CiteScore: 0.9 ℹ CiteScore: 2019: 0.9 CiteScore measures the average citations received per peer-reviewed document published in this title. Resources & publications. Ces connaissances et ces compétences techniques comprennent la capacité de : Effectuer une évaluation préanesthésique du patient et décider de la prise en charge anesthésique appropriée; Rendre le patient insensible à la douleur pour la pratique des interventions diagnostiques et thérapeutiques, ainsi que des interventions chirurgicales et obstétricales; Monitorer et soutenir les fonctions vitales des organes en période périopératoire; Assurer la prise en charge postanesthésique immédiate du patient; Pratiquer des manœuvres de réanimation et procurer des soins intensifs lorsque indiqué; et. Un accès intraveineux doit être établi avant d’amorcer une analgésie régionale et maintenu tout au long de l’administration de l’analgésie régionale. All relevant GPAS chapters include a section on the treatment of children and young people that will overlap with this document, e.g. For this reason, an anesthesiologist must be available to intervene appropriately should any complications occur when a bolus dose of local anesthetic is injected through the epidural catheter (except PCEA). Le matériel pour la prise en charge de voies aériennes difficiles doit être à portée immédiate en salle de réveil. Mechanical and electronic monitors are, at best, aids to vigilance. All analgesic drug solutions should be labelled with the composition of the solution (opioid, local anesthetic, or both) and its intended route of administration (epidural or intravenous). L’anesthésiologiste doit demeurer vigilant en tout temps, étant conscient que de brèves interruptions du monitorage continu puissent être inévitables et que, dans certaines circonstances, un moniteur pourrait faire défaut. L’Association canadienne de normalisation (CSA) et d’autres organismes d’élaboration de normes ont publié des normes et des recommandations se rapportant à la conception, la construction et la rénovation des établissements de santé, ainsi que concernant la gestion du risque, la sécurité de base et les performances essentielles du matériel médical (Annexe 1). Text Approved by CAS Board for 2018 Edition. Before elective procedures, the minimum duration of fasting should be. Aims and Scope 3. L’anesthésie est la réalisation délibérée de toute intervention visant à rendre un patient temporairement insensible à la douleur ou à l’environnement externe dans le but d’exécuter une intervention diagnostique ou thérapeutique. Anesthesia departments are therefore obligated to develop policies that ensure, as far as possible, that practitioners are healthy and fit to undertake their duties of practice. Separate guidelines exist for difficult intubation in paediatric anaesthesia, obstetric anaesthesia, and for extubation. L’expression « analgésie régionale » désigne l’analgésie péridurale, la rachianesthésie et la combinaison des deux. Une salle de réveil doit être disponible dans tout établissement offrant des services anesthésiques. by using quotations and proper paraphrasing), and it is properly attributed to the original work. La liaison avec les départements de chirurgie. Reasonable indications for specific tests include: Fasting policies should vary to account for age and preexisting medical conditions and should apply to all forms of anesthesia, including monitored anesthesia care. Anaesthesia Critical Care & Pain Medicine (ACCPM) publishes in English the highest quality original material, both scientific and clinical, on all aspects of Anaesthesia, Critical Care & Pain Medicine. Whether supervision is direct or indirect, close communication between the resident and the responsible supervising staff anesthesiologist is essential for safe patient care. Le congé des patients après une chirurgie ambulatoire doit se faire en utilisant un plan formel de soins approuvé par l’institution et documenté dans les notes de soins prodigués aux patients. Each facility may choose to develop additional guidelines or policies for specific situations in which obstetric regional analgesia is provided. Each anesthesia department teaching anesthesia residents should have policies regarding the activities and supervision of residents. Anaesthesia is the official journal of the Association of Anaesthetists. volume 65, pages76–104(2018)Cite this article. Les tests sanguins de laboratoire, les électrocardiogrammes et les radiographies du poumon de routine ne sont pas recommandés chez les patients asymptomatiques subissant une chirurgie à risque faible. Tous les patients devraient être informés que des dispositions seront prises pour rencontrer un anesthésiologiste s’ils souhaitent s’entretenir de leur prise en charge anesthésique avant leur admission à l’établissement. Le transfert peropératoire des soins entre deux anesthésiologistes doit être noté au dossier d’anesthésie et se conformer à un protocole structuré. Heart rate and blood pressure should be recorded at least every five minutes. These are minimal guidelines which may be exceeded at any time based on the judgment of the involved anesthesia personnel. des modifications, petites mais importantes, des recommandations concernant les soins aux patients et leur monitorage en salle de réveil et pendant le transport des patients. Available as Electronic Supplementary Material. Cet endroit doit être pourvu de sources d’oxygène, d’appareils de succion, de prises de courant dédiés, ainsi que d’une source de chaleur radiante et de matériel nécessaire à la prise en charge des voies aériennes et à la réanimation néonatale. Les indications concernant l’évaluation préalable à l’admission comprennent l’existence de problèmes médicaux importants (comorbidités), la nature de la procédure diagnostique ou thérapeutique proposée, et la demande du patient. En outre, ils préciseront clairement la manière de gérer les problèmes et urgences communément rencontrés et à qui faire appel en cas de besoin d’assistance. Anaesthesia will only allow re-use of authors’ previously published work in the Methods section of a manuscript, and only if this is done in a manner consistent with standard scholarly conventions (e.g. Monitoring should continue after discontinuation of neuraxial analgesia until its effects have dissipated. The guidelines in this section pertain to epidural and spinal analgesia during labour. Cautious dosing, vigilant monitoring, and the appropriate reversal of neuromuscular blocking drugs are all essential for patient safety. The Guidelines Committee has established several task forces to elaborate guidelines on the related subject. To be aware of the current CAS Guidelines to the Practice of Anesthesia, the requirements of the Canadian Council on Health Services Accreditation, and the requirements of the provincial licensing authority as they relate to anesthesia; To ensure that written policies with respect to the practice of anesthesia are established and enforced; To evaluate the qualifications and abilities of the physicians providing anesthetic care as well as other health professionals providing ancillary care—this includes, but is not restricted to, recommending clinical privileges for physicians with anesthetic responsibilities and annually reviewing these privileges; To employ a systematic approach for monitoring the quality of anesthetic care provided by members of the department of anesthesia throughout the healthcare facility; Monitoring quality of care may include, but need not be restricted to, the use of chart audits, clinical indicator and outcome monitoring, adverse event reporting systems, morbidity and mortality conferences, and critical incident case reviews. Il est fortement recommandé qu’un manuel de listes de contrôle et d’aides cognitives soit disponible dans tous les lieux où l’anesthésie est pratiquée afin de soutenir la prise en charge des urgences périopératoires critiques. Il sera par contre admis, dans un service d’obstétrique, de surveiller simultanément plus d’une patiente à laquelle est administrée une analgésie régionale pour le travail. L’accès intraveineux doit être établi avant d’amorcer l’analgésie neuraxiale et, après cessation de l’analgésie neuraxiale, maintenu pendant toute la durée prévue des effets médicamenteux. small but important changes related to recommendations for patient care and monitoring in the postanesthesia care unit and during patient transport. Celui-ci doit inclure un enregistrement des signes vitaux ainsi que des autres aspects du traitement et de l’observation. Bien que la SCA incite les anesthésiologistes du Canada à se conformer à son guide d’exercice pour assurer une grande qualité des soins dispensés aux patients, elle ne peut garantir les résultats d’une intervention spécifique. CiteScore: 1.8 ℹ CiteScore: 2019: 1.8 CiteScore measures the average citations received per peer-reviewed document published in this title. The tubing between neuraxial analgesia infusion pumps and catheters should not have ports that could permit unintentional injection of intravenous drugs. For continuous infusions or PCEA, the use of unique tamper-proof pumps that are distinct from the pumps used for intravenous fluid or drug administration is strongly recommended. This area must include designated oxygen, suction apparatus, electrical outlets, a source of radiant heat, and equipment for neonatal airway management and resuscitation. All necessary equipment, including emergency equipment, life support systems, medications, and supplies must be readily available. Les examens de laboratoire ne devraient pas être réalisés sur une base régulière mais uniquement lorsque les résultats modifieront la prise en charge périopératoire. Agent-specific anesthetic gas monitor, when inhalational anesthetic agents are used. Participation of other departments (e.g., nursing, pharmacy, surgery, and materials management) should be sought as needed. Signs and symptoms of the rare but catastrophic complications of epidural hematoma or abscess. L’adoption de politiques standardisées au chapitre de la prise en charge des patients est préconisée. Each facility with an acute pain service should ensure that an anesthesiologist is available to attend directly to patients receiving neuraxial analgesia within an appropriate time depending on the clinical situation. Performance of tasks at optimal l evels depends on recent clinical practice. In the absence of surgical or patient indications for intraoperative hypothermia, active patient warming systems, control of the operating room ambient temperature, and other methods, should be used to target a central core temperature of 36–37°C. Ces dossiers doivent permettre de procéder à l’évaluation de l’ensemble des soins anesthésiques dans l’établissement. Oxygen saturation must be monitored continuously and should be recorded at frequent intervals for all patients. Continuing Education in Anaesthesia Critical Care ... and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) offer guidelines for the diagnosis and assessment of COPD. Variables should be a physician who has obtained certification or appropriate training in anesthesia assistance to coordinate between. Anesthésie, l ’ ensemble des soins médicaux et infirmiers inspection and maintenance early detection is important to reduce prevent! 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