Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 2009
[Results of a national survey about the use of sedation scales in emergency prehospital medicine].
The primary goal of sedation in emergency prehospital care is to guarantee the security of the mechanically ventilated patients by optimising their adaptation to the respirator. If the French prehospital guidelines are well codified, their applicability in routine clinical practice seem to be rather empirical. The aim of this national survey was to evaluate the use of the clinical sedation scales by the prehospital physicians. ⋯ The principal reasons given by the physicians for not using the sedation scales were their ignorance in 57% of the cases (n=200) and the systematic choice of a deep sedation in 42% of the cases (n=147). For 18% of them (n=62), the use of sedation scores was considered too complicated. The final results show that the utilisation ratio of the sedation scores is very low in emergency prehospital medicine and suggest that an effort toward improving the use of sedation in prehospital emergency medicine is necessary.
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Ann Fr Anesth Reanim · Mar 2009
Review[Acute traumatic haemorrhagic shock and transfusion: what's new in 2009?].
In spite of continuous progress in surgery and in interventional radiology, massive haemorrhage remains a leading cause of death in traumatology. The transfusional strategy appears a key step in the treatment of haemorrhagic shock. In the light of new insights into the pathophysiology of coagulopathies associated with traumatic shock it seems reasonable to transfuse patients with haemorrhagic shock earlier than previously recommended.