Guillaume Pelée de Saint Maurice

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Violations are deliberate deviations from standard procedure. The usual reaction is to attempt to eliminate them and reprimand those concerned. However, the situation is not that simple. Firstly, violations paradoxically may be markers of high levels of safety because they need constraints and defences to exist. They may even become more frequent than(More)
BACKGROUND Safety rules continue growing rapidly, as if constraining human behaviour was the unique avenue for reaching ultimate safety. Safety rules are essential for a safe system, but their multiplication can have counterproductive effects. OBJECTIVE To monitor, in an anaesthesia ward, compliance with a process-oriented safety rule, and understand(More)
SIR—We read with interest the article by Chong et al. on the incidence of postoperative myocardial damages (PMD) measured by troponin (Tn) release after emergency orthopaedic surgery in older patients and its relationship with late mortality [1]. We fully agree with their conclusion when they say that PMD are very common after hip fracture. Indeed, two(More)
demonstrate that overdose vs. the drug therapy itself, as the causative issue. If the body weights are very low, it may actually demonstrate the overall safety in heavier populations or those treated appropriately for body weight. Also, the longstanding recommendation to start b-blockade 2 weeks before surgery, would allow for individuals susceptible to(More)
We report the perioperative management of a woman expressing an antibody against high frequency red cell antigen (anti-Kel4 antibody anti-kpb) who was scheduled for a total knee replacement. A specific strategy was designed to afford this major orthopedic surgery, considering specially the occurrence of unusual bleeding higher than the average bleeding(More)
BACKGROUND Adverse events in the perioperative period remain frequent, occurring in about 30% of the hospital admission and may be avoidable in nearly 50% of cases. Improving safety needs a continuous assessment of the risk level. MATERIAL AND METHODS Data from the MACSF-Sou medical insurance company, including all the statements declared by(More)