2 research outputs found
Broken needle during spinal anesthesia: an avoidable complication
No full textRawéléguinbasba Armel Flavien Kabore,1 Ibrahim Alain Traore,2 Salah Idriss Séif Traore,3 Cheik Tidiane Hafi Wind-Pouiré Bougouma,1 Pascal Augustin,4 Aboudoul-Fataou Ouro-Bang’na Maman5 1Department of Anesthesia, University Hospital Blaise Comparoé, Ouagadougou, Burkina Faso; 2Department of Anesthesia, Uiversity Hospital Sourou Sanou, Bobo Dioulasso, Burkina Faso; 3Department of Anesthesia, District Hospital of Bogodogo, Ouagadougou, Burkina Faso; 4Department of Anesthesia, Intercommunity Hospital of Meulan, Les Mureaux, Meulan en Yvelines, France; 5Department of Anesthesia, Ales-en-Cévennes Hospital, Alès-en-Cévennes, France Abstract: The occurrence of a needle breaking is a very rare complication of spinal anesthesia (SA). We report a case of a broken spinal needle occurring in a morbid obese pregnant woman during SA indicated for an emergent cesarean section. Multiple puncture attempts due to difficult identification of lumbar spine, associated with an inadequate use of the introducer, contributed to this complication. The recognition of predictive factors for difficult neuraxial anesthesia, the use of ultrasound in obese patients, and a properly executed technique may have allowed avoiding this complication. Keywords: spinal anesthesia, needle breaking, cesarean section, obesit
Evaluation de la satisfaction des patients d’un service d’urgences
No full textObjectif: évaluer la satisfaction des patients dans le service des urgences.Méthodes : étude descriptive transversale à passage unique par questionnaire, de janvier à avril 2010.Résultats : 338 patients d’âge moyen 44,9 ans ont été inclus. La majorité (51%) était analphabète;43,2% agriculteurs ou du secteur informel. Les motifs de consultation étaient surtout neurologiques (18,1%), cardiovasculaires (13,5%), digestives (15,5%) et néphrologiques (8,8%). Les taux de satisfaction étaient élevés pour : accueil (78,4%), qualité des soins (69%), relation avec le personnel médical (85,5%) et paramédical (80,2%), repas (71,6%) et qualité globale du service (66%). D’importants taux d’insatisfaction étaient notés pour : identification du personnel (95,3%), informations sur l’état de santé du patient (50,6%), confort et propreté (58,8%). Le coût des soins était élevé pour 44,7% des patients, qui ont bénéficié d’un soutien familial (73,3%). Les appréciations sur la qualité globale du service, l’accueil et le coût des soins étaient statistiquement associées au niveau d’instruction ou à la profession.Conclusion : Les taux de satisfaction, relativement élevés, reflètent probablementdes biais (désirabilité sociale, aversion de la critique) et les faibles attentes liées au bas niveau socio-économique des patients. L’insatisfaction était importante quant à lidentification du personnel, les informations sur l’état de santé des patients et l’hôtellerie. La solidarité familiale est importante dans la prise en charge des frais de soins. L’évaluation de la satisfaction des patients devrait être systématique et s’inscrire dans une démarche qualité des soins.Mots clés : évaluation, qualité des soins, satisfaction patients, urgence médicale, Burkina Faso. Assessment of patients’ satisfaction in a medical emergencies service.Objective: to assess patients’ satisfaction in a medical emergencies service.Methods: survey by questionnaire, during a non-continuous45 days period from January to April 2010.Results: 338 patients, mean age 44.89, have been included; the sex ratio was of 1.33. Main pathologies were neurological (18,1%), cardiovascular (13.5%) and digestive (15.5%). Global quality of the service was good for 223 patients (66%) and bad for 29 patients. Half of the patients (50.6%) have not been satisfied with the information on their health problem. Quality of care was good for 69%,relation with the staff was good for 85.5% (physicians) or 80.2% (paramedics) and staff's availability was bad for 10%. Comfort has been qualified as bad by 33.7% and very bad by 25.1%,and meal was good for 71.6%. The cost of the care was high for 44.7%. Patients benefitted from a financial support by family (73.3%), friends (17.6%), or insurance companies (0.76%). No patient declared tentative of corruption or racket.Discussions: The rate of patient who got an overall satisfaction is on the rise as well in this survey as in the literature, with an exception for communication. This good result may reveal the poor expectation of the population toward health services.Conclusion: assessment of the patients’ satisfaction and audit on the quality of care and management of resources should be instituted and be part of a quality process for a better health service.Keywords: Assessment, Burkina Faso, care quality, medical emergency, patients satisfaction
