Aspects particuliers de la ventilation mécanique en médecine d'urgence

In France, Emergency Medicine organization is based on two complementary procedures: admission to the Hospital Emergency Departments and Prehospital or Interhospital Medical Care for critically ill patients - the latter being performed by Emergency Medical Call Centers and Prehospital Medical Care Units. Invasive mechanical ventilation is a technique commonly operated by emergency physicians just as spontaneous breathing with continuous positive airway pressure. Noninvasive ventilation with bilevel positive airway pressure is sometimes operated in Hospital Emergency Departments but it remains to be seen if this method is convenient for prehospital ventilation strategies. In emergency medicine, patients who need ventilatory support are most of the time delicate and unsteady. They all need transportation with numerous restraints particularly in case of trying environment. We here describe features and limits of various ventilatory support devices now available in emergency medicine. Then, we suggest a choice of three classes of emergency medicine ventilators to be selected according to operation mode.