{"id":1904,"date":"2010-10-01T01:00:00","date_gmt":"2010-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/les-saignees-au-ch-de-st-brieuc\/"},"modified":"2018-10-20T18:39:55","modified_gmt":"2018-10-20T16:39:55","slug":"les-saignees-au-ch-de-st-brieuc","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/les-saignees-au-ch-de-st-brieuc\/","title":{"rendered":"Les saign\u00e9es au CH de St BRIEUC"},"content":{"rendered":"<p><strong>2010<\/strong><\/p>\n<p><em>Catherine TREGUIER,,Olivier NOUEL<\/em><\/p>\n<p><strong>H\u00e9patologie <\/strong>&#8211; \u00a02010-09-04 &#8211;\u00a0CO &#8211;<\/p>\n<p>________________________________<\/p>\n<p>Les phl\u00e9botomies sont le traitement quasiment unique des surcharges en Fer .Au CH de St BRIEUC nous prenons en charge les surcharges en Fer depuis 30 ans .<br \/>\nLa technique de cet acte est bien codifi\u00e9e , de m\u00eame que la surveillance .Du fait de son exp\u00e9rience (1500 saign\u00e9es par an depuis 10 ans),le r\u00f4le de l\u2019infirmi\u00e8re ne se limite pas \u00e0 l\u2019ex\u00e9cution du geste technique.Elle prends en charge les malades surveille l\u2019\u00e9volution de la d\u00e9pl\u00e9tion en fer ,alerte le m\u00e9decin en cas de baisse excessive ou insuffisante au cours du traitement ,organise et module la surveillance ,d\u00e9cide d\u2019\u00e9ventuelles consultations m\u00e9dicales .<br \/>\nLes derni\u00e8res ann\u00e9es ont \u00e9t\u00e9 marqu\u00e9es d\u2019un certain nombre d\u2019\u00e9v\u00e8nements concernant la prise en charge des surcharges en Fer ;Recommandation de l\u2019HAS sur la prise en charge de l\u2019h\u00e9mochromatose HFE 1(2004),circulaire fronti\u00e8re (Aout 2007),Autorisation d\u2019utiliser le sang des h\u00e9mochromatosiques par l\u2019EFS (JO du 12 Janvier 2009) ,Publication d\u2019une cotation pour les saign\u00e9es (19 fevrier 2009)<br \/>\nMalgr\u00e9 une stricte application des recommandations la CRAM nous a inflig\u00e9 une forte amende (un recours est en cours)<br \/>\nToutes les saign\u00e9es sont donc r\u00e9alis\u00e9es en Consultation externe ;les malades ach\u00e8tent leur poches,les examens de labo sont r\u00e9alis\u00e9s en externe .<br \/>\nNous avons par ailleurs tenter d\u2019externaliser le lieu des saign\u00e9es .Tous les malades (clients ?) ont \u00e9t\u00e9 revus en consultation ,et il leur a \u00e9t\u00e9 propos\u00e9 de r\u00e9aliser leur saignes soit dans le secteur lib\u00e9ral ,soit a l\u2019EFS .<br \/>\n187 malades ont souhait\u00e9 continuer \u00e0 venir dans l\u2019H\u00f4pital.37 sont all\u00e9s dans le secteur lib\u00e9ral (dont 14 n\u2019ont jamais \u00e9t\u00e9 revus).37 malades sont all\u00e9s a l\u2019EFS .<br \/>\nNotre collaboration avec l\u2019EFS est d\u00e9cevante ;malades refus\u00e9s ,horaires trop stricts, perte de temps,lourdeur administrative,<br \/>\nNotre collaboration avec le secteur lib\u00e9ral est tout aussi d\u00e9cevante ; probl\u00e8mes techniques ,difficult\u00e9s a trouver un cabinet infirmier qui accepte ,suivi m\u00e9dical interrompu.<br \/>\nAvec le nouveau bar\u00eame (39,85 Euros l\u2019acte) ,il nous semble que l\u2019h\u00f4pital est \u00ab b\u00e9n\u00e9ficiaire \u00bb,puisque le cout pour l\u2019h\u00f4pital est estim\u00e9 a 10 Euros.<br \/>\nJe n\u2019exclue pas cependant une d\u00e9cision autoritaire de la direction ,qui pourrait nous ordonner de ne plus faire cet acte\u2026..<br \/>\nD\u00e9cision en attente \u00e0 ce jour (22 Aout)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>2010 Catherine TREGUIER,,Olivier NOUEL H\u00e9patologie &#8211; \u00a02010-09-04 &#8211;\u00a0CO &#8211; ________________________________ Les phl\u00e9botomies sont le traitement quasiment unique des surcharges en Fer .Au CH de St BRIEUC nous prenons en charge les surcharges en Fer depuis 30 ans . La technique de cet acte est bien codifi\u00e9e , de m\u00eame que la surveillance .Du fait de [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[21],"class_list":["post-1904","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-21"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Les saign\u00e9es au CH de St BRIEUC - Abstracts des congr\u00e8s de l&#039;ANGH<\/title>\n<meta name=\"description\" content=\"ANGH R\u00e9sum\u00e9s congr\u00e8s H\u00e9patologie Gastroent\u00e9romogie Hepatology Gastroenterology Etudes cliniques Clinical study\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/angh.net\/abstracts\/les-saignees-au-ch-de-st-brieuc\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Les saign\u00e9es au CH de St BRIEUC - 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