ANESTHESIA RESUSCITATION AND OPERATING THEORY
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The anesthesia consultation is done every day from 8:30 a.m. o For the set program, activities take place between 7:30 a.m. and 5 p.m. o Emergencies are taken care of 24 hours a day
Presentation of the service
The intensive care unit of the Cheikh Ahmadoul Khadim National Hospital Center welcomes patients with a serious illness or one likely to get worse. The intensive care unit welcomes patients who have a failure of at least 2 vital functions:
The respiratory system (lungs, airways and respiratory muscles),
The circulatory system (heart and vessels),
Renal function,
The nervous system...
Resuscitation helps keep patients with severe failures alive with replacement or support devices. In this specialized service, they benefit from constant supervision.
Anesthesia is performed in the operating room in close collaboration with the surgeons. Anesthesia helps ensure the safety and comfort of patients during diagnostic or therapeutic procedures in the operating room. This may include: general anesthesia, which plunges the patient into a state of deep sleep, making it possible in particular to limit movements and prevent pain during surgical procedures, or locoregional anesthesia, when only a part of the body is asleep.
Treated pathologies
In the case of a planned surgical intervention, a diagnostic radiology or endoscopy procedure, the anesthesiologist receives the patient during a preanesthetic consultation. He assesses his state of health, studies his medical file (allergies, medical history, current treatments, etc.), chooses the anesthesia technique most appropriate to the surgical context and the field. The anesthetist gives all the information to patients and the precautions to take in preparation for the procedure.
Before any anesthesia except in an emergency, the doctor will ask you to follow a certain number of recommendations:
- remain fasting the morning of the procedure: do not eat, do not smoke from 12 a.m. You can drink a little water or coffee before 6 a.m.
- continue or stop certain medications according to the anesthesiologist’s recommendations during the anesthesia consultation
do not wear jewelry (earrings, bracelets, rings, piercings, etc.), or gris-gris
- remove nail polish, wigs
- wash the day before and the morning of the procedure with soap and water
- bring spare diapers for infants
- be accompanied by a close adult on the day of the procedure
- come with your medical file
- do not stay alone the days following anesthesia
The anesthesiologist carries out the pre-anesthetic visit on the day of the procedure. The anesthetist can postpone an intervention if he considers it necessary. Before the procedure, he anesthetizes the patient using gases diffused through a mask and/or an intravenous injection of anesthetic products. Throughout the operation, in close collaboration with the surgeon and assisted by a senior technician in anesthesia and resuscitation, he monitors the patient's condition using high-tech equipment: respiratory function, cardiac function, temperature, etc.
General anesthesia uses three main families of medications that can be combined (hypnotics, analgesics, muscle relaxants). This achieves major effects: immobility, memory loss (amnesia), loss of consciousness and the analgesic effect.
Regional anesthesia can in certain cases be combined with general anesthesia or used alone to combat pain after surgery.
After the operation, the anesthesiologist controls the awakening of the patient in the recovery room and works to reduce postoperative pain. The anesthetist-resuscitator can also intervene urgently in the event of accidents or critical situations.
In intensive care
The resuscitator anesthetist takes care of patients in serious condition with failures requiring emergency care. In intensive care, patients with very diverse serious pathologies with organ failure are hospitalized, which implies close collaboration with other medical and surgical specialties. The role is to understand the origin of the problems and to implement resuscitation techniques (respiratory, renal or cardiac assistance, etc.) and drug treatments to improve the health of patients. This profession requires technical skills, knowledge of emergency medications and great precision in movements. As part of emergency patient care, the resuscitator may be required to intervene in other departments of the hospital.
Loco-regional anesthesia has the advantage of not causing loss of consciousness. Breathing and state of consciousness are maintained. When surgery allows it, anesthesia of the lower abdomen or a limb reduces complications related to anesthesia. This type of anesthesia involves injecting a local anesthetic around the spinal cord or around the nerves of a limb using an ultrasound machine. This way the patient will be able to discuss with the anesthetist during the procedure.
The anesthesia consultation is done every day from 8:30 a.m.
- Hospitalization: we have eight intensive care beds. Hospitalized patients are visited at 6 p.m. and depending on the condition of the patients.
- Operating room:
o For the set program, activities take place between 7:30 a.m. and 5 p.m.
o Emergencies are handled 24 hours a day
Every day during office hours, the anesthesia team is distributed so that there is an effective medical presence in the different sectors:
- A resuscitator anesthetist in the operating room with the collaboration of senior anesthesia technicians
- An inpatient resuscitation anesthesiologist for the care of patients admitted to intensive care.
- A doctor in pre-anesthetic consultation
- A doctor for sedation outside the operating room and opinions in other departments
Outside of office hours, a resuscitator is available 24 hours a day for hospitalized patients and emergencies.
After deciding on the surgical procedure in agreement with the patient or his legal guardian, the surgeon refers the patient to the team of anesthetists. The pre-anesthetic consultation is mandatory. It takes place, except in an emergency, at the latest 48 hours before any surgical procedure or painful examination and treatment requiring anesthesia. This anesthesia consultation aims in particular to inform the patient about the conditions of their intervention. Additional examinations (blood tests, x-rays, ultrasounds, electrocardiograms, etc.) may possibly be required. If appropriate, the patient may be asked to choose between general or regional anesthesia. The anesthetist consulted is not automatically the one who will perform the anesthesia on the day of the procedure but a connection is ensured using the anesthesia file. A second, pre-operative consultation, carried out by the anesthesiologist who is preparing to intervene, takes place just before the operation, to ensure that the situation has not changed since the previous one.
Equipment and Premises
The intensive care unit has 12 hospital beds including 3 individual cabins. Each is equipped
- a patient monitoring monitor which allows continuous measurement of blood pressure, heart rate, respiratory rate, blood oxygen level, temperature and possibly exhaled carbon dioxide level
- a resuscitation respirator which allows respiratory assistance to be provided to patients
- electric syringes to administer certain medications in a continuous flow
- a suction device
The service also has common facilities:
- a semi-automatic defibrillator
- an equipped emergency trolley
- a portable ultrasound device
- a transport respirator
- a mobile x-ray
- an electrocardiography device
The operating room has 5 operating rooms, a recovery room and a patient preparation room in the central block. There is an operating room, a recovery room and a maternity preparation room. The operating rooms and recovery rooms are equipped with the equipment necessary to carry out operations safely in optimal comfort:
image intensifiers
- endoscopy and laparoscopy column
- operating microscopes
- laser ureteroscopy
The medical and surgical specialties involved in the operating room include:
an anesthesia respirator to ensure respiratory assistance during general anesthesia. This respirator is equipped with an anesthetic gas evaporator to induce or maintain sleep
- a multiparameter monitor to ensure continuous monitoring of the patient during anesthesia (general, loco-regional or local).
- a suction system
- an ultrasound device to locate nerves to put a single limb or vein to sleep to set up a perfusion or to assess the functioning of the heart.
- Visceral surgery
- Pediatric surgery
- Urology
- Gynecology and obstetrics
- Orthopedics and traumatology
- Neurosurgery
- ENT and head and neck surgery
- Ophthalmology
- Oral surgery
- Gastroenterology
Laparoscopy and diagnostic and interventional endoscopy are regularly performed in the operating room.
Anesthesia is performed in the operating room. It is a specialty that allows a medical procedure that would otherwise be too painful or very uncomfortable in the best conditions of comfort and safety. Anesthesia can target a limb, a region (local regional anesthesia) or the entire body (general anesthesia). It requires a certain amount of equipment:
In pictures
The team behind the service
The intensive care anesthesia department is headed by Doctor Mactar DIENG, intensive care anesthetist.
The medical team is made up, in addition to the head of department, of intensive care anesthetists, all graduates of UCAD before completing their training abroad as part of internships and diploma courses in the French universities of Lille 2 and Lyon 1. , Paris Cité, Strasbourg and the Saint-Louis hospital. These are:
- Doctor Papa Saliou FAYE, resuscitator anesthetist
- Doctor Thierno Birahim GUISSE, resuscitator anesthetist
- Doctor Mamadou TALL, resuscitator anesthetist
- Doctors at the end of training for the DES in intensive care anesthesia are temporarily assigned to our department
The anesthesia team has nearly 20 years of experience in intensive care anesthesia with skills and diplomas in the following areas:
- Perineural locoregional anesthesia guided by ultrasound
- Vascular access under ultrasound guidance
- Pediatric intensive care anesthesia
- Management of burns
- Ultrasounds in critical care
- Painless childbirth
- Management of serious patients with visceral failure in intensive care
The paramedical team is made up of three types of personnel
1. Senior technicians in intensive care anesthesia numbering seven (7), including the duty supervisor Mame Thierno DANG. The block constantly receives MSIAR students as part of their internships. As part of anesthesia, an IDE takes care of patients admitted to the post-interventional monitoring room during awakening.
2. The operating room nurses who assist the surgeons in their tasks, numbering 14 including the supervisor on duty Ms. SOUR Falé FALL
3. The intensive care unit nurses made up of 7 IDEs and 4 AIEs. Mr Abdou NDIAYE is the resuscitation supervisor
4. Ms. Khadiatou DIAGNE and Mame Mor SALL are the secretaries
Four (4) hygiene agents dedicated to the operating room