Global tests of haemostasis in critically ill patients with severe sepsis syndrome compared to controls.

Haemostatic changes in septic patients are complex, with both procoagulant and anticoagulant changes. Thirty-eight patients with severe sepsis and 32 controls were investigated by coagulation screens, individual factor assays, calibrated automated thrombography (CAT), whole blood low-dose-tissue factor activated (LD-TFA) Rotem and LD-TFA waveform analysis. Thirty-six of 38 patients had an abnormal coagulation screen. The mean levels of factors II, V (P < 0.05), VII, X, XI and XII, antithrombin and protein C (P < 0.01) was decreased in sepsis compared with controls. The mean factor VIII and fibrinogen level (P < 0.001) was increased. CAT in platelet rich and poor plasma showed a prolonged lag time (P < 0.02), decreased peak thrombin (P < 0.02) and delayed time to peak thrombin (P < 0.001) in sepsis patients, however, the endogenous thrombin potential was equivalent in sepsis and controls. In LD-TFA Rotem, septic patients had delayed clot times (P = 0.04) but an increased maximum velocity of clot formation (P < 0.01) and area under the clot elasticity curve (P < 0.01). LD-TFA waveform analysis showed a delayed onset time but an increased rate of clot formation (P < 0.005). In conclusion, global tests of haemostasis suggest that in this patient group, activation of haemostasis is delayed but once initiated thrombin generation and clot formation are normal or enhanced.

Organización y prestación de servicios médicos en operativos sanitarios realizados por el SAME en el a±o 2002 / Medical services organization in sanitary operatives made by SAME in 2002

Informe sobre el accionar del SAME en diferentes operativos sanitarios realizados durante el a±o, brindando cobertura en eventos de concurrencia masiva de público. Los datos se presentan por servicios y operativos, número total de ambulancias y unidades de apoyo utilizadas, y cantidad de personal participante

Organización y prestación de servicios médicos en operativos sanitarios realizados por el SAME en el a±o 2002 / Medical services organization in sanitary operatives made by SAME in 2002

Informe sobre el accionar del SAME en diferentes operativos sanitarios realizados durante el a±o, brindando cobertura en eventos de concurrencia masiva de público. Los datos se presentan por servicios y operativos, número total de ambulancias y unidades de apoyo utilizadas, y cantidad de personal participante

Atentado a la AMIA: experiencia del SAME / Terrorist assault at the AMIA: experience of the SAME

This article is related to the medical answer of the SAME (Public Emergency Medical System of the City of Buenos Aires) at the AMIA disaster at its different steps. We make a critical analusis of the actions executed at the impact area and we extract conclusion and suggestions to affront this special situation with multiple victims

Intervención de la Base Aeropuerto Ezeiza del SAME en el accidente del vuelo 932 de Lloyd Aéreo Boliviano / Intervention of Base Aeropuerto Ezeiza, SAME in the accident of 932 fly of Lloyd Aéreo Boliviano

Background: on december 17, 1903, the wright brothers put a human being in the air using a self-propelled mechanical system. The development of aviation has since then soared and turned present aviation into a safe and trustworthy activity. If an accident occurs in a modern airport, it brings togrther a complex mix of structures, companies, activities, and people, challenging the ability of aeronautic and sanitary emergency systems to respond. Objective: the intention of this communication is to detail the activity carried out by the Ezeiza Airport Base during the Lloyd Aereo Boliviano flight 932 accident on january 9, 2001. Case: at 5:10 pm, on this day, a Boeing 727-200 with 136 passengers and 8 crew members on board was taxing along Foxtrot towards runway 11. While the aircraft turned to position itself, the left section of the landing gear breaks down, causing the left wing to hit the ground, breaking the same and spilling fuel from the affected wingïs tanks. Of all the occupants of the aircraft (144) that were assisted and categorised, 14 required medical assistance, 8 were taken to Ezeiza hospital, 2 had to be hospitalised, and 12 were assisted by a human factor team