• F X Duchateau, A Burnod, C Chollet, A Ricard-Hibon, E Samain, and J Marty.
• Service d'anesthésie-réanimation-Smur, hôpital Beaujon, 100, boulevard du Général-Leclerc, 92110 Clichy, France. fxduchateau@wanadoo.fr
• Ann Fr Anesth Reanim. 2004 Sep 1;23(9):879-83.

ObjectiveTo evaluate the use of mannitol in prehospital care in Paris area.Study DesignSurvey using telephone interviews.MethodsEmergency physicians on duty in the 37 emergency departments in charge of prehospital care in Paris area were called by one investigator. They were asked to answer a questionnaire about their own use of mannitol in the prehospital setting.ResultsNinety-six questionnaires were recorded. Physicians were anaesthesiologists (9%) or emergency physicians (87%). In three departments, mannitol was not available in the ambulances. Thirty-five per cent (n = 34) reported no use of mannitol and 17% (n = 16) just once. Fourteen physicians (15%) did not want to use it. The reasons for not using mannitol were lack of knowledge about efficacy for five, need for previous brain imaging for seven or neurosurgeon's agreement before using mannitol for three. For those who had already used mannitol or were ready to use it, the main indication was increased intracranial pressure with clinical signs of brain herniation after severe brain injury for 92% of physicians. Thirty-one % reported not knowing the dose of mannitol, 33% having a memorandum immediately available and among those who answered the question, 63% gave a value compatible with guidelines.ConclusionA significant percentage of physicians tacking part in the French prehospital care system, do not follow published guidelines on the use of mannitol. Actions improving implementation of those guidelines should be supported.

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