[Assessment of Teleconsultation for planned orthopaedic surgery]. / Faisabilité d'une téléconsultation d'anesthésie en chirurgie orthopédique programmée.

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.

[Influenza incidence estimated with a rapid diagnostic test in critically ill patients with acute respiratory failure during the 2005 and 2006 winter flu epidemics]. / Incidence de la grippe estimée par un test de diagnostic rapide chez les patients hospitalisés en réanimation pour détresse respiratoire aiguë en période d'épidémie grippale durant les hivers 2005 et 2006.

OBJECTIVE: To estimate the incidence of influenza infection with a rapid diagnostic test in patients hospitalized in an intensive care unit (ICU) during the epidemic periods of two consecutive winters (2005-2006). METHODS: This study tested nasal aspirate of all patients admitted to the ICU for acute respiratory failure during the influenza epidemic period with the QuickVue influenza rapid diagnostic test. RESULTS: The study included 39 patients: 22 men and 17 women. Their mean age was 69.7+/-13 years, their mean SAPS II score 54+/-21, their mean length of stay 14.7+/-20 days, and 43.5% had been vaccinated against influenza. The mortality rate was 33.3% (n=13). Four patients (10.2%) had a positive QuickVue test and were considered to have influenza associated with their primary diagnosis: pneumococcal pneumonia, haemophilus pneumonia, acute bronchitis, and acute bronchitis with acute cardiogenic edema. These patients were older than those with a negative test (80+/-7 versus 68+/-13 years, p=0.02). Their SAPS II, length of stay and mortality rate did not differ statistically from those with negative results. Chronic heart failure (but not COPD or non-vaccination) was more frequent in these patients (p=0.01). DISCUSSION: Several published studies report a satisfactory specificity and sensitivity for QuickVue. With this test, we estimated the incidence of influenza in patients hospitalized in our ICU for acute respiratory failure during flu epidemics at around 10%, close to that reported in previous studies.