Amputation in emergency situations: indications, techniques and Médecins Sans Frontières France's experience in Haiti

PURPOSE: The decision to amputate is always difficult but becomes even harder in emergency situations, which usually present extra complicating factors. MSF EXPERIENCE: These include human factors (related to both the surgeon and the patient); poor or nonexistent medical facilities, especially in war conditions or resource-poor countries; and cultural and religious considerations. Médecins Sans Frontières (MSF) has developed a quick medical and logistical response that relies on surgical protocols adapted to emergency situations, together with complete "kits" of medical equipment, supplies and inflatable facilities. CONCLUSION: Our response to Haiti's 2010 earthquake relied on these tools but also highlighted the need to develop more detailed protocols that will help our teams on the ground

Amputation in emergency situations: indications, techniques and Médecins Sans Frontières France's experience in Haiti

Abstract Purpose The decision to amputate is always difficult but becomes even harder in emergency situations, which usually present extra complicating factors. MSF Experience These include human factors (related to both the surgeon and the patient); poor or nonexistent medical facilities, especially in war conditions or resource-poor countries; and cultural and religious considerations. Médecins Sans Frontières (MSF) has developed a quick medical and logistical response that relies on surgical protocols adapted to emergency situations, together with complete "kits" of medical equipment, supplies and inflatable facilities. Conclusion Our response to Haiti's 2010 earthquake relied on these tools but also highlighted the need to develop more detailed protocols that will help our teams on the ground

La 4-méthyléphédrone sera-t-elle une "Ecstasy" du XXIème siècle ?

L'analyse d'une substance contenue dans une gélule, transmise pour analyse au laboratoire de l'IRCGN en mai 2007, et présumée a priori être de l'ecstasy, a été identifiée différemment comme étant de la 4-méthyléphédrone après avoir été analysée par spectrométrie de mobilité ionique, chromatographie en phase gazeuse couplée à la spectrométrie de masse sous ionisation électronique (GC-EI/MS), résonance magnétique nucléaire (RMN), et couplage de la chromatographie en phase liquide à la spectrométrie de masse en mode electrospray (LC-ESI/MS). Ce cas constitue un exemple de l'apparition sur le marché des stupéfiants illicites de nouvelles substances spécifiquement conçues par des chimistes pour contourner les régulations et contrôles prévalant en France, souvent nommées designer drugs

Classification and Minimum Standards for Foreign Medical Teams in Sudden Onset Disasters

The Foreign Medical Teams (FMT) Working Group under the auspices of the Global Health Cluster and the WHO commissioned this document. It introduces a simple classification, minimums standards and a registration form for FMTs that may provide surgical and trauma care arriving within the aftermath of a sudden onset disaster (SOD). These can serve as tools to improve the coordination of the foreign medical team response, and be the reference for registration on arrival as well as a possible global registration mechanism similar to what exists for urban search and rescue teams. The document explains the registration form that allows FMTs to declare their services and capacities, and an overview of the classification system, principles and standards. The definitions, process and technical details of the various requirements for teams to be registered are further elaborated. The classification and standards are designed for FMTs, but can also serve as guidance for developing domestic trauma response capacities. The FMTs are divided into three distinct categories and are expected to declare which category they belong; Type 1, 2 or 3 depending on their capacity and capability matched to the definition of each type, as well as any additional specialist services they can provide. Furthermore they are expected to confirm that they are able and willing to meet the guiding principles and adhere to the minimum standards. The FMT can then, following consultation with the receiving country, provide services within a functioning national hospital or health centre, or offer to bring a field facility with them. This registration process will greatly clarify, to both service providers as well as recipients of the assistance, what type of assistance is offered and will facilitate the on-site coordination. The approach to registration will seek to be inclusive rather than exclusive, with self-declared information on capacities and commitment to adhere to the FMT principles and core standards. If an FMT declares its capability to offer a specific type and declares any additional services, it also is expected to comply with the technical standards of this document related to those services