Critical care : the official journal of the Critical Care Forum
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Both in emergency and elective surgical patients increased blood lactate levels warn the physician that the patient is at risk of increased morbidity and decreased changes of survival. Prompt therapeutic measures to restore the balance between oxygen demand and supply are warranted in these patients.
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Editorial
Prehospital advanced trauma life support: how should we manage the airway, and who should do it?
Adequate oxygenation at all times is of paramount importance to the critically injured patient to avoid secondary damage. The role of endotracheal intubation in out-of-hospital advanced trauma life support, however, remains controversial. ⋯ Recent evidence suggests that comprehensive ventilatory care already initiated in the field and maintained during transport may require the presence of a physician or another adequately skilled person at the scene. Benefits of such as service need to be balanced against increased costs.
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In August 2003, France sustained an unprecedented heat wave that resulted in 14,800 excess deaths. The consequences were maximal in the Paris area. The Assistance Publique-Hôpitaux de Paris reported more than 2600 excess emergency department visits, 1900 excess hospital admissions, and 475 excess deaths despite a rapid organization. Indeed, simple preventice measures before hospital admissions are only able to reduce mortality which mostly occurred at home and in nursing homes.