[Emergencies and exceptional health situations: The Paris fire department at the heart of the action]. / Urgences et situations sanitaires exceptionnelles : la brigade des sapeurs-pompiers de Paris au cœur de l'action.

The Paris fire department is at the heart of the management of exceptional health situations and large-scale emergencies. Their operational strategies are benchmarks, both in France and internationally. Their expertise in the context of the Olympic Games makes them a major player.

French lyophilized plasma versus normal saline for post-traumatic coagulopathy prevention and correction: PREHO-PLYO protocol for a multicenter randomized controlled clinical trial.

BACKGROUND: Post-trauma bleeding induces an acute deficiency in clotting factors, which promotes bleeding and hemorrhagic shock. However, early plasma administration may reduce the severity of trauma-induced coagulopathy (TIC). Unlike fresh frozen plasma, which requires specific hospital logistics, French lyophilized plasma (FLYP) is storable at room temperature and compatible with all blood types, supporting its use in prehospital emergency care. We aim to test the hypothesis that by attenuating TIC, FLYP administered by prehospital emergency physicians would benefit the severely injured civilian patient at risk for hemorrhagic shock. METHODS/DESIGN: This multicenter randomized clinical trial will include adults severely injured and at risk for hemorrhagic shock, with a systolic blood pressure < 70 mmHg or a Shock Index > 1.1. Two parallel groups of 70 patients will receive either FLYP or normal saline in addition to usual treatment. The primary endpoint is the International Normalized Ratio (INR) at hospital admission. Secondary endpoints are transfusion requirement, length of stay in the intensive care unit, survival rate at day 30, usability and safety related to FLYP use, and other biological coagulation parameters. CONCLUSION: With this trial, we aim to confirm the efficacy of FLYP in TIC and its safety in civilian prehospital care. The study results will contribute to optimizing guidelines for treating hemorrhagic shock in civilian settings. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02736812. Registered on 13 April 2016. The trial protocol has been approved by the French ethics committee (CPP 3342) and the French Agency for the Safety of Medicines and Health Products (IDRCB 2015-A00866-43).

Remote damage control during the attacks on Paris: Lessons learned by the Paris Fire Brigade and evolutions in the rescue system.

On November 13, 2015, in 40 minutes, Paris suffered four suicide bombers attacks; shootings at three different restaurant terraces; and an attack on the Bataclan concert hall, resulting in 130 dead and 495 wounded. How did the Parisian rescue system respond and how did it evolve since?We proved we could deploy quickly wide prehospital and hospital resources and teams' equipment and preparedness is being further developed. To secure a swifter initial response, we need a better integration of the operators of the rescue chain with a simpler and more robust organization as well as improved communications channels. We must continue to anticipate and prepare for possible future attacks.