ABSTRACT
Résumé La téléconsultation d’anesthésie est autorisée pour tous les patients et toutes les chirurgies et remboursée par l’assurance maladie. Le système se doit de préserver la confidentialité des échanges. La consultation fait l’objet d’un compte rendu inclus dans le dossier médical du patient. Son coût économique est inférieur et son bilan carbone est moindre que celui d’une consultation présentielle. La consultation d’anesthésie repose pour une grande partie sur l’interrogatoire qui est réalisable à distance. Une teleconsultation peut se transfomer en convocation présentielle si un examen physique semble nécéssaire ou recourir à un autre avis spécialisé ( ex: cardiologue). Summary The teleconsultation is cost saving and reduces carbon footprint. It allows acceptable evaluation of preoperative patients scheduled for anaesthesia. It is reimbursed by the national insurance system. Preservation of confidentiality is required. A report of the conclusions in the patient’ medical file is mandatory. Physical examination is not possible but can be done on hospital admission and complementary investigations commonly provide more information about the patient’ medical status. Thanks to COVID pandemic, there is an opportunity to promote teleconsultation before surgery.
ABSTRACT
The COVID-19 pandemic has motivated the development of teleconsultation in anaesthesia. We have conducted a single centre prospective study in patients scheduled for planned orthopaedic surgery during 9 weeks between may and july 2020 to assess its practicability. The quality of the consultation and patients' satisfaction, were evaluated during this period. The teleconsultation was successful in 90% of the patients without the need of attendance to the hospital for assessment before anaesthesia. The process was satisfactory for 97% of these patients. The mean duration was 15 minutes. The support of a third party was required in 46% of patients older than 65 years. The main cause of failure was the poor quality of the connection. Only two patients were cancelled for surgery because they did not understand fasting rule. The teleconsultation is now an integral part of preoperative assessment of patients for anaesthesia with good practicability and reliability.
ABSTRACT
OBJECTIVES: The world is currently facing an unprecedented healthcare crisis caused by the COVID-19 pandemic. The objective of these guidelines is to produce a framework to facilitate the partial and gradual resumption of intervention activity in the context of the COVID-19 pandemic. METHODS: The group has endeavoured to produce a minimum number of recommendations to highlight the strengths to be retained in the 7 predefined areas: (1) protection of staff and patients; (2) benefit/risk and patient information; (3) preoperative assessment and decision on intervention; (4) modalities of the preanaesthesia consultation; (5) specificity of anaesthesia and analgesia; (6) dedicated circuits and (7) containment exit type of interventions. RESULTS: The SFAR Guideline panel provides 51 statements on anaesthesia management in the context of COVID-19 pandemic. After one round of discussion and various amendments, a strong agreement was reached for 100% of the recommendations and algorithms. CONCLUSION: We present suggestions for how the risk of transmission by and to anaesthetists can be minimised and how personal protective equipment policies relate to COVID-19 pandemic context.