Prise en charge de l'asthme aigu au Service d'Accueil des Urgences du C.H.U. Lyon-Sud entre mars 1999 et février 2000 (à propos d'une étude rétrospective de 147 observations)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Analysis of the medical response to November 2015 Paris terrorist attacks: resource utilization according to the cause of injury

International audiencePURPOSE: The majority of terrorist acts are carried out by explosion or shooting. The objective of this study was first, to describe the management implemented to treat a large number of casualties and their flow together with the injuries observed, and second, to compare these resources according to the mechanism of trauma.METHODS: This retrospective cohort study collected medical data from all casualties of the attacks on November 13th 2015 in Paris, France, with physical injuries, who arrived alive at any hospital within the first 24 h after the events. Casualties were divided into two groups: explosion injuries and gunshot wounds.RESULTS: 337 casualties were admitted to hospital, 286 (85%) from gunshot wounds and 51 (15%) from explosions. Gunshot casualties had more severe injuries and required more in-hospital resources than explosion casualties. Emergency surgery was required in 181 (54%) casualties and was more frequent for gunshot wounds than explosion injuries (57% vs. 35%, p < 0·01). The types of main surgery needed and their delay following hospital admission were as follows: orthopedic [n = 107 (57%); median 744 min]; general [n = 27 (15%); 90 min]; vascular [n = 19 (10%); median 53 min]; thoracic [n = 19 (10%); 646 min]; and neurosurgery [n = 4 (2%); 198 min].CONCLUSION: The resources required to deal with a terrorist attack vary according to the mechanism of trauma. Our study provides a template to estimate the proportion of various types of surgical resources needed overall, as well as their time frame in a terrorist multisite and multitype attack

Blood product needs and transfusion timelines for the multisite massive Paris 2015 terrorist attack: A retrospective analysis

International audienceObjective: Hemorrhage is the leading cause of death after terrorist attack, and the immediacy of labile blood product (LBP) administration has a decisive impact on patients' outcome. The main objective of this study was to evaluate the transfusion patterns of the Paris terrorist attack victims, November 13, 2015.Methods: We performed a retrospective analysis including all casualties admitted to hospital, aiming to describe the transfusion patterns from admission to the first week after the attack.Results: Sixty-eight of 337 admitted patients were transfused. More than three quarters of blood products were consumed in the initial phase (until November 14, 11:59 PM), where 282 packed red blood cell (pRBC) units were transfused along with 201 plasma and 25 platelet units, to 55 patients (16% of casualties). Almost 40% of these LBPs (134 pRBC, 73 plasma, 8 platelet units) were transfused within the first 6 hours after the attack. These early transfusions were massive transfusion (MT) for 20 (6%) of 337 patients, and the average plasma/red blood cell ratio was 0.8 for MT patients who received 366 (72%) of 508 LBPs.The median time from admission to pRBC transfusion was 57 (25-108) minutes and 208 (52-430) minutes for MT and non-MT patients, respectively. These same time intervals were 119 (66-202) minutes and 222 (87-381) minutes for plasma and 225 (131-289) minutes and 198 (167-230) minutes for platelets.Conclusion: Our data suggest that improving transfusion procedures in mass casualty setting should rely more on shortening the time to bring LBP to the bedside than in increasing the stockpile

Blood product needs and transfusion timelines for the multisite massive Paris 2015 terrorist attack: A retrospective analysis

International audienceObjective: Hemorrhage is the leading cause of death after terrorist attack, and the immediacy of labile blood product (LBP) administration has a decisive impact on patients' outcome. The main objective of this study was to evaluate the transfusion patterns of the Paris terrorist attack victims, November 13, 2015.Methods: We performed a retrospective analysis including all casualties admitted to hospital, aiming to describe the transfusion patterns from admission to the first week after the attack.Results: Sixty-eight of 337 admitted patients were transfused. More than three quarters of blood products were consumed in the initial phase (until November 14, 11:59 PM), where 282 packed red blood cell (pRBC) units were transfused along with 201 plasma and 25 platelet units, to 55 patients (16% of casualties). Almost 40% of these LBPs (134 pRBC, 73 plasma, 8 platelet units) were transfused within the first 6 hours after the attack. These early transfusions were massive transfusion (MT) for 20 (6%) of 337 patients, and the average plasma/red blood cell ratio was 0.8 for MT patients who received 366 (72%) of 508 LBPs.The median time from admission to pRBC transfusion was 57 (25-108) minutes and 208 (52-430) minutes for MT and non-MT patients, respectively. These same time intervals were 119 (66-202) minutes and 222 (87-381) minutes for plasma and 225 (131-289) minutes and 198 (167-230) minutes for platelets.Conclusion: Our data suggest that improving transfusion procedures in mass casualty setting should rely more on shortening the time to bring LBP to the bedside than in increasing the stockpile

La plume et le sabre

Histoire d’une presse en Révolution, histoire militaire aux multiples facettes, histoire du Consulat et de l’Empire sont autant de thèmes chers à Jean-Paul Bertaud, tant dans ses activités d’inlassable chercheur que par son constant souci d’intégrer ses découvertes à son enseignement, qui a passionné des générations successives d’étudiants. D’un livre à l’autre, ses travaux nous ont donné à voir les réalités contrastées de l’entreprise de presse, les portraits de ceux qui prenaient la plume, intégrant les recherches en cours, en histoire politique comme en histoire culturelle, en histoire sociale comme en histoire militaire. Cette dernière, en profond renouvellement depuis trente ans, a vu Jean-Paul Bertaud engagé sur tous les fronts, du récit classique des batailles aux dimensions anthropologiques du combat et des combattants. Ce temps est certes celui de la Révolution française, mais peut-être surtout celui du Consulat et de l’Empire, dont Jean-Paul Bertaud est devenu l’un des spécialistes reconnus. Jeunes historiens s’inscrivant dans son sillage, auteurs plus chevronnés qui ont souvent été ses compagnons de recherche, chercheurs étrangers qui témoignent du rayonnement international de ses travaux, tous, avec le présent ouvrage, ont voulu rendre hommage au chercheur, à l’enseignant, à l’homme enfin. Les nombreuses contributions ici rassemblées apportent de multiples éclairages sur la presse de la fin de l’Ancien Régime au premières décennies du xixe siècle, sur les diverses manières d’aborder l’histoire militaire, sur les acteurs historiques et les espaces européens à l’époque du Consulat et de l’Empire