateral dissection of the internal carotid arteries was only evoked belatedly in view of the increase of the neurologic symptoms. They benefitted from anticoagulant treatment. The clinical evolution was good. Dissection of both carotid arteries from blunt head or neck trauma has been reported but is unusual. Diagnosis and treatment are discussed.
