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J-F Timsit

Publications and source records attributed to J-F Timsit.

6 recordsLinked to original sources
PubMed2005

[Evaluation of a continuous training program at Bichat hospital for in-hospital cardiac arrest resuscitation].

UNLABELLED: Management of in-hospital cardiac arrest is now considered as a hospital quality indicator. Such management actually requires training health care workers (HCWs) for basic life support (BLS). OBJECTIVE: To assess the usefulness and efficacy of a short mandatory BLS training course amongst general ward HCWs in a 1,200 bed teaching hospital. STUDY DESIGN: The in-hospital medical emergency team (MET) established a 45-min BLS training course comprising 10 goals for basic CPR and preparing for the arrival of the MET. Assessment was based on satisfaction questionnaires, cross-sectional evaluation of knowledge and skills of HCWs before and 1 year after the start of the training course. Efficacy of BLS performed on ward was assessed by the MET on scene. RESULTS: One year after, 68 training sessions had been fulfilled and 522 HCWs had been trained (46.27% of total HCWs). HCWs were satisfied with the teaching course. Instant retention of objectives was over 90%. Cross-sectional surveys showed an improvement of BLS knowledge and skills. The knowledge of initial clinical assessment remained low. Knowledge and skills were significantly higher amongst HCWs who had been trained than amongst those who had not. Unfortunately, general ward BLS performance showed no improvement. CONCLUSION: Short mandatory training courses are stimulating and well appreciated amongst HCWs. Although basic knowledge and skills improve dramatically, no improvement of on-scene BLS performance occurs.

Cardiopulmonary Resuscitation↗
PubMed2005

[How to improve central venous catheter use in intensive care unit?].

OBJECTIVE: Central venous catheter (CVC) insertion is routinely performed in critically ill patients but causes mechanical, thrombotic, or infectious adverse events in 15% of cases. It should be possible to improve the benefit/risk ratio of central venous catheterization in intensive care unit. DATA SOURCE: We searched Pubmed using the terms: "catheterization, central venous, peripheral, adverse effects"; then "thrombosis, phlebitis, thrombophlebitis, jugular vein, femoral vein, subclavian vein, pneumothorax, haemothorax, extravasation of diagnostic and therapeutic materials". We then discuss this with a panel of intensivists in a workshop. DATA SYNTHESIS: Few data are available on the risk/benefit ratio of central vs. peripheral venous catheterization. In some cases (cardiac arrest, rapid fluid loading, parenteral nutrition) the choice is based on clear recommendations. In others (irritating drugs, pressure monitoring, peripheral access failure), the choice depends on medical and nurses daily evaluation. When CVC insertion is mandatory, it is important to implement the recommendations of the consensus conferences to prevent infectious and thrombotic complications. Mechanical complications should be improved by selecting the most appropriate insertion site, and, if unsuccessful, switching to another operator before the complications occurs. Doppler-ultrasound guidance is recommended, but is limited by the cost and training of the technique. CONCLUSION: Studies evaluating the risk/benefit ratio of CVCs versus peripheral catheters are needed to develop a venous-access strategy for ICU patients. When a CVC is mandatory, recent data are available to improve the risk/benefit ratio and can be used to build a decision algorithm.

Catheterization, Central Venous↗
PubMed2005

[Updating of the 12th consensus conference of the Société de Réanimation de langue française (SRLF): catheter related infections in the intensive care unit].

Concerning catheter-related infections, many studies have been conducted until the last consensus conference of the Sociétéde réanimation de langue française (SRLF) in 1994. This text is the synthesis of the considerable amount of work performed by the experts of the society to review recent studies. The experts' texts as well as extensive bibliography are available at http://www.srlf.org.

Catheterization↗
PubMed2004

Sedation, sucralfate, and antibiotic use are potential means for protection against early-onset ventilator-associated pneumonia.

To examine risk factors for early-onset ventilator-associated pneumonia (EOP) in patients requiring mechanical ventilation (MV), we performed a prospective cohort study that included 747 patients. Pneumonia was defined as a positive result for a protected quantitative distal sample. EOP was defined as pneumonia that occurred from day 3 to day 7 of MV. Eighty patients (10.7%) experienced EOP. Independent predictors of EOP were male sex (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.18-3.63), actual Glasgow Coma Scale value of 6-13 (OR, 1.95; 95% CI, 1.2-3.18), high Logistic Organ Dysfunction score at day 2 (OR, 1.12 per point; 95% CI, 1.02-1.23), unplanned extubation (OR, 3.19; 95% CI, 1.28-7.92), and sucralfate use (OR, 1.81; 95% CI, 1.01-3.26). Protection occurred with use of aminoglycosides (OR, 0.36; 95% CI, 0.17-0.76), beta -lactams and/or beta -lactamase inhibitors (OR, 0.47; 95% CI, 0.28-0.83), or third-generation cephalosporins (OR, 0.33; 95% CI, 0.16-0.74). Sucralfate use and unplanned extubation are independent risk factors for EOP. Use of aminoglycosides, beta-lactams/ beta-lactamase inhibitors, or third-generation cephalosporins protects against EOP.

Aged↗