Les événements indésirables dans les soins de santé hospitaliers: une situation complexe améliorable par un support électronique?
BASSLEER, Bernard ; DELGAUDINE, Marie ; BODSON, Lucien
Conference (2014, July)
Développer un système de gestion de la sécurité et augmenter la culture de sécurité en milieu hospitalier sont des objectifs essentiels dans des systèmes complexes et dynamiques. Après avoir passé en ... [more ▼]
Développer un système de gestion de la sécurité et augmenter la culture de sécurité en milieu hospitalier sont des objectifs essentiels dans des systèmes complexes et dynamiques. Après avoir passé en revue les mécanismes et la prévention des événements indésirables, nous proposons une réflexion sur une approche complémentaire pour le choix d’un outil capable de s’intégrer dans le quotidien des soins. Dans un esprit Safety-II, l’effort se porte vers une élévation des connaissances mais aussi des compétences pour que les tâches et donc les processus soient exécutés avec facilité et sans erreur. [less ▲]Detailed reference viewed: 32 (3 ULg)
A-t-on evalue l'interet du SAMU?
Bodson, Lucien ; ; Micheels, Jean et al
in Revue Médicale de Liège (2006), 61(5-6, May-Jun), 494-9
Recent international guidelines about emergency situations (ILCOR / ERC) pointed to the need of the whole "chain of survival". ALS, Advanced Life Support (the last and "medical" part of the chain ) is ... [more ▼]
Recent international guidelines about emergency situations (ILCOR / ERC) pointed to the need of the whole "chain of survival". ALS, Advanced Life Support (the last and "medical" part of the chain ) is important and influences survival rate. If no doubt exists about "what" and "when" to do in such situations, there is no consensus in industrialized countries about "who" should be in charge of such out-of-hospital acute diagnosis and treatment: emergency physicians, emergency nurses, emergency medical technicians (EMT), other "new" professionals ? ... A description of the MICU system in Belgium is given. [less ▲]Detailed reference viewed: 65 (3 ULg)
Biochemical changes in patients at risk from the adult respiratory distress syndrome: does the pancreas play a role?
Lamy, Maurice ; Faymonville, Marie ; et al
in Kox, W.; Bihari, D. (Eds.) Current concepts in critical care - Shock and the adult respiratory distress syndrome (1988)Detailed reference viewed: 10 (1 ULg)
Thromboxane and prostacyclin release in adult respiratory distress syndrome
Deby, Ginette ; ; Lamy, Maurice et al
in Intensive Care Medicine (1987), 13Detailed reference viewed: 13 (2 ULg)
Biochemical investigations after burning injury: complement system, protease-antiprotease balance and acute-phase reactants.
Faymonville, Marie ; Micheels, Jean ; Bodson, Lucien et al
in Burns (1987), 13(1), 26-33
Seventeen burned patients were investigated--Group I (n=10) with a mean burned area expressed as unit burn standard (UBS) of 69 +/- 24 and Group II (n = 7) with a mean UBS of 23 +/- 8. Blood samples were ... [more ▼]
Seventeen burned patients were investigated--Group I (n=10) with a mean burned area expressed as unit burn standard (UBS) of 69 +/- 24 and Group II (n = 7) with a mean UBS of 23 +/- 8. Blood samples were collected immediately after admission, 6-12 h after injury, during the morning and evening of day 1, and then daily for 2 weeks. This prospective study demonstrated complement activation in vivo in all burned patients, measured by C3d/C3 ratio index which was not related to the extent of the burned surface. A significant protease-antiprotease imbalance, correlated to the severity of burns, was found, leukocyte elastase was increased throughout the observation period, alpha 2-macroglobulin drastically decreased in severely burned patients, and alpha 1-proteinase inhibitor promptly decreased below the normal level in patients with more than 40 UBS. Finally, there was a delayed but then persistent acute-phase reactant protein response involving C-reactive protein, haptoglobin and alpha 1-acid glycoprotein, the concentrations of which reached a plateau on days 6 or 7. [less ▲]Detailed reference viewed: 67 (3 ULg)
Prostaglandin E2, prostacyclin, and thromboxane changes during nonpulsatile cardiopulmonary bypass in humans.
Faymonville, Marie ; Deby, Ginette ; Larbuisson, Robert et al
in Journal of Thoracic and Cardiovascular Surgery (The) (1986), 91(6), 858-66
To study the effect of lung bypass on the production of prostaglandin E2, prostacyclin, and thromboxane A2, we measured simultaneously arterial and venous plasma concentrations of prostaglandin E2, 6-keto ... [more ▼]
To study the effect of lung bypass on the production of prostaglandin E2, prostacyclin, and thromboxane A2, we measured simultaneously arterial and venous plasma concentrations of prostaglandin E2, 6-keto-prostaglandin F1 alpha (stable metabolite of prostacyclin), and thromboxane B2 (stable metabolite of thromboxane A2) before, during, and after cardiopulmonary bypass. Seventeen patients (age range 46 to 69 years) undergoing aorta-coronary bypass grafts were investigated. The prostaglandin E2 production rose sharply immediately after the onset of bypass (baseline: 9.7 +/- 2.9 pg/ml to 85 +/- 16.6 pg/ml in venous and 87 +/- 12 pg/ml in arterial plasma, p less than 0.03) and rapidly decreased after pulmonary reperfusion (53 +/- 6.4 and 57 +/- 20 pg/ml, respectively, in venous and arterial plasma at the end of bypass). The increase in prostaglandin E2 was influenced by the heart-lung machine itself (as demonstrated by a closed "bypass" circuit) and by lung bypass. Pulmonary metabolism of prostaglandin E2 was maintained after bypass. The prostacyclin production rose significantly at the beginning of bypass (154 +/- 26 pg/ml venous prebypass level to 361 +/- 94 pg/ml after aortic clamping, p less than 0.03). Prostacyclin decreased progressively during rewarming of the patient, pulmonary reperfusion, and discontinuation of bypass. When prostacyclin decreased, thromboxane B2 production rose significantly and reached peak arterial levels when the lungs were reperfused (112 +/- 33 pg/ml prebypass levels to 402 +/- 101 pg/ml, p less than 0.01). Except for prostaglandin E2, there were no significant differences between arterial and venous plasma levels of these substances. The same prostanoids were also measured in five patients undergoing major orthopedic operations, and no significant changes in prostanoids were observed. Our data demonstrate significant production of prostaglandin E2 in the systemic circulation during cardiopulmonary bypass in humans. They further indicate that lung bypass disturbs the plasma prostaglandin/thromboxane balance. [less ▲]Detailed reference viewed: 47 (5 ULg)
Changes in cerebrospinal fluid enzyme activity after severe head injury. Diagnostic and prognostic values.
Hans, Pol ; ; Chapelle, Jean-Paul et al
in Acta Anaesthesiologica Belgica (1984), 35(1), 79-86
We studied CSF CK and LDH isoenzyme activities in 27 patients with severe head injury and in 10 patients with chronic hydrocephalus not related to trauma. CSF enzymes showed an increased activity ... [more ▼]
We studied CSF CK and LDH isoenzyme activities in 27 patients with severe head injury and in 10 patients with chronic hydrocephalus not related to trauma. CSF enzymes showed an increased activity immediately after trauma, contrasting with the low values measured in the patients with hydrocephalus. In severe head injury, we found a correlation between enzyme release and brain dysfunction assessed according to two methods: the Glasgow coma scale (GCS), and the Liege coma scale (LCS) which uses elements of the GCS and the study of 5 brain stem reflexes. The correlation between enzyme activity and the Liege coma scores is better than that observed with the Glasgow coma scores. High enzyme activity is associated with a bad outcome at six months. It has a prognostic value on so far as it reflects the severity of traumatic structural brain damage. [less ▲]Detailed reference viewed: 16 (0 ULg)