References of "Ghuysen, Alexandre"
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See detailCOMMENT JE TRAITE ... L’arrêt cardio-respiratoire extrahospitalier : la fenêtre du centraliste 112
STIPULANTE, Samuel ULg; ZANDONA, Régine; EL-FASSI, Mehdi ULg et al

in Revue Médicale de Liège (in press), 69

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See detailAIR VERSUS GROUND TRANSPORT OF PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: EXPERIENCE IN A RURAL-BASED HELICOPTER MEDICAL SERVICE
MOENS, Didier ULg; Stipulante, Samuel ULg; Donneau, Anne-Françoise ULg et al

in European Journal of Emergency Medicine (in press)

Aims Primary pre-hospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We ... [more ▼]

Aims Primary pre-hospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We designed a prospective study involving patients with acute myocardial infarction aimed at the evaluation of the potential benefit of such primary HEMS interventions as compared with classical EMS ground transport. Methods & results This prospective study was conducted from July 1, 2007 to June 15, 2012. Successive patients with ST-segment elevation myocardial infarction (STEMI) eligible for percutaneous coronary intervention (PCI) were included. Simulated ground-based access times were computed using a digital cartographic program, allowing the estimation of healthcare system delay from call to admission to the catheterisation laboratory. During the study period, 4485 patients benefited from HEMS activations. Of these patients, 342 (8%) suffering from STEMI were transferred for primary PCI. Median primary response time time was 11 min (IQR: 8 - 14 min) using the helicopter and 32 min (25 – 44 min) using road transport. Median transport time using HEMS was 12 min (9 – 15 min) and 50 min (36 – 56 min) by road. The median system delay using HEMS was 52 min (45 – 60 min), while this time was 110 min (95 – 126 min) by road. Finally, the system delay median gain was 60 min (47 – 72 min). Conclusions Using HEMS in a rural region allows STEMI patients to benefit from appropriate rescue care with similar delays as those seen in urban patients. [less ▲]

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See detailReliability and validity of a new French-language triage algorithm : the ELISA scale
JOBE, Jérôme ULg; Ghuysen, Alexandre ULg; GERARD, P et al

in Emergency Medicine Journal (2014), 31(2), 115-20

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See detailImplementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres.
STIPULANTE, Samuel ULg; Tubes, Rebecca; Fassi, Mehdi El et al

in Resuscitation (2014), 85(2), 177-181

Objectives: Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liegeois d'Encadrement a la ... [more ▼]

Objectives: Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liegeois d'Encadrement a la Reanimation par Telephone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area. Methods: We designed a before and after study based on a 3-month retrospective assessment of victims of OHCA in 2009, before the implementation of the ALERT protocol in Liege emergency medical communication centre (EMCC), and the prospective evaluation of the same 3 months in 2011, immediately after the implementation. Results: At the moment of the call, dispatchers were able to identify 233 OHCA in the first period and 235 in the second. Victims were predominantly male (59%, both periods), with mean ages of 64.1 and 63.9 years, respectively. In 2009, only 9.9% victims benefited from bystander CPR, this increased to 22.5% in 2011 (p<0.0002). The main reasons for protocol under-utilisation were: assistance not offered by the dispatcher (42,3%), caller physically remote from the victim (20.6%). Median time from call to first compression, defined here as no flow time, was 253sec in 2009 and 168sec in 2011 (NS). Ten victims were admitted to hospital after ROSC in 2009 and 13 in 2011 (p=0.09). Conclusion: From the beginning and despite its under-utilisation, the ALERT protocol significantly improved the number of patients in whom bystander CPR was attempted. [less ▲]

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See detailA fatal case of Perthes syndrome
JOBE, Jérôme ULg; Ghuysen, Alexandre ULg; Hartstein, Gary ULg et al

in Journal of Emergencies, Trauma and Shock (2013), 6(4), 296-297

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden ... [more ▼]

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of this syndrome. Current treatment is symptomatic: urgent relief of chest compression and cardiopulmonary resuscitation if needed. Outcome may be satisfactory depending on the duration and severity of compression. Prolonged thoracic compression may sometimes lead to cerebral anoxia, irreversible neurologic damage and death. We report a fatal case of Perthes syndrome resulting from an industrial accident. [less ▲]

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See detailEvaluating the psychological impact of practice dispatch-assisted cardiopulmonary instructions using the ALERT protocol: preliminary results in Liege dispatching centre.
Hirtz, Elodie; Ghuysen, Alexandre ULg; STIPULANTE, Samuel ULg et al

Poster (2013, July)

ABSTRACT Background. The ALERT algorithm, an effective compression-only phone cardiopulmonary resuscitation (CPR) protocol has the potential to help bystanders initiate CPR. This study evaluates the ... [more ▼]

ABSTRACT Background. The ALERT algorithm, an effective compression-only phone cardiopulmonary resuscitation (CPR) protocol has the potential to help bystanders initiate CPR. This study evaluates the psychological impact of the CPR’s practice on untrained persons (UP). Methods. This is a quasi experimental longitudinal study (n = 153). We used: demographics data, CPR’ emotional characteristics; the Peritraumatic Dissociative Experiences Questionnaire ; the Way of Coping Check List and the Impact of Event Scale. Findings. Two psychological profiles: UP at high risk to develop a post traumatic disorder (higher average scores ; high emotional distress during the CPR) versus UP at low risk. Discussion. These preliminary results highlight the importance of identifying the psychological profile of the UP. For a CPR, UP at high risk should be treated differently: first, take the time to reduce emotional distress and then only talk about the CPR. This step could reduce the risk for PTSD [less ▲]

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See detailEvaluation of a Model-Based Hemodynamic Monitoring Method in a Porcine Study of Septic Shock
Revie, James; Stevenson, David; Chase, J. Geoffrey et al

in Computational and Mathematical Methods in Medicine (2013)

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See detailAssessment of ventricular contractility and ventricular-arterial coupling with a model-based sensor.
Desaive, Thomas ULg; LAMBERMONT, Bernard ULg; JANSSEN, Nathalie ULg et al

in Computer Methods & Programs in Biomedicine (2013), 109(2),

Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of ... [more ▼]

Estimation of ventricular contractility and ventricular arterial coupling is clinically important in diagnosing and treating cardiac dysfunction in the critically ill. However, experimental assessment of indexes of ventricular contractility, such as the end-systolic pressure-volume relationship, requires a highly invasive maneuver and measurements that are not typical in an intensive care unit (ICU). This research describes the use of a previously validated cardiovascular system model and parameter identification process to evaluate the right ventricular arterial coupling in septic shock. Model-based ventricular arterial coupling is defined by the ratio of the end systolic right ventricular elastance (E(esrvf)) over the pulmonary artery elastance (E(pa)) or the mean pulmonary inflow resistance (R(pulin)). Results are compared to the clinical gold-standard assessment (conductance catheter method). Six anesthetized healthy pigs weighing 20-30kg received a 0.5mgkg(-1) endotoxin infusion over a period of 30min from T0 to T30, to induce septic shock and veno-venous hemofiltration was used from T60 onward. The results show good agreement with the gold-standard experimental assessment. In particular, the model-based right ventricular elastance (E(esrvf)) correlates well with the clinical gold standard (R(2)=0.69) and the model-based non-invasive coupling (E(esrvf)/R(pulin)) follow the same trends and dynamics (R(2)=0.37). The overall results show the potential to develop a model-based sensor to monitor ventricular-arterial coupling in clinical real-time. [less ▲]

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See detailValidation of subject-specific cardiovascular system models from porcine measurements.
Revie, J. A.; Stevenson, D. J.; Chase, J. G. et al

in Computer Methods & Programs in Biomedicine (2013), 109(2),

A previously validated mathematical model of the cardiovascular system (CVS) is made subject-specific using an iterative, proportional gain-based identification method. Prior works utilised a complete set ... [more ▼]

A previously validated mathematical model of the cardiovascular system (CVS) is made subject-specific using an iterative, proportional gain-based identification method. Prior works utilised a complete set of experimentally measured data that is not clinically typical or applicable. In this paper, parameters are identified using proportional gain-based control and a minimal, clinically available set of measurements. The new method makes use of several intermediary steps through identification of smaller compartmental models of CVS to reduce the number of parameters identified simultaneously and increase the convergence stability of the method. This new, clinically relevant, minimal measurement approach is validated using a porcine model of acute pulmonary embolism (APE). Trials were performed on five pigs, each inserted with three autologous blood clots of decreasing size over a period of four to five hours. All experiments were reviewed and approved by the Ethics Committee of the Medical Faculty at the University of Liege, Belgium. Continuous aortic and pulmonary artery pressures (P(ao), P(pa)) were measured along with left and right ventricle pressure and volume waveforms. Subject-specific CVS models were identified from global end diastolic volume (GEDV), stroke volume (SV), P(ao), and P(pa) measurements, with the mean volumes and maximum pressures of the left and right ventricles used to verify the accuracy of the fitted models. The inputs (GEDV, SV, P(ao), P(pa)) used in the identification process were matched by the CVS model to errors <0.5%. Prediction of the mean ventricular volumes and maximum ventricular pressures not used to fit the model compared experimental measurements to median absolute errors of 4.3% and 4.4%, which are equivalent to the measurement errors of currently used monitoring devices in the ICU ( approximately 5-10%). These results validate the potential for implementing this approach in the intensive care unit. [less ▲]

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See detailProspective study of an advanced nurse triage for a target pathology at the admission in the emergency department
JOBE, Jérôme ULg; VANDERCLEYEN, C; Ghuysen, Alexandre ULg et al

in Acta Clinica Belgica (2013), 68(6), 2

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See detailComputer-based monitoring of global cardiovascular dynamics during acute pulmonary embolism and septic shock in swine
Revie, JA; Stevenson, D; Chase, JG et al

in Critical Care (2012), 16 (Suppl 1)

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See detailReliability and validity of a new french-language triage algorithm : the ELISA scale
JOBE, Jérôme ULg; Ghuysen, Alexandre ULg; GERARD, Paul et al

in Emergency Medicine Journal (2012)

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See detailCognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department?
Gillet, Aline ULg; GHUYSEN, Alexandre ULg; BONHOMME, Suzanne ULg et al

in European Journal of Emergency Medicine (2012)

AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then ... [more ▼]

AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling. RESULTS: Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. CONCLUSION: The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care. [less ▲]

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