Revue médicale suisse
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Revue médicale suisse · Dec 2012
Review[Non-invasive ventilation: indication for acute respiratory failure].
Mask or Non-invasive ventilation (NIV) is used for critically ill patients with acute respiratory failure (ARF): acute exacerbation of chronic obstructive bronchopulmonary disease and severe cardiogenic pulmonary edema are considered as the best indications for NIV since it improves the outcome of these patients. This technique is also proposed for hypoxemic respiratory failure, with more various results. ⋯ NIV is also proposed after invasive ventilation or in patients in whom endotracheal intubation is not desirable. Its use has increased and its effectiveness seems to have improved, due to a better understanding of the technique but also thanks to technological progress.
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Intensive care units are highly stressful for the patients but for the caregivers as well, including nurse-assistants, nurses and physicians. The psychological syndrome of work exhaustion more commonly named burnout threatens these caregivers. ⋯ We suggest some possible ways to decrease the incidence of burnout. Finally, since the problematic of burnout is not specific to intensive care, we sought to underline some possible consequences of the burnout of caregivers on health systems.
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Revue médicale suisse · Nov 2012
[Community pharmacy and general internal medicine are at the same crossroads: some opportunities should be seized].
The medicines give some symptoms relief and save lives every day. However, the responsible use of medicines is not definitively attained for the modern health systems. The shortcomings in this area are the cause of major negative clinical outcomes for the patients and the cause of additional cost for the health financing system. The two centenarians, as the International Pharmaceutical Federation (FIP) and the "Policlinique Médicale Universitaire (PMU)" in Lausanne, preview the solutions from now on for reversing this trend, such as the interdisciplinary collaborative approaches, the introduction of adequate financial incentives and the strengthening of education and research in community medicine, pharmacy and health.