Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Mar 2008
Case Reports[Paraumbilical block for strangulated umbilical hernia in emergency].
The authors describe a strangulated umbilical hernia surgery performed in emergency with a paraumbilical block associated with a local infiltration. For this patient, 3-4 ASA status, in occlusion, with iterative vomiting and coagulation disorders, general or spinal anaesthesia were high-risk technics. Paraumbilical block, sometimes used for anaesthesia or/and analgesia for programmed umbilical hernia surgery, allowed surgery with good conditions and procured prolonged postoperative analgesia. This block, easy to perform, is an interesting alternative in emergency for general or spinal anaesthesia in high-risk patients.
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The purpose of benchmarking is to settle improvement processes by comparing the activities to quality standards. The proposed methodology is illustrated by benchmark business cases performed inside medical plants on some items like nosocomial diseases or organization of surgery facilities. Moreover, the authors have built a specific graphic tool, enhanced with balance score numbers and mappings, so that the comparison between different anesthesia-reanimation services, which are willing to start an improvement program, is easy and relevant. This ready-made application is even more accurate as far as detailed tariffs of activities are implemented.
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Ann Fr Anesth Reanim · Mar 2008
[Quality indicator survey of anaesthesia records in hospitals of Aquitaine].
Assessing the quality of anaesthesia records according to the criteria of the reference frame of professional practices evaluation proposed by the French Anaesthetists College (Cfar) in 2005. ⋯ This study brings information concerning the clinical relevance of anaesthesia records and preoperative evaluation practices.
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Ann Fr Anesth Reanim · Mar 2008
Case Reports[Lemierre's syndrome from necrotizing pneumonia treated with extracorporeal CO2 removal].
We report a case of Lemierre's syndrome complicated with pulmonary septic abscesses, leading to necrotizing pneumonia. In spite of administration of appropriate antibiotics and a protective ventilation strategy, the patient had several bilateral pneumothoraces. ⋯ The patient was weaned from mechanical ventilation on day 68. He was then transferred to the chest surgery unit on day 83.