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Biomedical subjects

Claude Lapandry

Publications and source records attributed to Claude Lapandry.

5 recordsLinked to original sources
PubMed2005

[Determination of early markers of a sanitary event. The example of the heat wave of August 2003 at the Samu 93-centre 15 in France].

OBJECTIVE: The aim of this study was to determine, a posteriori, the parameters detecting an event in a French medical emergency dispatching centre (SAMU). METHODS: Six parameters were retained: total number of medical requests received by the Samu 93-centre 15: the number of decisions to send a mobile intensive care unit (MICU), number of decisions to send a non-medical unit, number of decisions to send a general practitioner and number of deaths observed by the physicians of the MICU. For each parameter, a daily referential was established over the five previous years (1998 to 2002) and compared with the results of August 2003 RESULTS: The number of decisions to send a non-medical unit and the number of decisions to send a general practitioner were unchanged. The number of deaths on the 8th of August observed by the MICU physician should have led to an alert being given: 5.0 deaths for a referential of 1.7 (+ 194%). The number of decisions to send an MICU on the 7th of August should have led to an alert being given: 41 interventions for a referential of 25 (+64%). The number of medical interventions on the 6th of August should have led to an alert being given: 351 interventions for a referential of 299 (+17%). CONCLUSION: The total number of medical interventions treated by the SAMU 93-centre 15 is a the most sensitive and earliest marker of a sanitary event, such as that observed in August 2003 with the heat wave.

Disaster Planning↗
PubMed2005

Prognostic factors in victims of falls from height.

OBJECTIVE: Falls from height cause significant mortality in the urban environment, but reliable prognostic factors have not been identified. Even the intuitive relation between the distance fallen and mortality rate has been questioned. Our objective was to determine factors predictive of increased mortality rate in victims of falls from height. DESIGN: Clinical observational study, retrospective for January 1998 to May 1999 and prospective from June 1999 to September 2000. SETTING: The study population was drawn from Seine-Saint-Denis, an urban region near Paris with 1.3 million inhabitants treated by a French out-of-hospital medical emergencies unit. PATIENTS: Patients were victims of falls from height >3 m, age >12 yrs. Study entry was performed on the scene by an emergency physician from the medical emergencies unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Studied data included age, gender, circumstances of fall, height of fall, nature of the impact surface (soft or hard), transient impact preceding final impact, and part of the body touching the ground first. The primary end point was mortality. The study included 287 patients, 116 (40%) during the retrospective phase and 171 (60%) during the prospective phase. Ninety-seven patients (34%) ultimately died. In multivariate analysis, age (mean, 41.6 +/- 16.6 yrs in patients who died vs. 34.9 +/- 14.9 in survivors; odds ratio, 1.05; p < .0005); height of fall (median, 5.0; 3.8-8.0 vs. 2.0; 1.2-3.0 floors; odds ratio, 1.24; p < .0001); nature of the impact surface (hard in 39% vs. soft in 22%; odds ratio, 2.7; p < .05); and head, anterior, and lateral body surfaces touching the ground first (with respectively mortality rates of 44%, odds ratio, 16.7, p = .0001; 57%, odds ratio, 10.6, p < 0.005; 32%, odds ratio, 11.1, p < .001) were independently correlated with the final mortality rate. CONCLUSIONS: Patient age, height of fall, impact surface nature, and body part first touching the ground are independent prognostic factors in victims of falls from height.

Accidental Falls↗
PubMed2003

[Thoracic trauma].

Approximately 30% of trauma cases include significant chest trauma as a component. The vast majority of chest trauma is related to motor vehicle accidents. A key of management of patients with blunt thoracic trauma is a high index of suspicion for thoracic injury, in particular aortic injury. This is based on history, including knowledge of the type and force of injury, and clinical examination. The majority of such injuries may be diagnosed with relatively simple tests such as chest radiographs. Transesophageal echocardiography and CT scan are becoming the corner-stone of evaluation of severe chest trauma patients.

Biomechanical Phenomena↗