Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Oct 2008
Practice Guideline Guideline[Field 5. Safety practices procedures for mechanical ventilation. French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
Invasive or endotracheal mechanical ventilation can lead to numerous complications likely to burden morbidity and mortality of patients in the intensive care unit. Various safety practices for mechanical ventilation may involve intubation, the mechanical ventilation period, weaning and extubation, the use of tracheostomy as well as non-invasive ventilation. The main objective of safety practices described in this chapter is to prevent or avoid the main risks due to invasive mechanical ventilation.
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Ann Fr Anesth Reanim · Oct 2008
Practice Guideline[Field 8. Safety practices in paediatric intensive care medicine. French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
A paediatric intensive care unit is a complex environment with many hazards for potential medical errors. Due to the high acuity of illness and the complexity of medical care with multiple disciplines and individuals involved, medical errors occur due to breakdowns in communication and teamwork. Medication errors are the most frequent errors in paediatrics. This chapter proposes some strategies to prevent medical errors in paediatric intensive care units.
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Ann Fr Anesth Reanim · Oct 2008
Guideline[Field 3. Structural and managerial skills for improvement in safety practice. French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
ICU activity has to be authorized by regional hospital agencies. The structural aspects of ICU have been defined in official text in 2002. Thus, quality related to structural issues should be settled in the next future. ⋯ This new quality-security oriented policy must be supported by the institution. The volume-outcome relationship has been demonstrated across a wide range of medical and surgical procedures. On average, higher volume is associated with higher quality and better outcome.
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Ann Fr Anesth Reanim · Oct 2008
Practice Guideline[Field 6. Safety practices for haemodynamic procedures (administration of vasoactive drugs, vascular and cardiac catheterization). French-speaking Society of Intensive Care. French Society of Anesthesia and Resuscitation].
Arterial and central venous catheterizations and their use for continuous infusion of vasoactive drugs could lead to serious adverses events that could be life threatening. The incidence of human errors related patient adverses events could be decreased by the uses of algorithms and procedures. Concerning the continuous infusion of vasoactive drugs, the name of drug and its concentration should be clearly notified. ⋯ These catheters should be removed when they are not indicated. Concerning the pulmonary artery catheter, the balloon tip should be inflated with visual control of the pulmonary artery pressure. Its removal is recommended within the first five days.
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Ann Fr Anesth Reanim · Oct 2008
Case Reports[Delayed diagnosis of a postanaesthesia temporomandibular joint dislocation].
Temporomandibular joint (TMJ) dislocation during anaesthesia is a rare occurrence. Patients with a history of prior dislocations or TMJ dysfunction, and patients with mandibular retrognathism are at risk of this complication. This is a case report of delayed diagnosis of TMJ dislocation after a general anaesthesia for aortic valvular replacement surgery in a predisposed patient. ⋯ In at-risk patients, one should not worry about TMJ dislocation during intubation but concentrate on glottic exposure. However, afterwards, one should be highly aware of this possible complication in order to detect it early, allowing an immediate simple manual reduction. This manoeuver may be performed with or without sedation by a practitioner, familiar with this way of resetting a dislocated jaw.