Medical Health Information

The CEC is composed of two entities: the machine heart / lung circuit.
Heart lung machine (also called console CEC) carries the pumps, the arrival of fresh gas monitoring equipment and safety. It is a combination of precision mechanics, electronics and computing. On the console is installed circuit CEC. It includes several elements, disposable, plastic, of different natures: the pipes (or tubes) is connected to the cannula inserted into the vessels surgeon to drain venous blood and oxygenated blood return.

The pump receives the blood pressure of the venous reservoir and blows it into the patient's body through the gas exchanger. The oxygenator or gas exchanger ensures patient's pulmonary function during cardiac surgery (oxygen and release carbon dioxide). The filter uses arterial bubble trap and is responsible to remove all impurities and bubbles out of the blood oxygenator before being reintroduced into the aorta.

Work pro!
CEC is performed in 90% of cases by a technician CEC, that is to say, a nursing graduate of State (DE), under the joint responsibility of the surgeon and the anesthetist: "The perfusionist has a key role but it is a profession unknown. " Since the 80s, the CEC has been conventionally used in the majority of interventions through the miniaturization of equipment, which reduces the boot volume) circuit CEC equivalent performance. Thanks to these advances, the pump-oxygenator system is adapted to the size of newborns, and trauma intervention reduced.

Congenital heart surgery: details
It is about 3800 operations per year. Mortality was 3% all interventions combined. It requires highly specialized structures with advanced skills in:

- Prenatal diagnosis and maternity
- Pediatric Cardiology
- Surgery
- Resuscitation postoperative
- Service postoperative hospital stay

Only eight hospitals in France have sufficient activity to qualify for this expertise Paris with 3 centers (1800 patients, Lyon, Marseille, Bordeaux, Nantes and Strasbourg.

You wanted to breastfeed. You do not have. You planned to breastfeed for at least a year. Before you had to stop. We told you everything would be obvious, but for you, breastfeeding was complicated. In short, things did not go as planned, and you are experiencing any difficulty. You're not alone.

First read our article Do not be breast-feed: a failure?

Here are some testimonies on the Facebook page survey.

Have you experienced the end of your breast as a failure? Why?
Yes, because I was not ready to stop. I did work for seven months, and I would have liked to continue ... It was difficult because the baby felt my stress!
Melanie

No, because from the beginning I told myself that if breastfeeding works fine otherwise the bottle. I was game from the start with two solutions in mind not to live as a failure precisely.
Stephanie

I would have loved to continue. I stopped at one month and a half because I did not have enough milk .! However, I also believe that my guy was from lactose intolerance. Today, he is four months, and he drinks lactose-free milk. I so broke my heart not to be able to continue breastfeeding, but I think I tried anyway!
Chantal

I would really, seriously. And yes it would be a big failure for me. I did not want to give these powder mixtures.
Emmanuelle

My daughter never wanted to breastfeed so I had to opt for the bottle, and I think I do not feel as responsible would be if it was not the nurses at the hospital that made me really feel guilty.
Genevieve

I spent a LOT of breastfeeding difficulties. I even consulted three lactation consultants. I think when we want, we can! I am now breastfeeding godmother, and I love helping my men tee. For cons, I struggled to my grief when I had to stop breastfeeding my son at nine months because I was pregnant with her little brother for two months, and my production had fallen sharply.
Marie-Pierre

For my oldest, I stopped after about two weeks, he drank a lot, and I had no one to guide me ... In the second, I got two months, but he did not drink and was very nearly not bawling, so bright the bottle! For my youngest, I told myself that if it works, great, if not, I'm not a good mother, and finally, I do breast fed eight months and a half ... For my boys, I was disappointed not bad, but with my daughter, I was very proud ...
Julie

My daughter had no sucking reflex so breastfeeding did not work for me, and yes I experienced a failure and grief. Even today, I saw hardly more than a year after his birth, I feel bad about not being able to breastfeed my daughter.
Claudine

I really wanted to breastfeed, both for the mother-child relationship as the beneficial side. Unfortunately, my son did not sucking. At the hospital, I felt a lot of pressure sometimes I even three nurses who were trying to make me into drinking the breast. The point that he makes hypoglycemia because it does not feed enough. It was a torture to feed every two hours. I saw nurses arrive. I wanted much, and everyone told me that nothing was supposed to prevent this. I mothered two days ago, and I was so bad. Until my husband gets tired and brings a bottle. Finally, Antoine regained strength! Except that nurses returning me asking if I wanted again. I held my end, and all is well. It's hard to resist the pressures of breastfeeding and not feel "unfit mother" and I have to constant justify myself when I leave a bottle. I'm all for breastfeeding, but I think we exaggerate with it.
Amylene

The nursing pillows

Some will tell you to take a pillow for breastfeeding; however, the nursing pillow is a tool best suited to your position and baby during breastfeeding.

Do not forget that we must compensate several inches between the knees and breasts and breastfeeding often lasts 15 to 30 minutes. Media that is too thin (or worse, not at all!) Will give you serious back pain. Regardless of the form, choose a pillow that provides good strength and does not overwrite a simple hand pressure. Finally, beyond the color of the cover, make sure it is washable.

Cushion C
Appreciated for its firmness, the pad contains a polyester fill which is not deformed with use. Form C guard in place on the hips. Two sizes are available depending on the size of mom. The amount of padding is adjustable. $ 40 to $ 55 depending on the cover chosen.

Cushion cylinder
This long cylinder filled with shells brash easy to use regardless of the breastfeeding position chosen. You can nest in a hollow baby or raise his head by simply moving the shells to the right place. Additional scales can be purchased separately. It also makes a body pillow during pregnancy. $ 60

U cushion (square) Baby Carousel.
This cushion provides a sizeable surface for the baby thanks to its large plateau in front. Ties to ensure you back it stays in place. In its washable cover, the cushion is waterproof and therefore protected from unexpected damage. Small pockets at the corners can keep on hand some basic (swabs, tissues, etc....) $ 60.

Molded cushion My breast friend
This pillow is made of molded foam, without granule or bump. It completely surrounds the waist and offers unparalleled back support. It is adjustable and closes by a loop of plastic the washable cover sewn pouch to store some useful items. A twin version is also available. $ 55 (reg.) or $ 95 (twins)

Cushion moon
This versatile long cushion that looks like a moon gives you full support. Buckwheat hulls embrace your body to support baby in the front but also your back. You can adjust the volume of shells based on their age. Its length and flexibility make it an excellent body pillow. It is perfect for breastfeeding twins also. - $ 140

Finally, most of the cushions can be used to support the child begins to sit. It will also be small (big brothers or sisters; supervision please) who want to keep baby safe. And come to think, breastfeeding or not, it is always more comfortable to have a baby when you have a support. Some nights may be long ...

Nurses who will take the certification exams should take the time to prepare. Test requirements vary by state, but the review is generally divided into two parts. The success of two exams ensures employers that candidates have met state and federal requirements for nursing, according to the National Council of State Nursing Councils (NSCBN).

Written examination
Written examinations are the generally multiple choices. They cover the patient hygiene, grooming, elimination process, dressing, nutrition, hydration, relaxation and comfort. Knowledge base included vocabulary, patient safety, infection control, procedures, data collection and emergencies. Assist nurses with procedures, skin care, cleanliness and skills restorative room are additional topics of study, according to the NSCBN.

Competency Exam
Part skills examination tests your ability to accomplish what you have learned in clinical settings. Some states, such as Oregon, provide all the necessary equipment and the candidate will perform five skills of their choice. Clinical skills, patient ambulation, food aid, aid basin, bed covers and nail care blood pressure, pulse, temperature and respiration (vital signs), range of motion, patient positioning, hand washing and to collect samples of the major areas of study nurse aide.

Pre-employment
It needed to pass a pre-employment test, some employers, such as Louisiana State University Medical Center, Nursing Assistant. Written test and skills test in addition to a math test, are. Math portion domestic apothecary, and includes questions about the metric system of measurement.

Nursing

Nurses Health Canada provides quality nursing services that are based on evidence and respect the cultural,  in the perspective of improving the health of First Nations.

Where nurses work.

Nurses working in rural, remote and isolated First Nations south of the 60th parallel. In better than 600 First Nations communities across Canada, there are 76 nursing stations and more than 195 health centers. Nurses are often the main point of contact with the community health care system. In nearly half of the health facilities, the RNs are employed by Health Canada, which is part of the federal government.

Through the Office of Nursing Services (ONS) and regional offices of the SPNI, Health Canada employs hundreds of nurses. Regional offices of the SPNI provide service, support and management, dealing, for example, the orientation of newly recruited nurses. BSI develops standards, policies, guidelines and leads national initiatives.

What the nurses

Provision of primary health care in remote communities and cultures of First Nations communities create special requirements for nurses. In  schools, health centers, nursing stations and homes nurses can:

Visit new parents and facilitate the care of the newborn;
to immunization;
encourage physical activity;
animate community education sessions;
provide primary care services in the context of current clinical planned;
respond to emergencies (e.g., trauma, emergency obstetric care and heart problems).
Primary care

Such as access to hospitals and doctors is limited, nurses in remote communities often provide care that requires advanced knowledge and skills, as well as clinical judgment. Nurses employed by Health Canada in respect of care to clients requiring treatment for common health problems, immediate and urgent, a holistic approach focuses on:

The promotion of health;
disease prevention;
Management of the disease;
clinical assessment.
Community Health Nursing

Nurses working in First Nations communities are responsible for the planning and implementation of health programs adapted to different cultures.

Health Canada requires that the nurse who is deficient in terms of formal education in community health nursing follow and successfully complete the appropriate courses in this area. Nurses employed receive financial support to attend these courses and earn credits for their bachelor's degree in nursing.

"As part of the reorganization of health care in Friuli Venezia Giulia and the objective to strengthen services in the territory, it gradually expanded the model of a community nurse, for their demonstrated ability to reduce this figure to the emergency room, and effective as a filter to the hospital. " The president says the region, Renzo Tondo, in his capacity as commissioner for Health, commenting on the positive results of 10 years of experimentation with this method of community care, initiated experimentally since 2001, in the District 5 Ass " Lower Friuli " which also operates hospitals in Palmanova and Latisana.

In the period 2009-2011 in two hospitals were in fact recorded 79,397 accesses to the emergency room with white code (no urgency), as compared to 97,282 requests for the three years 2005-2007, with a reduction of 17,885 accesses, equivalent to a minus 18.3 %. In 2011, people who went to the emergency room of two hospitals to code white, were 4,742 fewer than in 2009. While stressing that a more appropriate use of the emergency-room results from the combination of different factors and specific strategies implemented by the local health, and that is why the trend is generally down across the region, the presiding round shows how the presence of the nurse in the community, both outpatient and at home, reducing hospital use. The most vulnerable, chronically ill or simply because older, are kept under control in the long term.

Even the nurses can detect early signs of aggravation of a disease and alert the family physician. "It's a brilliant example of medicine and care initiative - said Tondo - no longer centered on the hospital, but on local services closer to the demands and needs of social-health of the population." Latisana and Palmanova they have the lowest regional rate of hospitalization, which is accompanied by the highest rate of coverage of care of the elderly (over 65 and over 75). Community nurses, therefore, as a promoter of continuity of care and the socio-health, in collaboration with professionals and players in the area. However, also as a key element in the care of patients discharged from a hospital, in close relationship with family doctors and social workers of Commons.

In short, a professional, Round concludes, can give effective responses to some objectives that the region has been given to modernize and make more uniform the health and social services: strengthening of local services, taking charge of integrated persons with chronic illnesses and disabilities, enhancement of home-care interventions, referral hospital for true emergencies and acute illnesses. The nurse is a community project with commitment and passion from the executive nursing association 5, Mara Pellizzari, and its contributors. We were progressively activated 21 "stations" of the community nurse, laid against the 23, with a coverage of 29 communes of 31 (missing Latisana and San Giorgio). In 2011, the initiative has been awarded by the Ministry of Health as one of the 10 best projects, as part of a research sponsored by the University on "The driver of development of local services."

At the emergency-room nurse who "sees and cherishes"

It's called See & Treat in means "to see and care," the new way to manage the emergency room where the nurse becomes more and more managers, which in recent months has sparked the ire of doctors. The spark was a decision reached last year of the Tuscany Region, which has formalized the See & Treat, hitherto only a trial.

Access to the emergency room - is the new forecast - the nurses, formerly responsible for assigning the "color" of triage to determine the severity of the case. It can directly send the patient to a specialist without going to the doctor or emergency room, in case of minor procedures (such as minor cuts and abrasions, minor bruising, sunburn, insect stings, rhinitis, conjunctivitis), act by itself.

"The fundamental skills of the role of a guarantor of the physician cannot be subject to overlapping or inappropriate subtract, instead forming an exclusive legal obligation and an ethical duty of the doctor and dentist," was the summary of the response of the National Federation of Associations of doctors.

Harder the hospital. According to the Anaao, the largest trade union, the study should have "clear responsibility profiles and not to conceal attempts to move towards a low-cost health care." And Cimo has launched an appeal to the Minister of Health, Ferruccio Fazio, to "immediately change the law with national expertise in the healthcare professions: a resolution to come is not enough." Even the Medical Association of Bologna raised the issue of competence.
It dampens the tone instead Federation of Nurses (Ipasvi), stating that it is a "no news" because the See & Treat formalizes what many year's nurses are in the emergency department: It is expected to indent the less severe cases have to be a law of 1992.

However, if one of the See & Treat is an open dispute between doctors and nurses; the "struggle" between the health professions does not stop there. Off the dispute between doctors and biologists in the 90s on the direction of the testing laboratories, is the last week's announcement of the medical college of Rome (the biggest in Europe) the judgment of the court in the capital with which freezes the opportunity to own biologists to prescribe diets: an exclusive competence of the physician, the order said dryly.

It is still early March attack each other therapists (doctors)-physiatrists (technical) on the new rehabilitation plan developed by the Ministry of Health. According to the doctor's aims to "unify the service, overcoming sectional interests," while for the engineers is a "specialist for the Superman."

And it is now ancient history the "nyet" to the recognition of the profession of dentistry as a dental technician and ophthalmologists to that of an optician. Reason: doctors do not want to invasions of the field.