ABSTRACT
Background: Communication improvement and family satisfaction in intensive care unit (ICU) are the main indicators of care quality. Our study aims were to evaluate family satisfaction in our intensive care and identify factors influencing the satisfaction level. Materials and methods: We performed a descriptive prospective study in the ICU of Ben Arous régional hospital conducted between October 2016 and June 2018. We included parents of patients hospitalized for more than 48 hours, with available contact details and they agreed to reply to the questionnaire. Results: One hundred and twelve family representatives were included. Ten (9%) were illiterate and 40 (36%) had a primary level education. Noninvasive ventilation and hemodialysis were, respectively, used in 53 and 9.8% of cases. Thirteen patients had sequelae at their hospital discharge. The median satisfaction score was 133.5 (120; 145.7). Ninety-five (85%) relatives were always satisfied with cleanliness of the unit. The medical and paramedical staff availability was appreciated as excellent, respectively, by 65 (56%) and 66 (59%) family members. The information provided by doctors and paramedical staff was considered very clear by 75 (65%) and 65 (58%) parents, respectively. The medical secret was respected by medical (n = 107) and paramedical (n = 105) staffs in most cases. Patient management was considered excellent by 90 (80%) parents. The level of satisfaction was lower when the parent interviewed was illiterate (p = 0.04) or had a primary-level education (p = 0.012), with hemodialysis resort (p = 0.011) and with the presence of sequelae at hospital discharge (p = 0.017). Conclusion: Family members were satisfied with the unit environment, the communication, the healthcare management, and the patient care. Low education level, hemodialysis use, and sequelae at hospital discharge influence negatively the satisfaction. How to cite this article: Fathallah I, Drira H, Habacha S, Kouraichi N. Can We Satisfy Family in Intensive Care Unit? A Tunisian Experience. Indian J Crit Care Med 2022;26(2):185-191.
ABSTRACT
BACKGROUND: Cardiac arrest (CA) is a public health problem, with various etiologies and a fatal issue in 90-95% of cases. Toxin-induced cardiac arrests (TICA) are poorly described. Scarcity of national data prompted us to carry-out this study. AIM: To determine TICA frequency in a Tunisian reference center in toxicology and its hospital prognosis, and to describe its clinical and therapeutic aspects Methods : Data were collected retrospectively over an 8-years period. We included patients admitted for post-CA care with highly suspected or confirmed TICA. Clinical and toxicological data were recorded. RESULTS: We recorded 21 cases of TICA, which represented 48.8% of CA. A single toxic agent was incriminated in 90% of cases. Main causative agents identified in our series were pesticides and betablockers: chloralosed (n = 6), carbamate inhibitor of cholinesterase (n = 5), acebutolol (n = 4) and organophosphate (n = 2). One case of opiates and cocaine poisoning was reported. Median duration of "no flow" was 0 minutes. Mean duration of "low flow" was 13.74±9.15 minutes. An initial shockable rhythm was noted only in three patients. Mortality rate was 76% (16/21). Four of the five survivors had a Cerebral Performance Category Scale (CPC) 1, only one patient survived with a CPC 3. Factors associated with mortality were : the duration of "low flow" (p=0.02) and APACHE II score (p=0.014). APACHE II≥29 was the only independent factor (OR=2.0, 95%CI [1.07;3.71]). CONCLUSION: TICA were most frequently provoked by pesticides, mortality was high and was independently predicted by APACHE II score.
