RESUMO
OBJECTIVE: To evaluate the implementation of the checklist HAS 2010 in two Lorraine health facilities to identify objectively brakes and levers to suggest possible improvements. STUDY DESIGN: Descriptive survey. MATERIAL AND METHODS: Operating rooms of the Neurosciences building Central University Hospital, Nancy, Belle-Isle Hospital participating public hospital service, Metz. Two stages: a retrospective audit allowed to objectify quantitatively the presence of CL in the patient record and monitor compliance with the instructions of filling. A survey by self-administered questionnaire to professionals to assess the use of CL. RESULTS: CL was present in 50 % and 100 % records. The filling did not comply with instructions of the HAS (occupancy, three different times, time out before incision, stop the procedure if "no") and it was hard for about 30 % of participants, some items have problems of understanding. CL has strengthened information sharing about one third of respondents, over half of them are of interest, it has already helped to prevent errors. The deployment strategy influences directly the involvement of professionals. The evaluation of the use of CL cannot be done only through an audit record; the association with a self-administered questionnaire appears to be relevant. CONCLUSION: Good adhesion to the concept, hope for better results after stock enhancement: optimize information and training of all professionals, avoid duplication with other documents. The audit record alone is not a good tool for evaluating the use of LBC, we must associate a self-administered questionnaire.
Assuntos
Anestesia , Lista de Checagem/normas , Salas Cirúrgicas/normas , Gestão da Segurança/normas , Adulto , Idoso , Feminino , França , Fidelidade a Diretrizes , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
We present a case of pulmonary embolism which resulted from the migration of an oesophageal variceal sclerosing agent. Despite its frequency, this complication is rarely described in the literature.
Assuntos
Varizes Esofágicas e Gástricas/tratamento farmacológico , Extravasamento de Materiais Terapêuticos e Diagnósticos/etiologia , Embolia Pulmonar/induzido quimicamente , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Adulto , Autopsia , Extravasamento de Materiais Terapêuticos e Diagnósticos/complicações , Extravasamento de Materiais Terapêuticos e Diagnósticos/diagnóstico por imagem , Evolução Fatal , Feminino , Humanos , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico por imagem , Choque Séptico/etiologia , Tomografia Computadorizada por Raios XRESUMO
Spontaneous regression of disc herniation is well known but the mechanism is not clear. Some hypotheses have been made. We present here a large thoracic disc herniation diagnosed by MRI which completely regressed one year after a medical treatment with complete amendment of symptoms.