ANESTHESIA RESUSCITATION AND OPERATING THEORY

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.