Emergency medicine specialization: the French and Belgian perspective

Asbroeck, P. J. Van; Javaudin, François; Leach, Robert; Yordanov, Youri

doi:10.1097/mej.0000000000000849

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…All emergency physicians were board certified in emergency medicine, that is, in addition to their 3-year residentship, they have at least 1 year of experience in emergency medicine. Residents may also be present [5]. When intubation was indicated, patients were intubated by an emergency physician or a resident.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with tracheal intubation–related complications in the prehospital setting: a prospective multicentric cohort study

Bastard

Pès²,

Leroux³

et al. 2023

European Journal of Emergency Medicine

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Background Emergency tracheal intubation is routinely performed in the prehospital setting. Airway management in the prehospital setting has substantial challenges. Objective The aim of the present study was to determine risk factors predicting tracheal intubation–related complications on the prehospital field. Setting A prospective, multicentric, cohort study which was conducted in three mobile ICUs (MICUs; service mobile d’urgence et de réanimation).Outcome measures and analysis Tracheal intubation–related complications were defined as the occurrence of at least one of the following events: oxygen desaturation (SpO2 < 90%) during tracheal intubation, aspiration (regurgitation visualized during laryngoscopy), and vomiting. Difficult intubation was defined as more than two failed direct laryngoscopic attempts, or the need for any alternative tracheal intubation method. Multivariate logistic regressions were used. Results During the 5-year study period, 1915 consecutive patients were intubated in the MICUs participating in the study. Overall, 1287 (70%) patients were successfully intubated after the first laryngoscopic attempt, with rates of 90, 74, 42, and 30% for Cormack–Lehane grade 1, 2, 3, and 4, respectively. Tracheal intubation was difficult in 663 cases (36%). Tracheal intubation–related complications occurred in 267 (14%) patients. In the multivariate analysis, we found that the leading risk factors for tracheal intubation–related complications were Cormack and Lehane grade 3 and 4 [odds ratio (OR) = 1.65; 95% confidence interval (CI), 1.05–2.61; and OR = 2.79; 95% CI, 1.56–4.98, respectively], a BMI of more than 30 (OR = 1.61; 95% CI, 1.13–2.28), when intubation was difficult (OR = 1.72; 95% CI, 1.15–2.57), and when tracheal intubation required more than one operator (OR = 2.30; 95% CI, 1.50–3.49).Conclusions In this prospective study, we found that Cormack and Lehane more than grade 2, BMI >30, difficult intubation, and tracheal intubation requiring more than one operator were all independent predictors of tracheal intubation–related complications in the prehospital setting. When these risk factors are identified on scene, adapted algorithms that anticipate the use of a bougie should be generalized to reduce morbidity on the prehospital field.

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Section: Methodsmentioning

confidence: 99%

Factors associated with tracheal intubation–related complications in the prehospital setting: a prospective multicentric cohort study

Bastard

Pès²,

Leroux³

et al. 2023

European Journal of Emergency Medicine

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“…In Europe, Emergency Medicine has been recognized as basic specialty or supraspecialty in 27 countries. However, the training programs are very heterogeneous and their integration and harmonization is a work in progress [1,2].…”

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confidence: 99%

Using high-fidelity simulation for testing purposes: the experience of the European Board Examination in Emergency Medicine

Innocenti¹,

Spiteri²,

Butt³

et al. 2023

European Journal of Emergency Medicine

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“…One of the typical characteristics of knowledge in our specialty of emergency medicine is that much of its content is shared with that of other specialties. Our specialty has the particularity of dealing with the first hours of many of the vital processes of patients, the care of whom subsequently passes into the hands of our colleagues in the hospital wards [1][2][3][4]. However, there are some exceptions to this situation.…”

mentioning

confidence: 99%

Role of emergency departments and emergency physicians in expanding clinical knowledge on drug-related events

Galícia

Miró

2022

European Journal of Emergency Medicine

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Emergency medicine specialization: the French and Belgian perspective

Cited by 4 publications

References 8 publications

Factors associated with tracheal intubation–related complications in the prehospital setting: a prospective multicentric cohort study

Factors associated with tracheal intubation–related complications in the prehospital setting: a prospective multicentric cohort study

Using high-fidelity simulation for testing purposes: the experience of the European Board Examination in Emergency Medicine

Role of emergency departments and emergency physicians in expanding clinical knowledge on drug-related events

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