Publications of Alexandre GHUYSEN
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See detailCan video-assistance improve the quality of pediatric dispatcher-assisted cardiopulmonary resuscitation? (IN PROGRESS)
PETERS, Michaël ULiege; Stipulante, Samuel ULiege; Cloes, Véronique et al

in Pediatric Emergency Care (in press)

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See detailCONTRIBUTION A LA VALIDATION D’UN PROTOCOLE 112 D’ASSISTANCE A LA MISE EN PLACE D’UN GARROT ARTERIEL : UNE ETUDE CONTROLEE ET RANDOMISEE
Poncin, Elodie; Stipulante, Samuel ULiege; Losfeld, Xavier et al

Conference (2020, March 31)

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See detailSALOMON, un modèle coopératif entre la première et la seconde ligne de soins pour les appels d'urgence nocturnes
BRASSEUR, Edmond ULiege; GILBERT, Allison ULiege; Servotte, Jean-Christophe ULiege et al

in Revue Médicale de Liège (2020), 75(2), 83-88

L’objectif de notre étude est d’apporter une réponse originale à la problématique de la permanence médicale de première ligne liée au vieillissement médical et à la charge de travail croissante. Nous ... [more ▼]

L’objectif de notre étude est d’apporter une réponse originale à la problématique de la permanence médicale de première ligne liée au vieillissement médical et à la charge de travail croissante. Nous proposons, à cet effet, la mise en place d’une interface de régulation des appels en période critique (nuit profonde) au moyen d’un outil algorithmique original dénommé SALOMON («Sys- tème Algorithmique Liégeois d’Orientation pour la Méde- cine Omnipraticienne Nocturne»). En fonction du degré de gravité supputé, la plateforme propose l’orientation opti- male du patient parmi quatre options possibles : renvoi de la demande vers le centre d’appel unifié 112 et prise en charge par les moyens de l’Aide Médicale Urgente (AMU), orientation du malade vers un service d’urgence spécialisé (SUS) de son choix pour une Mise Au Point Hospitalière (MAPH), mise en Contact avec le Médecin Généraliste de garde (CMG) ou enfin prise en charge par une Visite Diffé- rée (VD) via le médecin de famille. Après une description de l’outil, nous présentons l’étude de faisabilité qui a porté sur une période de 12 mois. Cette étude préliminaire était destinée à vérifier la robustesse de SALOMON avant de prévoir, le cas échéant, sa diffusion au sein d’une zone plus vaste. Les résultats préliminaires suggèrent une grande fiabilité de SALOMON. Nous avons également observé que son utilisation était associée à un réel état de satis- faction de l’ensemble des acteurs impliqués, qu’ils aient été infirmiers dispatcheurs ou médecins généralistes. Sous réserve d’une étude à plus grande échelle, les bénéfices actuellement notés en matière d’épargne de ressources humaines durant la garde de première ligne ont rapidement entraîné la fusion de deux zones de garde. [less ▲]

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See detailLe cas clinique du mois. Complication hémorragique d’une forme sévère de maladie de moyamoya
ANGELOZZI, Valeria ULiege; GERMAY, Caroline ULiege; GILBERT, Allison ULiege et al

in Revue Médicale de Liège (2020), 75(2), 75-77

La maladie de moyamoya est une vasculopathie cérébrale souvent méconnue. Sa découverte est majoritairement brutale dans les suites de la survenue d’un accident vasculaire ischémique ou, dans certains cas ... [more ▼]

La maladie de moyamoya est une vasculopathie cérébrale souvent méconnue. Sa découverte est majoritairement brutale dans les suites de la survenue d’un accident vasculaire ischémique ou, dans certains cas, hémorragique. L’artériographie est l’examen de choix pour confirmer le diagnostic. Différentes approches thérapeutiques ont été proposées, qu’elles soient médicamenteuses, endoscopiques ou chirurgicales. Nous présentons le cas d’une jeune patiente chez qui un diagnostic de maladie de moyamoya a été posé dans le décours d’une hémorragie cérébrale avec altération rapide de l’état de conscience. [less ▲]

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See detailInformal fatigue-related risk management in the emergency department: A trade-off between doing well and feeling well
Berastegui, Pierre ULiege; Jaspar, Mathieu ULiege; GHUYSEN, Alexandre ULiege et al

in Safety Science (2020), 122

Emergency physicians are known to be particularly vulnerable to sleep deprivation due to inconsistent shift rotation, extended duty periods and overnight calls. However, naturalistic studies have actually ... [more ▼]

Emergency physicians are known to be particularly vulnerable to sleep deprivation due to inconsistent shift rotation, extended duty periods and overnight calls. However, naturalistic studies have actually failed to systematically demonstrate that sleep deprivation is associated with poorer work performance in emergency physicians. The inconsistency of these results could reside in physicians’ ability to compensate for fatigue-related impairments. Our aim is to assess the effectiveness of informal fatigue proofing (FPS) and reduction (FRS) strategies used by emergency physicians. We conducted a prospective longitudinal study with 28 emergency physicians (mean age 36.89 ± 10.73 years, 11 females) for a total of 182 shifts. At enrollment, participants answered the Maslach Burnout Inventory and the Fatigue Management Survey. During shifts, we measured fatigue-related impairments using the Psychomotor Vigilance Task and work performance using an adapted version of the Physician Achievement Review. Of the four work performance dimensions addressed, patient interaction was the only one associated with decreased reaction time (F = 27.61, p < 0.001). Our findings revealed a significant interaction between reaction time and FPS frequency of use for the patient interaction (F = 4.91, p = 0.03) and self-management subscales (F = 5.92, p = 0.02). However, the frequency of use of FPS were found to be positively associated with early symptoms of burnout (β = 0.79, p < 0.001). Finally, our results show that FRS frequency was associated with decreased reaction time (F = 8.02, p = 0.01) with no associated risk of burnout. We propose further considerations for the implementation and follow-up of a fatigue risk management system in the emergency department. [less ▲]

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See detailFatigue-related risk perception among emergency physicians working extended shifts.
Berastegui, Pierre ULiege; Jaspar, Mathieu ULiege; Ghuysen, Alexandre ULiege et al

in Applied Ergonomics (2020), 82

There is a growing body of studies indicating that extended shift duration has an adverse effect on fatigue, consequently leading to reduced work performance and higher risk of accident. Following modern ... [more ▼]

There is a growing body of studies indicating that extended shift duration has an adverse effect on fatigue, consequently leading to reduced work performance and higher risk of accident. Following modern fatigue risk management systems (FRMS), acceptable performance could be maintained by the mobilization of appropriate mitigation strategies. However, the effective deployment of such strategies assume that workers are able to assess their own level of fatigue-related impairments. In this study, we sought to determine whether emergency physicians’ subjective feelings of sleepiness could provide accurate knowledge of actual fatigue-related impairments while working extended shifts. We conducted a prospective observational study with a within-subjects repeated measures component. We collected sleep logs, sleepiness ratings and reaction times on a Psychomotor Vigilance Task (PVT) at different time points during shifts. Our results show that the PVT is sensitive to sleep loss and fatigue, with a 10% increase in mean reaction time across the shift. Subjective sleepiness, however, showed no significant association with time since awakening and was not a significant predictor of PVT performance. Our results are consistent with experimental studies showing that individuals tend to underestimate fatigue-related impairments when sleep deprived or functioning under adverse circadian phase. The discrepancy between subjective sleepiness and actual fatigue-related impairments may give workers the illusion of being in control and hinder the deployment of mitigation strategies. Further research is needed to determine the relative weight of circadian phase shifting and cumulative sleep deprivation in the decline of self-knowledge in extended shifts. [less ▲]

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See detailNouvelle approche de régulation de la demande de soins non planifiés: l'application interactive d'auto-triage ODISSEE
GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege; GHUYSEN, Alexandre ULiege et al

in Revue Médicale de Liège (2020)

La régulation de la demande de soins non planifiés fait partie des approches envisagées pour obtenir une meilleure répartition de la demande de soins parmi les différents intervenants de la santé. En ... [more ▼]

La régulation de la demande de soins non planifiés fait partie des approches envisagées pour obtenir une meilleure répartition de la demande de soins parmi les différents intervenants de la santé. En effet, tant la première ligne de soins que les services d’urgence font face à des flux de patients conséquents, saturant fréquemment les ressources qu’ils possèdent pour y répondre. L’apparition de nouvelles technologies et l’entrée dans la pratique courante de la diffusion de l’information médicale se sont révélées être des précurseurs de nouvelles stratégies adaptatives, mais également de nouveaux défis quotidiens. La création d’une application interactive permettant l’auto-triage du patient vers la ligne de soins la plus appropriée fait intervenir ces différents concepts. Nous avons donc développé une plateforme interactive, l’application ODISSEE (Outil Décisionnel et Informatif des Structures de Soins Efficientes Existantes), permettant au patient d’autoévaluer la gravité de son problème et de bénéficier d’un conseil avisé sur le niveau de soins à envisager. Les protocoles utilisés sont directement issus d’un outil créé précédemment dans notre institution et ayant fait ses preuves durant 5 années d’utilisation, l’outil SALOMON (Système Algorithmique Liégeois d’Orientation pour la Médecine Omnipraticienne Nocturne). La création d’un système interactif d’auto-triage du patient le guidant vers le niveau de soins le plus approprié pourrait être une méthode prometteuse pour la régulation de la demande de soins non planifiés. [less ▲]

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See detailVirtual reality experience: immersion, sense of presence and cybersickness
Servotte, Jean-Christophe ULiege; Goosse, Manon ULiege; Campbell, Suzanne et al

in Clinical Simulation in Nursing (2020)

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See detailMachine learning algorithms performed no better than regression models for prognostication in traumatic brain injury
Gravesteijn, Benjamin Y.; Nieboer, Daan; Ercole, Ari et al

in Journal of Clinical Epidemiology (2020), 122

Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed ... [more ▼]

Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n = 11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with Glasgow Coma Scale <13, n = 1,554). Both calibration (calibration slope/intercept) and discrimination (area under the curve) was quantified. Results: In the IMPACT-II database, 3,332/11,022 (30%) died and 5,233(48%) had unfavorable outcome (Glasgow Outcome Scale less than 4). In the CENTER-TBI study, 348/1,554(29%) died and 651(54%) had unfavorable outcome. Discrimination and calibration varied widely between the studies and less so between the studied algorithms. The mean area under the curve was 0.82 for mortality and 0.77 for unfavorable outcomes in the CENTER-TBI study. Conclusion: ML algorithms may not outperform traditional regression approaches in a low-dimensional setting for outcome prediction after moderate or severe traumatic brain injury. Similar to regression-based prediction models, ML algorithms should be rigorously validated to ensure applicability to new populations. © 2020 The Authors [less ▲]

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See detailEmergency Department Crowding: why do patients walk-in?
BRASSEUR, Edmond ULiege; GILBERT, Allison ULiege; Servotte, Jean-Christophe ULiege et al

in Acta Clinica Belgica (2019)

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See detailErythema ab igne and its association with cannabinoid hyperemesis syndrome : a case report
Sime Sidieu, Delphine; GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege et al

in International Journal of Medical Reviews and Case Reports (2019)

The erythema ab igne is an uncommon skin disorder related to repeated heat exposure such as open fires or heating pads. Cannabinoid hyperemesis syndrome is an entity including several symptoms such as ... [more ▼]

The erythema ab igne is an uncommon skin disorder related to repeated heat exposure such as open fires or heating pads. Cannabinoid hyperemesis syndrome is an entity including several symptoms such as nausea, vomiting or frequent abdominal pain following marijuana use. Most of those symptoms can be relieved by hot showering or baths. Recently in the literature, erythema ab igne has been associated with cannabinoid hyperemesis syndrome because cannabis users tend to resort to heating pads to relieve persistent abdominal pain. We report the case of a patient with recurrent vomiting and abdominal pain attributed to cannabinoid hyperemesis syndrome, whose physical examination revealed an erythema ab igne. [less ▲]

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See detailParsonage-Turner Syndrome as a rare extra hepatic complication of hepatitis E infection
Ngah Njabom, Claude Bérenger ULiege; GILBERT, Allison ULiege; BRASSEUR, Edmond ULiege et al

in European Journal of Case Reports in Internal Medicine (2019)

Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered ... [more ▼]

Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered, among other factors, by some viral infections, although its pathophysiology remains unclear. Moreover, it has rarely been related to hepatitis E virus infection. We report the case of a 33-year-old man who was diagnosed with Parsonage-Turner syndrome following acute hepatitis E infection. [less ▲]

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See detailWhen Simulation Should and Should Not Be in the Curriculum
Servotte, Jean-Christophe ULiege; Ghuysen, Alexandre ULiege; Bragard, Isabelle ULiege

in Chiniara, Gilles (Ed.) Clinical simulation: Education, operations, and engineering (2019)

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See detailImpact of simulation training for intravenous medication administration safety: a randomised controlled study
Servotte, Jean-Christophe ULiege; Ghuysen, Alexandre ULiege; Gasteratos, Konstantinos et al

Conference (2019, March 28)

Detailed reference viewed: 29 (7 ULiège)