References of "PIAZZA, Justine"
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See detailGestion des admission aux urgences durant la pandémie de COVID-19 au sein du CHU de Liège : Apport d'un centre de tri avancé
GILBERT, Allison ULiege; PIAZZA, Justine ULiege; SZECEL, Julien ULiege et al

in Revue Médicale de Liège (2020), 75(Supplement), 11-17

résumé : La pandémie de COVID-19 a débuté au mois de mars 2020 sur le territoire belge. Elle a contraint nos institu- tions hospitalières à une série de réorganisations singulières soutenues par ... [more ▼]

résumé : La pandémie de COVID-19 a débuté au mois de mars 2020 sur le territoire belge. Elle a contraint nos institu- tions hospitalières à une série de réorganisations singulières soutenues par l’activation du Plan d’Urgence Hospitalier. Cet article a pour objet de décrire l’expérience du Centre Hospitalier Universitaire de Liège (CHU de Liège) durant la pandémie de COVID-19 et de relater l’efficience de la mise en place d’un centre de tri avancé en amont des services d’urgences pour la gestion des admissions hospitalières. Méthodes : dès le 2 Mars 2020, le CHU de Liège a mis en place une infrastructure d’accueil des patients suspects d’infection par le SARS-CoV-2. D’abord initiée au sein de l’institution hospitalière, la nécessité d’une infrastructure indépendante s’est rapidement révélée indispensable et a, dès lors, vu le jour dès la fin du mois de mars, sur les deux sites hospitaliers universitaires. Du 2 mars au 3 mai 2020, l’ensemble des données relatives aux visites au sein des centres de tri avancé ont été collectées (nombre d’ad- missions, motif des visites, examens complémentaires et évolutions cliniques). Résultats : sur la période de l’étude, 3.094 patients ont transité par les centres de tri du CHU de Liège. Cette fréquentation était constituée d’un volume global de 3.431 contacts dont 337 représentaient des réad- missions. La sensibilité et la spécificité des centres de tri en regard de la nécessité d’une hospitalisation étaient, respectivement, de 87,9 % et 93,4 %. Conclusion : notre expérience suggère une efficience optimale des centres de tri avancé, en amont des structures hospitalières tradi- tionnelles, pour orienter de manière appropriée le flux des patients suspects d’infection par le SARS-CoV-2. [less ▲]

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See detailDevelopment and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19.
Servotte, Jean-Christophe ULiege; Welch-Horan, T. Bram; Mullan, Paul et al

in Advances in Simulation (2020), 5(1), 32

BACKGROUND: Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical ... [more ▼]

BACKGROUND: Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical debriefing program to identify opportunities to address teamwork and patient safety during the COVID-19 pandemic. METHODS: We reviewed existing literature on best-practice guidelines to answer key clinical debriefing program design questions. An end-of-shift huddle format for the debriefs allowed multiple cases of suspected or confirmed COVID-19 illness to be discussed in the same session, promoting situational awareness and team learning. A novel ED-based clinical debriefing tool was implemented and titled Debriefing In Situ COVID-19 to Encourage Reflection and Plus-Delta in Healthcare After Shifts End (DISCOVER-PHASE). A facilitator experienced in simulation debriefings would facilitate a short (10-25 min) discussion of the relevant cases by following a scripted series of stages for debriefing. Data on the number of debriefing opportunities, frequency of utilization of debriefing, debriefing location, and professional background of the facilitator were analyzed. RESULTS: During the study period, the ED treated 3386 suspected or confirmed COVID-19 cases, with 11 deaths and 77 ICU admissions. Of the 187 debriefing opportunities in the first 8-week period, 163 (87.2%) were performed. Of the 24 debriefings not performed, 21 (87.5%) of these were during the four first weeks (21/24; 87.5%). Clinical debriefings had a median duration of 10 min (IQR 7-13). They were mostly facilitated by a nurse (85.9%) and mainly performed remotely (89.8%). CONCLUSION: Debriefing with DISCOVER-PHASE during the COVID-19 pandemic were performed often, were relatively brief, and were most often led remotely by a nurse facilitator. Future research should describe the clinical and organizational impact of this DISCOVER-PHASE. [less ▲]

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See detailImmersion in an emergency department triage center during the Covid-19 outbreak: first report of the Liège University hospital experience
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; PETIT, Meredith ULiege et al

in Acta Clinica Belgica (2020)

Objectives: Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective ... [more ▼]

Objectives: Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective solution proposed in disaster medicine, also works well to manage Emergency Department (ED) flow. The aim of this study was to describe the role of an ED Triage Center for patients with suspected novel coronavirus disease (Covid-19) and character- ize the patient flow. Methods: In March 2020, we established a Covid-19 triage center close to the Liège University EDs. From March 2 to March 23, we planned to analyze the specific flow of patients admitted to this triage zone and their characteristics in terms of inner specificities, work-up and manage- ment. During this period, all patients presented to the ED with symptoms suggestive of Covid- 19 were included in the study. Results: A total amount of 1071 patients presented to the triage center during the study period. 41.50% of the patients presented with flu-like symptoms. In 82.00% of the cases, no risk factor of virus transmission was found. The SARS-Cov2 positive patients represented 29.26% of the screened patients. 83.00% of patients were discharged home while 17.00% were admitted to the hospital. Conclusion: Our experience suggests that triage centers for the assessment and management of Covid-19 suspected patients is an essential key strategy to prevent the spread of the disease among non-symptomatic patients who present to the EDs for care. This allows for a disease- centered work-up and safer diversion of Covid-19 patients to specific hospital units. [less ▲]

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See detailTranscutaneous Ultrasound for Maxillary Disease Screening in Intensive Care Unit: a Preliminary Study
Benchimol, Lionel ULiege; PIAZZA, Justine ULiege; ROGISTER, Florence ULiege et al

Conference (2020)

Introduction and Aim: Nosocomial airway infections are common and associated with high morbidity and mortality in Intensive Care Unit. Endotracheal intubation duration is an independent risk factor for ... [more ▼]

Introduction and Aim: Nosocomial airway infections are common and associated with high morbidity and mortality in Intensive Care Unit. Endotracheal intubation duration is an independent risk factor for maxillary sinusitis, which is a frequent gateway for pneumoniae, meningitis or sepsis. Diagnosis remains challenging, as CT imaging is not easily repeated in the daily assessment of unstable patients. Our aim was to evaluate the efficiency of transcutaneous ultrasound to screen maxillary sinus infection. Material and Methods: Patients presenting to our ENT department with a same-day sinus CT scan were prospectively included in this pilot study. Maxillary transcutaneous ultrasounds were performed by two independent examiners and scored in supine and sitting positions, blindly to the CT imaging, the clinical and endoscopic evaluations. Ability to diagnose sinusitis, repeatability in different positions and inter-examiners comparison were studied. Ultrasound scores were compared to Lund-Mackay-derived CT scores. Results: 7 patients (5 men and 2 women, median age 60 [56-64]) were enrolled in this experiment. In total, 14 left and right maxillary sinus were studied by same-day sinus CT scan and ultrasound in prone and sitting positions by 2 blind and independent examiners. Ultrasound was able to detect maxillary pathology the majority of the cases, with a sensitivity of 71.4% and a specificity of 87.5% in sitting position. However, sensitivity dropped to 46.8% in prone position, with a preserved specificity of 84.4%. Agreement between examiners was observed in 85.7% cases. Conclusion: Transcutaneous ultrasound was capable of screening for maxillary sinus disease compared with conventional sinus CT scan. A special attention should be paid to patient position, as sitting position improved the screening accuracy. Agreement between examiners could be improved. Moreover, despite its limitations, it is an attractive method for the screening of maxillary disease, allowing the ability to screen and/or monitor infection in unstable patients. [less ▲]

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See detailImpact of a prehospital discrimination between trauma patients with or without early acute coagulopathy of trauma and the need for damage control resuscitation: rationale and design of a multicenter randomized phase II trial.
TONGLET, Martin ULiege; D'ORIO, Vincenzo ULiege; MOENS, Didier ULiege et al

in Acta Chirurgica Belgica (2019)

BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be ... [more ▼]

BACKGROUND: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be evaluated. The primary objective of this study is to evaluate the impact on mortality of a prehospital discrimination between trauma patients with or without a potential need for damage control resuscitation. METHODS: The trial will be designed as randomized phase II clinical trial with comparison of the experimental protocol against the standard of care. The TICCS will be calculated on the site of injury for the patients of the intervention group and treatment will be guided by the TICCS value. Seven days mortality, 30 days mortality, global use of blood products and global hospital length-of-stay will be compared. DISCUSSION: Many data suggest that a very early flagging of trauma patients in need for DCR would be beneficial but this need to be proved. Do we improve our quality of care by an earlier diagnosis? Does a prehospital discrimination between trauma patients with or without a potential need for DCR has a positive impact? [less ▲]

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See detailTentative de suicide au pentobarbital : A propos d'un cas
DEVILLE, Marine ULiege; PIAZZA, Justine ULiege; DENOOZ, Raphael ULiege et al

Poster (2017, October)

Objectif : L’usage des barbituriques en médecine humaine est progressivement abandonné au profit de médicaments moins toxiques, telles que les benzodiazépines. En Belgique, seul le phénobarbital est ... [more ▼]

Objectif : L’usage des barbituriques en médecine humaine est progressivement abandonné au profit de médicaments moins toxiques, telles que les benzodiazépines. En Belgique, seul le phénobarbital est encore utilisé tant en milieu hospitalier qu’en ambulatoire, bien qu’il soit de moins en moins prescrit. Nous rapportons le cas d’une femme de 42 ans, vétérinaire de profession, retrouvée inconsciente à son domicile, suite à l’auto-injection d’un autre barbiturique, le DOLETHAL®, spécialité contenant du pentobarbital utilisé pour l’euthanasie en médecine vétérinaire. Méthodes : Le screening toxicologique (antidépresseurs, benzodiazépines, opiacés, barbituriques, éthanol) a été réalisé sur un échantillon de sérum prélevé à l’admission, au moyen d’immunoessais enzymatiques effectués sur l’automate Architect® Ci4100 de la firme Abbott. Les recherches de paracétamol et de salicylés, également inclues dans le screening, ont quant à elles été réalisées par colorimétrie enzymatique sur le même automate. Pour préciser les résultats des immunoessais, l’échantillon sérique a ensuite été analysé par chromatographie en phase liquide couplé à un détecteur à barette de diodes (HPLC-DAD, Waters), après extraction liquide-liquide en présence de prazépam, utilisé comme standard interne. Enfin, le dosage des barbituriques a été réalisé par chromatographie en phase gazeuse couplée à un spectromètre de masse triple quadripôle (GC-QQQ, Agilent) après une extraction en phase solide, en utilisant le butalbital-d5 comme standard interne. Résultats : Lors de la prise en charge médicale, la patiente présentait une altération de l’état de conscience justifiant son intubation. Les autres signes clinico-biologiques étaient une tachycardie, une acidose métabolique (pH = 7,28), et une augmentation des enzymes hépatiques (TGO = 164 U/L; TGP = 128 U/L ; LDH = 301 U/L). Le dépistage des barbituriques effectué sur le prélèvement de l’admission s’est révélé positif, avec un résultat supérieur à 1mg/L, et le taux de pentobarbital mesuré par chromatographie était de 9,29 mg/L, soit inférieur aux concentrations mesurées lors d’intoxications fatales décrites dans la littérature, qui rapportent des taux supérieurs à 15 mg/L [1]. En l’absence d’antidote spécifique, un traitement supportif a été instauré avec maintien de la sédation, hémofiltration et administration de bicarbonate en vue de corriger l’acidose. L’hémofiltration a permis une diminution lente des concentrations de pentobarbital, tel que représenté dans le tableau ci-dessous : Date, heure 17/05/17, 18h22 18/05/17, 11h38 20/05/17, 06h09 21/05/17, 05h51 Pentobarbital (mg/L) 9,29 7,20 2,40 0,80 Evolution des taux de pentobarbital Le screening toxicologique a également relevé la présence d’un taux d’alcoolémie à 2,10 g/L, susceptible d’aggraver la dépression du système nerveux central induite par le pentobarbital, ainsi qu’une concentration de lorazépam infrathérapeutique (12 µg/L). Sept jours après son admission, la patiente a pu quitter l’hôpital en direction d’une institution psychiatrique. Conclusion : Si le phénobarbital est le seul barbiturique encore disponible en ambulatoire, le pentobarbital, accessible aux professionnels travaillant en milieu vétérinaire, peut aussi être utilisé dans les cas de tentative de suicide. En l’absence de prise en charge médicale, la tentative de suicide décrite dans ce cas aurait pu conduire au décès par arrêt cardiorespiratoire. Références : 1. Melo P. et coll. Pentobarbital in the context of possible suicides: Analysis of a case. Forensic Sci Int. 2017; 274: page 109-page 112. [less ▲]

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See detailThe Mediation Service, what interest for emergencies?
PIAZZA, Justine ULiege; BRASSEUR, Edmond ULiege; DOPPAGNE, Caroline ULiege et al

Poster (2015, January 17)

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See detailAn unusual cervicalgy.
PIAZZA, Justine ULiege; BRASSEUR, Edmond ULiege; GHUYSEN, Alexandre ULiege et al

in Acta Clinica Belgica (2014), 69(S1), 23

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See detailAN UNUSUAL CERVICALGY.
PIAZZA, Justine ULiege; BRASSEUR, Edmond ULiege; Ghuysen, Alexandre ULiege et al

Poster (2014, January 18)

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See detailLe cas clinique du mois. Syndrome du bebe bleu: la verite cachee au fond du puits.
PIAZZA, Justine ULiege; Douin, C.; Bodson, Liliane ULiege et al

in Revue Médicale de Liège (2014), 69(4), 175-9

Methemoglobinemia is a rare disorder preferentially affecting children. The outcome may be dramatic when the disorder remains unidentified, however early recognition using unspecific exams allows prompt ... [more ▼]

Methemoglobinemia is a rare disorder preferentially affecting children. The outcome may be dramatic when the disorder remains unidentified, however early recognition using unspecific exams allows prompt therapy. We report the case of a 14-month-old baby who presented with a sudden access of cyanosis resulting from acute methemoglobinemia. Careful investigation identified contamination of familial food by an excess of nitrates related to the use of well water from rural location. [less ▲]

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