Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jun 2000
Review[The "impact factor" of anesthesia and intensive care journals].
The "impact factor" (IF) of scientific journals is defined as the number of citations obtained over a one-year period of articles published during the two previous years in a journal, divided by the number of articles published in that journal during the preceding two years. The IF, initially devised as an indicator of the quality of a journal, is at present mainly considered as an indicator of the quality of an article contained in that journal. However the IF of a journal is not equivalent to the actual impact of an article. ⋯ The IF of the journal of the French society for anaesthesiology and intensive care, the Annales françaises d'anesthésie et de réanimation (Afar), is about seven times below the IF of Anesthesiology, which has the highest IF in the category "Anesthesiology". From 1992 to 1998, the relative impact value of the Afar has increased by 429%. However the absolute value remains low.
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Meningitis is a severe and an uncommon complication of both spinal and epidural anaesthesia. This review summarizes the knowledge on epidemiology, clinical and microbiological diagnosis and the ways to prevent them. ⋯ The unexpected appearance of meningitis during the wearing-off of a spinal anesthesia is exceptional; the possibility of death or serious sequela must be taken into account. The sources of contamination are quite frequently exogenous, the germs coming most often from the patient's cutaneous flora or the anesthetist's ENT flora. Prevention of this risk involves a rigorous respect for cutaneous disinfection and hygiene procedures. The anesthetist's medico-legal responsibilities will be called upon in case of exogenous contamination.
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Ann Fr Anesth Reanim · Apr 2000
Review[Management of severe head injuries during the first 24 hours, in the emergency department, in neurosurgery].
In France, the role of the neurosurgeon in the emergency department depends on local health care policies and geographical constraints. Some departments include a neurosurgical team with a dedicated operating room. In others, a neurosurgeon can be reached by phone, possibly with an image transfer. ⋯ The management of a haematoma of the posterior fossa or a bleeding dural venous sinus would be difficult for a surgeon not qualified in neurosurgery. The optimal situation is the presence of a neurosurgeon in the medical team admitting patients with a severe head or spine trauma, for assessment of the neurological status, or interpretation of radiological explorations, insertion of an intracranial pressure monitoring device. Besides the extradural haematoma, other injuries such as an acute subdural haematoma, a haematoma associated with a contusion, an acute hydrocephalus, a depressed fracture of the skull, or a craniocerebral wound, also require an emergency decompressive procedure.
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Ann Fr Anesth Reanim · Apr 2000
Review[Role of the regulation in the management of patients with severe head injuries].
The regulator of the emergency medical ambulance service is involved in the various steps of the initial management of severe head trauma patients: handling calls, basic life support, prehospital advance life support, transport and hospital admission. The management is rapid (helicopter transports) coherent and adapted (adherence to the guidelines for severe head injury), and considers of local difficulties (geographical, possibility of admission to trauma centres), with the aim of improving the outcome of severely head-injured patients.