F Fouladvand | PubMed Health

PubMed2002

[Integrated clinical record: unique document for diverse uses].

Technological and scientific development and changes in the health system have led to modifications and greater complexity in health documents and clinical records, without there being at the same time definition of guidelines on their correct compilation and formulation. The present study was designed to develop a single Integrated Clinical Record that combines, on the one hand, data of all medical, nursing and technical interventions and, on the other, involves the patient in all decisional processes of diagnosis and treatment during the hospitalization period. All phases of the project related to development of the Integrated Clinical Record are discussed. The data of 240 new clinical records regarding patients admitted consecutively over a period of 6 months are reported. The results show a progressive reduction of compilation errors and an improved management of the patient's clinical course. The innovative aspects of the new clinical record are discussed, with particular reference to the system of quality management, within which context the clinical record has to function, and to the modalities of check, audit and improvement.

Humans↗

PubMed1999

Treatment of a native right coronary artery with the PercuSurge Guardwire protection system during PTCA and stenting.

Cardiac catheterization in a patient with recent-onset unstable angina demonstrated a suboccluded dominant right coronary artery (RCA), with angiographic evidence of a large thrombus load and a severe focal stenosis of the left anterior descending (LAD) coronary artery. After abciximab, uneventful PTCA and stenting of the LAD was performed. The thrombus containing lesion of RCA was treated with balloon predilatation and stent deployment, and the whole procedure was accomplished with protection of the distal vessel by means of PercuSurge. This device was planned to avoid distal debris migration during percutaneous interventions of saphenous bypass grafts. The system is designed to allow the placement of a temporary occlusion device, a low-profile balloon, distal to the lesion to be treated during the procedure. The occlusive balloon is kept inflated during the treatment of the lesion. Before deflating the balloon and allowing blood to reach the distal vessel, whenever it is necessary, the material proximal to the balloon is aspirated through a monorail catheter. This aspiration removes blood and thrombi proximal to the occlusive balloon from the treated coronary artery. The case we present first reports the application of the device in a large native coronary artery, with an optimal distal flow restoring and no evidence of thrombus embolization. This type of protection of distal coronary vessels towards micro- and macroembolization of thrombi is a promising system of performing safer percutaneous interventions, even in acute ischemic syndromes.

Aged↗