Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2012
Review[How to assess the impact of morbimortality conferences on healthcare quality and safety in ICU ?].
To estimate the morbidity and mortality conferences (MMC) impact in intensive care unit (ICU) setting on quality of care and patients' safety. ⋯ Further studies are required to assess the impact of MMC in the ICU. Based on this literature review, a 4-level evaluation scheme can be suggested: 1) evaluation of MMC implementation in care units and facilities; 2) evaluation of MMC organization; 3) evaluation of MMC on quality of care; 4) evaluation of MMC impact on patients' mortality and morbidity.
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Ann Fr Anesth Reanim · Jul 2012
[Drug's administration via feeding tubes: evaluation of practices in an intensive care unit of a Tunisian hospital].
Drugs' administration via feeding tubes is a potential source of iatrogenic events for the intensive care patients because of the problem of not adapted galenic forms. ⋯ This study shows that it is possible to reduce risk of administration errors in the intensive care unit and to facilitate the administration of drug via feeding tube by prescribing liquid oral form or soluble solid oral form. It also shows the need for cooperation with the pharmacist in order to adapt the galenic forms and to redact protocol of administration.
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Ann Fr Anesth Reanim · Jul 2012
[Hypnosis and ultrasound-guided paravertebral block in breast cancer surgery].
The combination of hypnosis and paravertebral block (PVB) was studied in three patients scheduled for breast cancer surgery. The three procedures were realized under hypnosis. Median postoperative pain was rated at zero and comfort felt at 8 on a 10 points scale. Hypnosis could be an alternative to conventional anesthesia in combination with a PVB for breast cancer surgery.
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Ann Fr Anesth Reanim · Jul 2012
Multicenter Study[Use of indicators of fluid responsiveness in septic shock: a survey in public emergency departments].
Fluid therapy is one of the major elements of severe sepsis and septic shock management. A systematic initial fluid bolus is recommended before evaluation of left ventricular filling pressure by the use of indicators of fluid responsiveness, preferentially dynamic ones. A massive fluid therapy could be damaging for the patient. Dynamic indicators of fluid responsiveness are not often relevant in the emergency department. This study was aimed to evaluate the use of indicators of fluid responsiveness by emergency practitioners during septic shock management. ⋯ Emergency practitioners use preferentially less invasive and less time-consuming indicators of fluid responsiveness.
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Ann Fr Anesth Reanim · Jul 2012
Review[From medical complication to compensation for the prejudice].
Claims in anesthesia and intensive care remains high, despite the reduction of morbidity and mortality associated with this activity. The absence of a national register makes it difficult to quantify. The Medical Committee of MACSF-Sou Medical Group, professional liability insurer of more than half of French physicians, provided us support. ⋯ With the establishment of the Regional Commissions of Conciliation and Compensation (RCCI) and the National Office for Compensation of Medical Accident (Oniam), it is now possible for a patient to be compensated for an injury resulting from an accident Medical non-offending, while acknowledging the lack of accountability of the practitioner. The expertise conducted by an RCCI is adversarial. For the practitioner called to the cause, it is important to prepare for both substance and form, with the assistance of the medical board's insurance company.