Bonne fête au Dr. Ricardo Michel (Médecin de Service)
Service d'Anesthesiologie et de Reanimation de l'Hopital de l'Universite d'Etat d'Haiti.
Articles
Marche silencieuse des médecins infirmières et étudiants contre la fermeture annoncée de l'HUEH demain à 9h am. Blouse blanche.
Suivez l'émission invités du jour sur Radio vision 2000 demain a 8h am. Médecins-Residents de l'HUEH vont parler des problèmes actuels de l'HUEH.
Sa ki soti nan reyinion avec MSPP jodia : MSPP di li vle pou fomasyon Rezidan , Entenn , eksten,MDS lopital jeneral la reprann pi vit posib (men Kibo??)
MSPP di gen 2 opsyon pou lopital jeneral : 1) Kraze l net epi voye tout pesonel la nan lot sant sante 2) Kraze epi rekonstwi an menm tan ke l'ap fonksyone (Li pa janm anvizaje pou li annik konstwi lopital la sou lot sit epi leu li fini yo t ap voye pesonel ladan li?)
MSPP di rekonstriksyon lopital la ap pran mwens tan ak lajan si yo femen l e rebati (Pouki yo pa jus bati l yon lot kote?)
MSPP vle voye Rezidan , Inten , Eksten ak MDS nan sant sante ki pa menm gen kote pou mete yo , ni ekipman.
Sa nou konprann : Grev la pa yon priyorite
Rekonstriksyon ap fet an bouyi vide
MSPP pa p reflechi ak kesyon fomasyon vreman.
Ce mercredi (24 août), les employés grévistes ont cadenassé les barrières principales de l’Hôpital de l’Université d’État d’Haïti (HUEH) où une grève du petit personnel sévit depuis plus d'un mois, a appris HPN. La grève qui sévit depuis près d’un mois et demi à l’Hôpital général semble prendre une autre tournure. le personnel continue de réclamer la démission du directeur général du plus grand centre de santé di pays. Les grévistes ont empêché mercredi, le directeur général de l’hôpital, Dr Alix Lassègue ainsi que l’administratrice de l’établissement, Marlène Thompson de se rendre à leurs bureaux. Ils ont fermé les barrières principales de l’institution. Une situation qui a créé une grande panique dans les parages de la rue Saint-honoré. Arrivées sur place, les forces anti-émeute de la Police Nationale d’Haïti (PNH), ont du faire usage de gaz lacrymogène afin de disperser les protestataires, visiblement en colère contre Mme Thompson et Dr Lassègue qu’ils reprochent de "ma
Vasopressin or antidiuretic hormone is a potent endogenous hormone, which is responsible for regulating plasma osmolality and volume. In high concentrations, it also raises blood pressure by inducing moderate vasoconstriction. It acts as a neurotransmitter in the brain to control circadian rhythm, thermoregulation and adrenocorticotropic hormone release. The therapeutic use of vasopressin has become increasingly important in the critical care environment in the management of cranial diabetes insipidus, bleeding abnormalities, esophageal variceal hemorrhage, asystolic cardiac arrest and septic shock. After 10 years of ongoing research, vasopressin has grown to a potential component as a vasopressor agent of the anesthesiologist's armamentarium in the treatment of cardiac arrest and severe shock states. Vasopressin: Its current role in anesthetic practice
Succinylcholine and rocuronium are widely used to facilitate rapid sequence induction (RSI) intubation in intensive care. Concerns relate to side effects of succinylcholine and to a slower onset and inferior intubation conditions associated with rocuronium. So far succinylcholine and rocuronium have not been compared in an adequately powered randomized trial in intensive care. Accordingly, the aim of the present study was to compare the incidence of hypoxemia after rocuronium or succinylcholine in critically ill patients requiring an emergent RSI. https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0B9_5O4o-ZNypMjY4NDcxOWYtNWIyOS00MTMyLTkwNDQtZjEyOTQwMGI4ZGYw&hl=en_US
Prevention of microemulsion propofol injection pain: a comparison of a combination of lidocaine and ramosetron with lidocaine or ramosetron alone
Background A microemulsion propofol causes a high incidence of pain during intravenous injection. In this study, we investigated the effect of ramosetron on pain induced by microemulsion propofol injection. Methods After prospective power analysis and institutional review board approval, a total of 200 ASA I and II patients undergoing general anesthesia were divided into 4 groups. They received one of the following intravenously after tourniquet application on the forearm 1 min before induction of anesthesia using microemulsion propofol; normal saline (Group N, n = 50), lidocaine 20 mg (Group L, n = 50), ramosetron 0.3 mg (Group R, n = 50) and lidocaine 20 mg plus ramosetron 0.3 mg (Group LR, n = 50) diluted into a 5 ml solution. The occlusion was released after 30 seconds and microemulsion propofol was injected over 10-15 seconds. The patients were observed and asked immediately if they had pain in the arm, and their responses were assessed. Results The incidence
Le Ketafol est une association de 2 drogues (Kétamine+Propofol) ayant un effet sédatif et analgésique. Vous voulez en savoir plus sur ce médicament? " La Sédation-Analgésie en situation d'urgence à l'HUEH" est la thèse de sortie (février 2011) du Dr. Myrlande Gabriel.
Efficacy of Small Doses of Ketamine With Morphine to Decrease Procedural Pain Responses During Open Wound Care
Objective: The purpose of this study was to evaluate differences in pain intensity, pain quality, physiological measures, and adverse effects when patients received morphine with saline (MS) compared with morphine and a small dose of ketamine (MK) before an open wound care procedure (WCP). Methods: A randomized, cross-over design was used to determine whether the addition of a small dose of ketamine would potentiate morphine's analgesic effects and decrease WCP pain intensity. Patients were randomized to receive either 0.1 mg/kg of morphine (8 mg maximum) plus saline intravenously (IV) or 0.05 mg/kg of morphine (4 mg maximum) plus ketamine 0.25 mg/kg IV before the WCP. Patients were crossed-over to receive the alternate treatment during the next WCP. Results: Eleven male patients participated in the study. Mean rank of pain intensity during WCP-MK was significantly less than during WCP-MS ( P =0.005). Mean±standard error of mean pain intensity during the WCP-MK was 3.09±0.99, wher
INFO-CHIR : La Revue Haitienne de Chirurgie Vol. 1 no. 2 Aout 2011
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La corporation chirurgicale a connu ces derniers jours, la perte de deux éminents représentants. Deux
chirurgiens exceptionnels qui ont eu à peu près le même parcours et qui ont collaboré pendant des années. Ils
paraissaient être ciselés dans le même bloc et partageaient les mêmes idéaux de grandeur. Je veux citer le
Dr. Boris Chandler qui est parti en Juillet dernier et le Dr Alix Adam récemment. Le monde médical,
particulièrement la collectivité des chirurgiens, saluent avec beaucoup d'émotion la mémoire de ces deux
hommes de coeur qui ont fait de leur vie professionnelle un sacerdoce avec une sublime abnégation. Info
CHIR à l’honneur de consacrer son deuxième numéro à la mémoire du Dr. Adam.
Après une formation post universitaire aux Etats-Unis, le Dr Alix Adam a prêté ses services plus
d'une vingtaine d'années à l'hôpital de l'Université d'Etat où il a gravi tous les échelons, de
Publication des résultats du concours d'admission à la résidence Hospitalière. A quand le choix des postes? Nous attendons impatiemment les nouveaux résidents du Service. D'avance nous leur disons: BIENVENUE :-) !!!
Postdural puncture headache (PDPH) has been a problem for patients, following dural puncture, since August Bier reported the first case in 1898. His paper discussed the pathophysiology of low–pressure headache resulting from leakage of cerebrospinal fluid (CSF) from the subarachnoid to the epidural space. Clinical and laboratory research over the last 30 years has shown that use of small–gauge needles, particularly of the pencil–point design, is associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke–point needle). A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high–risk patients , for example, age < 50 years, postpartum, large–gauge needle puncture, epidural blood patch should be performed within 24–48 h of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications of AEBP are rare.
Age is often the sole criterion for determining the need for preoperative electrocardiograms. However, screening electrocardiograms have not been shown to add value above clinical information. This study was designed to determine whether it is possible to target electrocardiograms ordering to patients most likely to have an abnormality that would affect management and if age alone is predictive of significant electrocardiograms abnormalities. Methods: A list was developed of electrocardiograms abnormalities considered significant enough to impact management, as well as a list of patient factors believed to increase cardiovascular risk. electrocardiograms in all patients over 50 yr of age presenting for preoperative evaluation during a 2-month period were reviewed. Results: A total of 1,149 electrocardiograms were reviewed, with 89 patients (7.8%) having at least one significant abnormality. These patients were compared with a group of 195 patients who had electroca