Change in Sleep Quality of Residents the Night Before High-Fidelity Simulation: Results From a Prospective 1-Year National Survey.

peer reviewed[en] OBJECTIVE: The stress level of participants in high-fidelity simulation stems from various factors but may result in anticipatory anxiety causing sleep disturbances during the night prior to simulation. The objective of this survey was to determine the change in sleep quality of residents during the night prior to the simulation. METHODS: The survey was proposed for 1 year to all residents at the beginning of the simulation, in 10 simulation centres. The questionnaire combined demographics and the Leeds Sleep Evaluation Questionnaire using visual analogue scales divided into 4 sleep qualitative domains. The primary outcome was the prevalence of sleep disturbance (>10 mm on 1 domain). Secondary outcomes were the prevalence of severe sleep disturbance (>25 mm), as well as qualitatively and quantitatively reported explanatory sleep parameters. RESULTS: Among respondents, 66% [95% CI: 63 to 69] of residents had more than 10 mm and 27% [95% CI: 24 to 30] had more than 25 mm of sleep disturbance. Residents with a sleep disturbance of more than 10 mm had fewer hours of sleep (6.4 [standard deviation=1.8] vs 7.3 [standard deviation=1.3], difference: -0.9 [95% CI: -1.1 to -0.7]; P < .0001), with a higher number of night-time awakenings (1.3 [standard deviation=1.5] vs 0.7 [standard deviation=0.9], difference: 0.6 [95% CI: 0.4 to 0.8]; P < .0001). CONCLUSION: Among residents participating in the simulation, a high prevalence of change in sleep quality during the night before the simulation was noted. Strategies to help residents achieve better sleep prior to simulation should be explored

Les ressorts de l'adhésion à la simulation haute-fidélité en santé : de la ressemblance du mannequin au réalisme de la simulation

National audienc

Les ressorts de l'adhésion à la simulation haute-fidélité en santé : de la ressemblance du mannequin au réalisme de la simulation

National audienc

Les ressorts de l'adhésion à la simulation haute-fidélité en santé : de la ressemblance du mannequin au réalisme de la simulation

National audienc

MakAir, un ventilateur né de la pandémie COVID-19 conçu grâce à l’impression 3D, le numérique et l’open innovation

International audienceLa récente pandémie de COVID-19 a révélé la nécessité de produire en masse des ventilateurs pour les patients en syndrome de détresse respiratoire aiguë afin de couvrir les graves déficits de matériels liés à l’afflux anormalement élevé de patients dans les services de réanimation. MakAir est un ventilateur mécanique conçu grâce au recours à l’impression 3D et l’open-source logiciel et matériel. Facile à produire en masse, il est destiné aux pandémies de type COVID-19. Pour faciliter sa production en temps de crise, la version minimale du dispositif médical de classe IIb MakAir fonctionne uniquement en pression contrôlée avec une turbine lui permettant d’être autonome en air. Une source d’oxygène (O2) externe permet d’insuffler un mélange allant jusqu’à 0,8 d’O2 en fraction d’air inspiré. Le MakAir a fait l’objet d’une évaluation préclinique complète sur banc d’essai. Le MakAir fournit une assistance ventilatoire conforme à la consigne dans des cas simulés d’insuffisance respiratoire aiguë dans divers scénarios de résistance. Traduit en pression motrice de 10–15 cmH2O, les consignes de ventilation en pression permettent une bonne approximation du volume courant. De même, le contrôle de l’apport en O2 par un débitmètre permet d’estimer la FiO2. Les performances techniques du MakAir sont conformes aux exigences appliquées aux appareils destinés à un usage commercial. Si la mise à disposition de matériel en nombre suffisant ne peut que soulager des équipes sur-sollicitées en période de crise, le MakAir peut constituer une alternative intéressante pour les pays à revenu faible ou modéré. Les caractéristiques du MakAir en open-source permettent également d’améliorer, de développer et de tester en continu, en parallèle et de manière délocalisée plusieurs améliorations technologiques et/ou algorithmiques, voire de produire une déclinaison locale

Educational Concerns About the Safety of Cataract Surgery During Residency: The E3CAPS Pedagogic Study

International audienceIntroductionCataract surgery is the most common surgical procedure performed in France. While the incidence of intraoperative complications affecting visual prognosis is extremely low, given the large number of patients operated on, the absolute number of patients affected by complications is quite high. Complication rates are significantly higher when ophthalmology residents (ORs) perform the surgery. Although lack of experience remains the main risk factor, sleep deprivation may adversely affect ORs' successful surgery rate. The value of the EyeSi and REG; surgical simulator in initial training has been demonstrated to increase cataract surgery safety through the transfer of surgical skills from the simulator to the operating room. However, there is no consensus regarding how much training is needed before the first-time ORs are allowed to operate. There is also no scientific evidence that sleep deprivation is associated with a decrease in surgical performance. Establishing a validated protocol for cataract surgery training using the EyeSi surgical simulator (referred to further as the EyeSi) and identifying risk factors for intraoperative complications related to sleep deprivation will improve cataract surgery safety and lead to the reorganization of our healthcare systems.Methods and Planned OutcomesThis multi-centre educational cohort study will include two distinct axes which will both aim to reduce the risks of cataract surgery. Enrollment will include 16 first-year ORs for Axis 1 and 25 experienced residents for Axis 2, all from the University Hospitals of Nantes, Tours, Angers and Rennes. Axis 1 will focus on investigating the learning curve of first-year ORs using the EyeSi, following the training program recommended by the &quot;College des Ophtalmologistes Universitaires de France&quot; in order to set up a future &quot;licence to operate.&quot; Axis 2 will evaluate the impact of sleep deprivation on the surgical performance of experienced ORs using the EyeSi

MANAGEMENT OF THE CHILD’S AIRWAY UNDER ANAESTHESIA: THE FRENCH GUIDELINES

International audienc

Follow up of pain reported by children undergoing outpatient surgery using a smartphone application: AlgoDARPEF multicenter descriptive prospective study

International audienceIn pediatric patients, pain remains the most common complaint after surgery. This French multicenter epidemiological study (AlgoDARPEF) aimed to evaluate the use of a smartphone application (App) to assess the duration and severity of pain experienced by children undergoing outpatient surgery. Children below 18 years of age scheduled for an elective outpatient procedure in one of the participating centers were eligible. Parents were invited to provide daily information for 10 days regarding their child’s pain and comfort via a smartphone App using the Parents’ Postoperative Pain Measure - Short Form (PPPM-SF). Children over 6 years old could also provide self-assessments of pain using a Numerical Rating Scale (NRS-11). Data regarding pain medication, preoperative anxiety, postoperative nausea and vomiting, and parent satisfaction were also analyzed. Repeated-measures analyses of variance (ANOVAs) were used to compare the self- and hetero-assessments of pain. Eleven centers participated in the study, and 1,573 patients were recruited. Forty-nine percent of parents (n = 772) actually used the App at least once. In all surgeries, the average pain rating on the PPPM-SF scale did not exceed 3/10 throughout the follow-up period, as well as for the four main surgical specialties. Age, visceral surgery, and preoperative anxiety ≥ 4/10 were identified as independent risk factors for experiencing at least one episode of pain ≥ 4/10 during the first 48 postoperative hours. While these findings indicated that postoperative pain management appears to be satisfactory in the families who used the App, some improvements in anxiety management are suggested. This study shows that inviting parents to use a smartphone App to assess and report the quality of postoperative management in pediatric patients, provides useful information. A continuous report is possible, regarding pain and adverse events, over a postoperative ten days period, by a self-reporting or a parent’s contribution. Future studies should investigate the ability of live data collection using an App to ensure fast, efficient interactions between patients and physicians