RESUMEN
The Covid-19 pandemic has taken its toll on health care teams faced with deaths and hospital overcrowding. Some caregivers suffered from vicarious trauma. Analyzing the impact of this trauma, its inclusion in a context of tension, fatigue and increased lassitude, is imperative in order to propose adjusted care. Eye Movement Desensitization and Reprocessing therapy seems to have a relevant place in this context.
Asunto(s)
COVID-19 , Humanos , Cuidadores , Pandemias , Hospitales , Grupo de Atención al PacienteRESUMEN
Care requires the full attention of caregivers, particularly in emergencies, where it consumes energy and generates emotions. To be efficient and to remain so, we must know how to manage our stress with full awareness. The culture of quality in the aeronautics industry teaches us to adjust the right tension over time, individually or as a team, on a daily basis as well as in times of crisis. The management of a patient in a critical somatic or psychological situation has strong similarities with the aeronautical crisis management model, which allows us to draw inspiration from it.
Asunto(s)
Cuidados Críticos , Emociones , HumanosRESUMEN
Damage Control Resuscitation (DCR) is a strategy designed to prioritize hemostasis procedures, from the point of injury to surgical management, whether faced with an influx of bleeding casualties or a single casualty with severe hemodynamic instability. Widely disseminated, it provides clear objectives for prioritizing physiological restoration to the anatomy required for short-term survival. Initially applied to surgery, DCR has now been extended to the entire upstream care chain, including first aid and emergency medicine.
Asunto(s)
Servicio de Urgencia en Hospital , Hospitales , Humanos , Resucitación/métodosRESUMEN
Two-thirds of ballistic injuries result in severe limb damage. Damage Control Orthopaedic is a surgical strategy that makes it possible to save life, limb and function using simple mnemonic markers: 5minutes, 6hours, 7 days, 8 weeks and 9 months. The many players involved in this coherent care pathway, with its multiple surgical challenges, help to meet the challenge of comprehensive rehabilitation for orthopaedic ballistic injuries.
RESUMEN
Ballistic injuries are disabling. Its functional impact is determined by its trajectory. Whether the injury affects a limb that could jeopardize its preservation, visceral lesions or craniocerebral and vertebro-medullary wounds, the nurse is at the heart of multidisciplinary care to limit and compensate for the after-effects. Directed healing, appropriate analgesia, settling in, technical training for this new, modified body (stoma, self-catheterization, appliances, etc.) and support in accepting the injury are all part of the nurse's role in helping the injured person rebuild his or her life.
Asunto(s)
Rol de la Enfermera , Heridas por Arma de Fuego , Heridas Penetrantes , Femenino , Humanos , Masculino , Balística Forense , Heridas por Arma de Fuego/enfermería , Heridas por Arma de Fuego/rehabilitación , Heridas Penetrantes/enfermería , Heridas Penetrantes/rehabilitaciónRESUMEN
Mobile emergency and resuscitation teams are confronted with death on a daily basis. In the home, the management of a death is complex. It raises ethical questions and sometimes destabilizes personal or collective values. Our single-center qualitative survey, conducted over a one-month period (2022), questioned 64/154 caregivers about the moral burden and challenges of such situations. The consequences of operational experience are discussed: time, fatigue, emotions and training. The quality of presence is an alternative to the success or failure of cardiac arrest care at home.
Asunto(s)
Paro Cardíaco , Medicina Hospitalar , Humanos , Paro Cardíaco/terapia , Cuidadores , Resucitación , MuerteRESUMEN
The profession of operating theater nurse in the French Armed Forces Medical Corps is often little-known. Called upon to serve in mainland France, but also deployed on overseas operations, they provide medical and surgical support to the French armed forces. Personal qualities - human, physical and technical - are essential to adapt to the environmental constraints of this isolated post.
Asunto(s)
Personal Militar , Humanos , FranciaRESUMEN
Allergy, anaphylaxis and adrenaline are three closely related terms in medicine. Upon identification or suspicion of anaphylaxis, adrenaline should be administered as soon as possible. An allergy can be characterised by anything from a simple skin rash to severe vital parameter abnormalities. The role of the reception nurse will be first to identify clinically relevant features, to assign the right level of triage to the patient and adjust the care pathway.
Asunto(s)
Anafilaxia , Anafilaxia/diagnóstico , Epinefrina/uso terapéutico , Humanos , TriajeRESUMEN
Non-allergic angioedema has a worrying morbidity. Clinical examination is central, as C1-esterase inhibitor deficiency will not be documented in the acute phase. In the case of anaphylaxis that does not respond to adrenaline, an early diagnosis can optimise referral of the patient to a reference healthcare establishment for a specific therapeutic protocol (icatibant, C1 inhibitor) recently updated by recommendations.
Asunto(s)
Anafilaxia , Angioedema , Angioedemas Hereditarios , Anafilaxia/diagnóstico , Anafilaxia/terapia , Angioedema/tratamiento farmacológico , Angioedema/terapia , Angioedemas Hereditarios/diagnóstico , Angioedemas Hereditarios/tratamiento farmacológico , Epinefrina/uso terapéutico , Esterasas/uso terapéutico , HumanosRESUMEN
Many emergency patients have pre-existing psychiatric conditions. They may also present a symptomatology likely to evoke this type of psychiatric pathology. The way in which these patients are received and managed is of prime importance, as it determines the subsequent treatment. It is therefore essential that the emergency services organise a specific pathway for these patients.
Asunto(s)
Servicio de Urgencia en Hospital , Trastornos Mentales , HumanosRESUMEN
The pharmacological management of patients with psychiatric presentations, on prescription, and by nurses in emergency medicine structures is based on knowledge of a limited number of molecules and their methods of administration. This is accompanied by a relational approach and techniques to ensure the safety of the teams in the case of an agitated or very resistant patient.
Asunto(s)
Servicio de Urgencia en Hospital , Agitación Psicomotora , Adulto , HumanosRESUMEN
In the particular case of exceptional health situations involving multiple victims or not, the early psychiatric care of patients affected, directly or not, relies on the medical-psychological emergency cells (Cump). The organisation of these units is based on ministerial instructions. The indications for recourse to the Cump as well as the method of triggering it are based on recommendations established by French learned societies.
Asunto(s)
Servicio de Urgencia en Hospital , Psicoterapia , Francia , HumanosRESUMEN
With the traumatic event, the victim has suffered and fallen into a world of horror, violence and chaos. Emergency first aid is intended to give him a sign, to reach out to him so that the victim can return to the shore of the living world. The duality of technical and psychological first aid is necessary for the immediate and post-medical management of these highly traumatic interventions. These are important points of reference for the future of the subject as well as for the carer in the management of his individual or team stress.
Asunto(s)
Trastornos por Estrés Postraumático , Servicio de Urgencia en Hospital , HumanosRESUMEN
During an event with a high traumatic potential, the patient, as well as the first intervener in the care process, will resonate with his or her own intimate life experience and that of the other person. This happens in the reality of experiences, but also in the constructed projections. These stress-related phenomena must be widely known and taught, in order to increase the capacity to respond and adjust to these individual and collective crisis situations. This guarantees the physical and psychological health of the people involved.
Asunto(s)
Acontecimientos que Cambian la Vida , Femenino , Humanos , MasculinoRESUMEN
The care and referral of patients with psychiatric conditions is a perilous process. It combines the need for care with respect for individual freedom. Knowledge of the different legal frameworks is thus necessary for psychiatric care at the request of a third party, care without request of a third party within the framework of a procedure for imminent danger, and finally for the injunction of psychiatric care on the decision of a State representative. These are necessary prerequisites for practising in an emergency structure.
Asunto(s)
Servicios Médicos de Urgencia , Trastornos Mentales , Internamiento Obligatorio del Enfermo Mental , Humanos , Psicoterapia , Derivación y ConsultaRESUMEN
The care of patients, especially in the field of agitation or psychiatry, requires close coordination between different actors. Interdisciplinarity makes it possible to analyse and harmonise the links between various disciplines with the common aim of solving complex problems. This interdisciplinarity must now become a fundamental in the teaching of health sciences and a prerequisite for the functioning of hospital services, in particular in the formalisation of acute care pathways.
Asunto(s)
Psiquiatría , Servicio de Urgencia en Hospital , Humanos , PsicoterapiaRESUMEN
The pre-hospital care process of a patient presenting a psychiatric emergency involves many pre-hospital and hospital personnel. Identifying such high-risk situations, allowing an initial approach that is adjusted and authorises care are often very delicate moments. An adapted management, concerted within a network, allows the safety of the patient, his entourage and the interveners. These situations are characterised by their polymorphism with major constants: training, anticipation and knowledge of organisations.
Asunto(s)
Servicio de Urgencia en Hospital , Servicios de Urgencia Psiquiátrica , Humanos , Personal de Hospital/educaciónRESUMEN
In March 2020, Covid-19, caused by the severe acute respiratory syndrome coronavirus 2, struck the Haut-Rhin region with extreme violence, overwhelming hospitals and requiring the massive opening of new resuscitation beds. The military resuscitation element of the French military health service was deployed for the first time in Mulhouse (68), in eastern France. Alsace-Lorraine, a European crossroads and the birthplace of European institutions, was once again at the heart of history. Perspectives.
Asunto(s)
COVID-19 , Personal Militar , Europa (Continente) , Francia , Humanos , SARS-CoV-2RESUMEN
Observation, interpretation, actions for improvement, questioning are all terms that echo the situation of caregivers since the outbreak of the COVID-19 epidemic in France at the beginning of 2020. All those involved in the healthcare chain have had to cope with the influx of patients and to show that they are capable of seeing their practices evolve on a daily basis. What was recommended a few weeks earlier could quickly become obsolete. It was necessary to be reactive and the question of drug treatments was at the heart of the concerns, requiring prescribers to keep themselves informed and pharmacists to be as mobilized as possible to respond to requests from the field as quickly as possible.
Asunto(s)
Tratamiento Farmacológico de COVID-19 , COVID-19 , Servicio de Farmacia en Hospital , COVID-19/epidemiología , Cuidadores/psicología , Francia/epidemiología , Humanos , Servicio de Farmacia en Hospital/organización & administraciónRESUMEN
Coagulopathy, acidosis and hypothermia form the lethal triad in trauma patients with acute hemorrhage. The prevention of this chain reaction relies on an adapted management from the first care in pre-hospital situation: rapid arrest of bleeding, fight against hypothermia, limited vascular filling with an early recourse to vasoactive amines. Pre-hospital transfusion is still rare, whereas in the hospital, an adapted transfusion strategy can wait for or support a surgical or radiological hemostasis procedure.