Annales françaises d'anesthèsie et de rèanimation
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France is one of main countries affected by the HIV-outbreak in Europe with more than 120,000 cases, among which 34,600 patients having developed an AIDS. The antiretroviral combination therapies (combined antiretroviral therapy [cART]) reduced by half the mortality. A low compliance to cART alters the virologic control and increases the morbimortality. ⋯ The main restriction belongs to the protease inhibitors, which could affect the metabolic pathways of opioids, NSAIDs and benzodiazepines (over dosage risks). During the postoperative period, the follow-up should include the thromboembolism prevention (increased risk compared to main people), the cardiovascular side effects, the nutritional status and the continuation of the treatment. Moreover, the psychological status related and a close collaboration with the corresponding physician is critical.
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Ann Fr Anesth Reanim · Jun 2011
Multicenter Study[Assessment of the French surgical checklist: the experience of 17 French cancer centres].
The use of WHO checklist has been associated to a decrease of complication incidence and mortality. This control is mandatory since January the 1st 2010. Evaluation of the quality of documentation is important and includes filling rate, which is a reflexion of participant adhesion and analysis of the circumstances where the team answers "no" during the control. ⋯ There is a large discrepancy between centres and for a given centre in reporting quality. Significant progress should be expected using target improvement. This approach implies multiple critical analysis of checklist content in each hospital and in multicentre enquiries.
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This is the case report of a 16-year-old male who suffered major facial trauma in a road traffic accident (unhelmeted scooter rider against signpost). During prehospital care, he was stable and awake. ⋯ This allowed rapid restoration of adequate ventilation and tracheostomy was performed under standard conditions without further problems. This case report confirms the superiority of orotracheal intubation under light sedation over emergent tracheostomy in this type of situation, as stated under the SFAR guidelines.
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Ann Fr Anesth Reanim · Jun 2011
[Check-list "Patient Safety" in the operating room: one year experience of 40,000 surgical procedures at the university hospital of Nice].
The implementation of the check-list "Safe surgery saves live" (CL) has proven effective to reduce morbidity and perioperative mortality. Since 1st January 2010 it is a requirement of the HAS as part of the process of certification of hospitals. The CL has been established on all the operating rooms of our hospital after the onset of a near accident. ⋯ The CL is involved in developing a safety culture in the operating room and led to the establishment of a risk mapping in the operating room and the recovery room and participation in the program error prevention procedure and surgical site through international program "High 5s" whose purpose is to improve the safety of care.
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Ann Fr Anesth Reanim · Jun 2011
Case Reports[Infections complicating femoral nerve catheter for postoperative analgesia: about two cases].
The process of inserting a perineural catheter on femoral region for a regional anesthesia is quite common amongst hospital practices. The resulting infectious complications, although rare, remain potentially serious. ⋯ In this paper, we will be presenting two cases of infections that were under serious investigation and led to major improvements of practice in the related hospitals. At the same time, we will give a reminder of good practices in inserting perineural catheters.