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Author: Nicolas Lerolle
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Le vieillissement de la population entraine une élévation du nombre de patients âgés admis en réanimation. L'impact de ce changement sur la charge en soin est mal connue. Cette étude rétrospective et observationelle porte sur les 2220 patients admis en réanimation médicale du CHU d'Angers entre le 1er janvier 2009 et le 31 décembre 2012. Nous avons analysé la charge en soin nécessaire pour permettre la survie d'un patient, en fonction de l' âge (moins de 75 ans et 75 ans et plus), de la gravité initiale (score IGSII délesté des points liés à l'âge) et du motif principal de recours à la réanimation. Pour ce faire, nous avons crée un indicateur de charge en soin par survivant, dénomé Omega/s en divisant la somme des points Omega (score de charge en soins) des patients par le nombre de survivants. Les patients âgés représentaient 26% des admissions, ils présentaient une surmortalité dans l'ensemble des catégories diagnostiques. L'IGSII à l'entrée était plus élevé et la durée de séjour plus longue. L'Omega/s des patients âgés était plus élevé de 22%. Néanmoins, la différence d'Omega /s s'amenuisait à mesure que la gravité initiale augmentait et n'était plus significative au delà d'un IGSII supérieur à 59. C'est principalement la surmortalité qui expliquait cette différence. Par ailleurs, aucune catégorie diagnostique ne présentait de différence d'Omega/s très marqué entre les 2 groupes d'âge. En conclusion, plus de soins de réanimation sont nécessaires pour permettre la survie d'un patient âgé, mais cette surcharge est surtout le fait des patients les moins graves.
Author: Nicolas Lerolle
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Le vieillissement de la population entraine une élévation du nombre de patients âgés admis en réanimation. L'impact de ce changement sur la charge en soin est mal connue. Cette étude rétrospective et observationelle porte sur les 2220 patients admis en réanimation médicale du CHU d'Angers entre le 1er janvier 2009 et le 31 décembre 2012. Nous avons analysé la charge en soin nécessaire pour permettre la survie d'un patient, en fonction de l' âge (moins de 75 ans et 75 ans et plus), de la gravité initiale (score IGSII délesté des points liés à l'âge) et du motif principal de recours à la réanimation. Pour ce faire, nous avons crée un indicateur de charge en soin par survivant, dénomé Omega/s en divisant la somme des points Omega (score de charge en soins) des patients par le nombre de survivants. Les patients âgés représentaient 26% des admissions, ils présentaient une surmortalité dans l'ensemble des catégories diagnostiques. L'IGSII à l'entrée était plus élevé et la durée de séjour plus longue. L'Omega/s des patients âgés était plus élevé de 22%. Néanmoins, la différence d'Omega /s s'amenuisait à mesure que la gravité initiale augmentait et n'était plus significative au delà d'un IGSII supérieur à 59. C'est principalement la surmortalité qui expliquait cette différence. Par ailleurs, aucune catégorie diagnostique ne présentait de différence d'Omega/s très marqué entre les 2 groupes d'âge. En conclusion, plus de soins de réanimation sont nécessaires pour permettre la survie d'un patient âgé, mais cette surcharge est surtout le fait des patients les moins graves.
Author: NAEMT,
Publisher: Jones & Bartlett Learning
ISBN: 1284187160
Category : Medical
Languages : en
Pages : 745
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Book Description
PHTLS Secours et soins préhospitaliers aux traumatisés, Huitième Édition est le programme mondial d'éducation de traumatologie et préhospitalière éprouvé le plus important de la NAEMT.
Author: Alessandro Falassi
Publisher: Scholarly Title
ISBN:
Category : Social Science
Languages : en
Pages : 472
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Book Description
Author: Timothy Devos
Publisher: Springer Nature
ISBN: 3030567958
Category : Medical
Languages : en
Pages : 110
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Book Description
This open access book has been written by ten Belgian health care professionals, nurses, university professors and doctors specializing in palliative care and ethicists who, together, raise questions concerning the practice of euthanasia. They share their experiences and reflections born out of their confrontation with requests for euthanasia and end-of-life support in a country where euthanasia has been decriminalized since 2002 and is now becoming a trivial topic.Far from evoking any militancy, these stories of life and death present the other side of a reality needs to be evaluated more rigorously.Featuring multidisciplinary perspectives, this though-provoking and original book is intended not only for caregivers but also for anyone who questions the meaning of death and suffering, as well as the impact of a law passed in 2002. Presenting real-world cases and experiences, it highlights the complexity of situations and the consequences of the euthanasia law.This book appeals to palliative care providers, hematologists, oncologists, psychiatrists, nurses and health professionals as well as researchers, academics, policy-makers, and social scientists working in health care. It is also a unique resource for those in countries where the decriminalization of euthanasia is being considered. Sometimes shocking, it focuses on facts and lived experiences to challenge readers and offer insights into euthanasia in Belgium.
Author: Atul Gawande
Publisher: Metropolitan Books
ISBN: 1429953381
Category : Medical
Languages : en
Pages : 225
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Book Description
The New York Times bestselling author of Being Mortal and Complications reveals the surprising power of the ordinary checklist We live in a world of great and increasing complexity, where even the most expert professionals struggle to master the tasks they face. Longer training, ever more advanced technologies—neither seems to prevent grievous errors. But in a hopeful turn, acclaimed surgeon and writer Atul Gawande finds a remedy in the humblest and simplest of techniques: the checklist. First introduced decades ago by the U.S. Air Force, checklists have enabled pilots to fly aircraft of mind-boggling sophistication. Now innovative checklists are being adopted in hospitals around the world, helping doctors and nurses respond to everything from flu epidemics to avalanches. Even in the immensely complex world of surgery, a simple ninety-second variant has cut the rate of fatalities by more than a third. In riveting stories, Gawande takes us from Austria, where an emergency checklist saved a drowning victim who had spent half an hour underwater, to Michigan, where a cleanliness checklist in intensive care units virtually eliminated a type of deadly hospital infection. He explains how checklists actually work to prompt striking and immediate improvements. And he follows the checklist revolution into fields well beyond medicine, from disaster response to investment banking, skyscraper construction, and businesses of all kinds. An intellectual adventure in which lives are lost and saved and one simple idea makes a tremendous difference, The Checklist Manifesto is essential reading for anyone working to get things right.
Author: National Research Council
Publisher: National Academies Press
ISBN: 0309154006
Category : Science
Languages : en
Pages : 246
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Book Description
A respected resource for decades, the Guide for the Care and Use of Laboratory Animals has been updated by a committee of experts, taking into consideration input from the scientific and laboratory animal communities and the public at large. The Guide incorporates new scientific information on common laboratory animals, including aquatic species, and includes extensive references. It is organized around major components of animal use: Key concepts of animal care and use. The Guide sets the framework for the humane care and use of laboratory animals. Animal care and use program. The Guide discusses the concept of a broad Program of Animal Care and Use, including roles and responsibilities of the Institutional Official, Attending Veterinarian and the Institutional Animal Care and Use Committee. Animal environment, husbandry, and management. A chapter on this topic is now divided into sections on terrestrial and aquatic animals and provides recommendations for housing and environment, husbandry, behavioral and population management, and more. Veterinary care. The Guide discusses veterinary care and the responsibilities of the Attending Veterinarian. It includes recommendations on animal procurement and transportation, preventive medicine (including animal biosecurity), and clinical care and management. The Guide addresses distress and pain recognition and relief, and issues surrounding euthanasia. Physical plant. The Guide identifies design issues, providing construction guidelines for functional areas; considerations such as drainage, vibration and noise control, and environmental monitoring; and specialized facilities for animal housing and research needs. The Guide for the Care and Use of Laboratory Animals provides a framework for the judgments required in the management of animal facilities. This updated and expanded resource of proven value will be important to scientists and researchers, veterinarians, animal care personnel, facilities managers, institutional administrators, policy makers involved in research issues, and animal welfare advocates.
Author: Helen Stanton Chapple
Publisher: Left Coast Press
ISBN: 1598744038
Category : Medical
Languages : en
Pages : 326
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Book Description
This book shows how dying is a management problem for hospitals, occupying space but few billable encounters and of little interest to medical practice or quality control. An anthropologist and bioethicist with two decades of professional nursing experience, Helen Chapple goes beyond current work on hospital care to present fine-grained accounts of the clinicians, patients, and families who navigate this uncharted, untidy, and unpredictable territory between the highly choreographed project of rescue and the clinical culmination of death.
Author: Paolo Falaschi
Publisher: Springer Nature
ISBN: 3030481263
Category : Anesthesiology
Languages : en
Pages : 355
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Book Description
This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.
Author: Carol Sue Carter
Publisher: MIT Press
ISBN: 0262033488
Category : Medical
Languages : en
Pages : 509
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Book Description
Scientists from different disciplines, including anthropology, psychology, psychiatry, pediatrics, neurobiology, endocrinology, and molecular biology, explore the concepts of attachment and bonding from varying scientific perspectives.
Author: Gin S. Malhi
Publisher: Springer
ISBN: 3319459236
Category : Medical
Languages : en
Pages : 345
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Book Description
This book provides a clear and comprehensive guide to the clinical prescription of lithium that draws upon evidence-based knowledge of its mechanisms of action. The book is divided into two parts, on the science of lithium and the practice of lithium therapy. The former covers aspects such as the properties of the lithium ion, pharmacokinetics and pharmacodynamics, impact on neurotransmission, and gene expression modulation. The section on practice includes discussion of variability in response to lithium, use of lithium in the treatment of bipolar disorders, its value in suicide prevention, administration during pregnancy and in the pediatric age group, and side effects. Lithium is arguably the only true mood stabilizer, and its multifaceted effects across many clinical domains have given rise to a resurgence of interest in recent years, fuelled by both researchers and clinicians. Nevertheless, its use remains constrained by exaggerated concerns about potential side-effects. In reality, lithium is a simple molecule that is relatively straightforward to administer and monitor and has potentially profound benefits at a fraction of the cost of contemporary agents. This book dispels the many myths and concerns that surround its use and will be of interest for clinicians and researchers worldwide, and those that are recipients of lithium therapy.
