Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2012
Review[What is new regarding anaesthetic monitoring in the operating room?].
This paper critically reviews the new devices that can be used on the operating room to monitor the oxygenation and the haemodynamics of the child undergoing general anaesthesia.
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Ann Fr Anesth Reanim · Jan 2012
Review[Application of ultrasound in paediatric abdominal trunk blocks].
Although relatively few studies have compared US guidance with established "blind" techniques, the available evidence suggests that the use of US guidance is a safe and effective way to facilitate correct needle placement and adequate spread of LA for abdominal wall nerve blocks. It improves block effectiveness and safety by reducing LA doses and by detecting anatomic variants or unsuspected pathologies. ⋯ Matched with improving technology, the use of US has significant benefits over conventional techniques to perform classic and new abdominal wall nerve blocks in children. However, more studies are required to evaluate the potential of US to support this finding.
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Ann Fr Anesth Reanim · Jan 2012
An information campaign on aminoglycosides use during septic shock failed to improve the quality of care.
Septic shock remains a major cause of death in intensive care units (ICU) and an inappropriate antibiotic regimen worsens the prognosis. The aim of the study was to assess the impact of an information campaign on modalities of prescription of aminoglycosides in septic shock. ⋯ An information campaign describing the modalities of prescription of aminoglycosides in septic shock failed to improve medical practices and patient outcomes. A mobile team of antibiotics could be useful in daily practice.
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Ann Fr Anesth Reanim · Jan 2012
[Second wave of the French drug harmonisation programme to prevent medication errors: overall appreciation of healthcare professionals].
Medication errors are a significant cause of severe healthcare-associated complications. In December 2006, the French Health Products Agency (Afssaps) has issued a protocol to harmonise labeling of injectable drugs vials. In 2007, a first change was launched for four drugs and was followed in 2008-2009 by a second wave concerning 42 active drugs. ⋯ This national survey describing the perception of healthcare professionals regarding the new harmonisation procedure for injectable drugs highlighted some progress but also a number of deficiencies, notably regarding communication and implementation of the change in clinical units. This survey will be used by the French Health Products Agency to improve future steps of the long-lasting campaign against medication errors.
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Ann Fr Anesth Reanim · Jan 2012
[Reliability of pulsatile saturometry in patients with shock. Digital standard sensors are not reliable for facial measurement!].
Non-invasive monitoring of oxygen saturation by pulse oxymetry (SpO(2)) is sometimes perturbed on fingers during shock states. Other sites are possible (toes, forehead, nose, ear). Self-adhesive standard digital sensors are commonly used off-label in these sites. We have assessed their reliability for all of these sites. ⋯ In patients with a shock receiving vasoconstrictive catecholamines, the reliability of SpO(2) measurements with standard sensors appears better for fingers than for toes and face locations. These standard sensors should be discouraged for facial measurement because of their low reliability, even when the plethysmographic curve seems correct. Sensors specifically designed for each facial site exist, and their reliability should be estimated in patients receiving vasoconstrictive catecholamines.