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673.More information
Between January 2016 and June 2020, Canada recorded more than 17,602 deaths attributable to opioid overdose, an increase that prompts healthcare professionals to develop clinical interventions aimed at decreasing population overdose. As emergency departments (EDs) are often the first point of care for people at risk of opioid overdose, the current intervention focused on dispensing take-home naloxone (THN) and initiating opioid agonist treatment (OAT) among ED patients who are at risk of opioid overdose (ROO). In 2018, the SuboxED project convened a multidisciplinary group of clinical experts to implement a clinical algorithm for dispensing THN and prescribing buprenorphine/naloxone (B/n) for at ROO patients in 3 Québec EDs.Methodology: This project had two phases: 1) planning and implementation, and 2) evaluation. This article will describe the first phase, from April 1, 2018 to April 30, 2019, which included several progressive stages: 1) convening a multidisciplinary group of clinicians ; 2) identifying the EDs, OAT clinics, and pharmacy partnerships in Quebec ; 3) establishing the eligibility criteria for intranasal naloxone and B/n based on scientific recommendations ; 4) developing training tools and the ED algorithm ; and 5) implementing the algorithm for patients at ROO.Conclusion: The SuboxED project developed a clinical algorithm in response to the opioid crisis in Quebec and contributed to improving naloxone access in EDs, despite many challenges. The implementation of such an algorithm is feasible and should be deployed widely, especially during health crises such as the COVID-19 pandemic. The clinical evaluation of the implementation process will follow.
Keywords: buprénorphine-naloxone, naloxone, algorithme, salle d'urgence, opioïdes, surdose, buprenorphine/naloxone, take-home naloxone, emergency room, overdose, opioid, algorithm, buprenorfina-naloxona, naloxona, algoritmo, sala de emergencia, opioides, sobredosis
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676.More information
Established in 1986, French palliative medicine emerged as a response to criticism of the hospital management of end-of-life care. Palliative Care Units (PCUs) are specialized facilities for patients in the advanced stages of serious and incurable diseases. Drawing from ethnographic research, we will focus on the practices employed by the team to stage, in language and imagery, the transitions from patient to deceased. Examining the moments surrounding death will enable us to analyze the post-mortem scene more specifically and explore its ritualistic and sacred aspects, demonstrating how this dual architectural and corporeal materialization functions in tandem.
Keywords: Soins Palliatifs, Rituel funéraire, Architecture hospitalière, Toilette post mortem, Cuidados Paliativos, Ritual funerario, Arquitectura hospitalaria, Aseo post mortem
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