Bedside BNP measurement and Doppler echocardiography are both useful for establishing the cause of acute dyspnea. However, Doppler analysis of the mitral inflow pattern was more accurate, particularly in patients with intermediate BNP levels or "flash" pulmonary edema.

BackgroundInfluenza-vaccination rates among healthcare workers (HCW) remain low worldwide, even during the 2009 A(H1N1) pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination.MethodsIn June–July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV) and pandemic (PIV) influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression–tree method.ResultsOf the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (p<0.0001 for both SIV and PIV vaccinations). Older age, prior SIV, working in emergency departments or intensive care units, being a medical HCW and the hospital they worked in were associated with both vaccinations; while work shift was associated only with PIV. Sociocognitive domains associated with both vaccinations were self-perception of benefits and health motivation for all HCW. For medical HCW, being a role model was an additional domain associated with SIV and PIV.ConclusionsBoth vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model.

Abstracts -12th World Congress on Disaster and Emergency Medicine, Lyon, France departments (n = 17). Most often, a nurse undertook daily (71%) or weekly (14%) systematic verification of endotracheal intubation equipments in 87 emergency departments (94.6%). The necessary drugs for the performance ofendotracheal intubation and that were present in emergency rooms were: (1) midazolam, 100%; (2) diazepam, 98.9%; (3) thiopental, 83.3; (4) propofol, 83.3%; (5) fentanyl, 81.1%; (6) succinylcholine, 77.8%; (7) etomidate, 77.8%; (8) ketamine, 57.8%; vecuronium, 55.6%; (9) rocuronium, 31.1%; and (10) other non-depolarizing agents, 26.7%. In case of difficult airway management, the emergency practitioners found these other supplies available in emergency rooms: (1) kit for cricothyroidotomy, 69.7%; (2) catheter for percutaneous transtracheal ventilation ; (3) kit for retrograde intubation, 21.3%; (4) intubating laryngeal mask airway, 21.3%; (5) combitube, 14.6%; (6) fibroscope, 14.6%; and (7) fast-track, 12.4%. Conclusion: Anaesthetic agents are present in most of emergency departments. These emergency departments are less equipped with equipment and supplies for difficult airway techniques. The presence of airway management protocols or guidelines are rare. However, in France, it is necessary to improve the endotracheal intubation training of emergency physicians. In this training, the practitioners also must learn rapid sequence intubation (RSI), which is a standard emergency department procedure, and new airway devices such as the intubating laryngeal mask airway and a Bullard laryngoscope bade.