Bonjour Pas pour relancer un vieux d�bat, mais ceci pose tout de m�me une question int�ressante:
1) O� se situe l'�vidence la plus solide pour la comparison "scoop and run" avec le "stay and play" en trauma, pour ceux qui ont r�vis� � fond la question? Par ailleurs, les d�lais �voqu�s ici sont tout de m�me surprenant. CIao ALain Vadeboncoeur ----- Original Message ----- From: "James S. Cohen, RR" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Saturday, March 16, 2002 10:36 PM Subject: [EMED-L] Princess Diana > To those of you with a particular interest in trauma EM or pre-hospital care > EM I shall recount some particulars of the night Princess Diana died (August > 31, 1998) as a lead up to some questions. > > The Mercedes crashed at 12:23 a.m. in a tunnel killing Prince Fayed and his > driver. At 12:26 a.m. Dr. Frederic Maillez, a French EP, arrived. At 12:29 > a.m. a military ambulance arrived. At 12:40 a.m. the SAMU ambulance > arrived. This is the highest level "EMS" ambulance in France and all have > physicians on board. Diana was reported to be saying "My God, what > happened" immediately after the accident. She was treated at the scene > until 1:20 a.m. at which time the SAMU began the trip to the hospital > (Piete'-Salpetrier) that was 3.7 miles away. She arrived at the hospital at > 2:01 a.m. Her prehospital care consisted of IVFs, (no blood), intubation, > external cardiac compressions, and possibly intracardiac epinephrine > (conflicting data on this last item). At the hospital she received a > thoracotomy, bypass etc. Her reported injuries were a tear of the left > pulmonary vein (repaired during surgery), 3 cm lac to forehead, cut lip, > some crushed ribs, fracture right arm, 8 cm cut right thigh. > > Thus, it took about 1 hour 20 minutes from the SAMU arrival to delivery to > the hospital. At that time of night, with minimal traffic, the trip could > have taken 5-10 minutes. > Clearly, the French pre-hospital trauma system differs radically from the > American one. Fending off criticism French medical authorities have stated > that they believe in stabilizing patients at the scene prior to transport. > As for the slow ride to the hospital (average speed was 5 mph) they have > stated that the slow ride was necessary to avoid bumps, shocks, and other > acceleration/deceleration forces that would worsen the patient's condition. > > Can anyone provide any references that support or otherwise "explain" > (translation-think politics) the French system? Although such references > likely originated in France they may have been cited in English language > journals. (nb-French citations OK, I can read French). Can anyone tell me > what other countries of the world use this French model? Does your EMS > system have any units that carry Type O neg blood for administration in the > field? Finally, what are the major studies in the USA that established the > "scoop and run, verses stay and play" model? > > thanks, > > James S. Cohen > [EMAIL PROTECTED] > > To unsubscribe, send the command "SIGNOFF EMED-L" to [EMAIL PROTECTED]
