B Acad Nat Med Paris
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The deprivation of numerous possibilities suffered by the severely-handicapped on account of their somato-psychic deficiency extends to many areas: mobility, relationships, autonomy in their everyday life, dependency, psychological or even mental consequences. The most elementary ethics would require to take all these deprivations into account, not just in the choice of accommodation structures but also in the behaviour of relatives and friends, or of qualified members of staff, in their approach to the handicapped. The range of application of these ethical rules must therefore extend from the quality of life and assistance, and the concern for efficiency of interventions, to the problems of security and securization, the assessment and the prevention of risks deriving from the handicap or its consequences, through the information of the patients regarding their elementary or specific rights, the introduction of the most favourable basis in order to make sure that they enjoy the dignity due to any human being, whatever his condition. Such a vast program requires a great many means of action, which all imply the recourse to the appropriate material and human assistance.
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B Acad Nat Med Paris · Nov 1994
[Anesthetic safety: recommendations of the French Society of Anesthesia-Resuscitation].
As in other developed countries, the French Society of Anaesthesia and Intensive Care has established since 1989 nine recommendations concerning the safety of anaesthetic practice, for all types of anaesthesia, and whatever the place where anaesthesia is to be given. They include recommendations for the preanaesthetic period (especially the preanaesthetic visit), for monitoring an anaesthetized patient, and for recovery. ⋯ For each recommendation, minimum standards for facilities, organisation, personal and equipment have been defined. These standards safety requirements could be used as indicators in assessing anaesthetic safety in a hospital accreditation process.
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Accidents caused by anesthesia constitute 4% of peri-operative mortality and are mostly preventable. The methods for reducing these accidents in pre-, intra- and post-operative situations are explained. Pre-operative tests are ineffective when used without clinical guidance which requires a pre-anesthetic consultation. ⋯ This situation requires a rapid improvement. The rational utilization of the described methods for improving anesthetic safely means avoiding the dispersion of anesthetic units. Professional demographics contradicts the idea that an increase in the number of anesthesiologists could solve problems caused by deficient organizations or systems.