Resuscitation
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The EMS (Emergency Medical Service) system in France is a centrally based, two-tiered, physician-manned system. The first level is composed of BLS (Basic Life Support) fire department ambulances (called "VSAB") based at fire stations. The second level is composed of ALS (Advanced Life Support) physician staffed-ambulances. ⋯ In France medical schools are part of free public universities. The length of medical training varies from 8 to 11 years according to speciality. Emergency Medicine is not recognised as a stand alone specialty.
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Among the fatal vascular complications associated with autosomal dominant polycystic disease (ADPKD), ruptured intracerebral aneurysm and ruptured abdominal aortic aneurysm are widely known. However, there are few reports on the dissecting thoracic aortic aneurysm as a fatal complication of ADPKD. We report a case of a 58-year-old man with a history of ADPKD who presented to the emergency department with out-of-hospital cardiac arrest. ⋯ The surgical specimen of the aorta showed cystic medial necrosis. This rare case emphasizes the need to consider such a diagnosis in a patient with ADPKD who presents to the emergency department with sudden cardiac arrest. In addition, the histological finding indicates the aetiological role of a collagen defect in addition to chronic hypertension in the pathogenesis of aortic dissection in ADPKD patients.