Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2014
Case ReportsAccidental dural puncture: Combination of prophylactic methods to avoid post-dural puncture headache.
Accidental dural puncture (ADP) is a common complication of epidural catheter insertion, and may lead to post-dural puncture headache (PDPH), especially in obstetric patients. Epidural blood patch (BP) is the most effective treatment of PDPH. Prophylactic BP has shown its efficacy to prevent PDPH; nevertheless, this method may be insufficient. ⋯ A prophylactic BP was performed immediately after removal of the intrathecal catheter. The patient did not experience any headache. This combination of treatments (intrathecal catheter insertion+prophylactic BP) may be a good alternative approach to prevent PDPH, even if it has to be warranted by other clinical studies.
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Ann Fr Anesth Reanim · May 2014
Review[Simulation in healthcare in North America: Update and evolution after two decades.]
Update on simulation-based education and its evolution in North America. ⋯ Simulation is fully integrated in healthcare in North America and represents one of the main elements for healthcare professional education. Simulation is also a symbol of excellence for health and teaching institutions. The evolution of simulation in North America is likely to inform the future of simulation in France.
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Ann Fr Anesth Reanim · May 2014
Case Reports[Medical decision in a very elderly patient: A case report of application of the Leonetti law in emergency medicine.]
Advanced care decision in emergency medicine is difficult for the elderly. How to be fair, avoiding an unreasonable obstinacy? Based on the case of very old person, we show how an optimal management can be decided in accordance with the spirit of the law.
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Ann Fr Anesth Reanim · May 2014
Review[Perioperative conflicts between anaesthesiologists and surgeons: Ethics and professionalism.]
In the perioperative period, several potential conflicts between anaesthetists/intensive care specialists and surgeons may exist. They are detrimental to the quality of patient care and to the well-being of the teams. They are a source of medical errors and contribute to burn-out. ⋯ The teaching of communication techniques that begins with the initial training, the evaluation of team behaviours (through simulation training for example), the respect of others' constraints, particularly when it comes to learning, as well as transparency regarding conflicts of interests, are all additional elements of conflict prevention. Lastly, conflicts may at times be caused by deviant behaviours, which must be met with a clear and uncompromising collective and institutional approach. This article concludes by offering a standardised approach for conflict resolution.