Aider à soulager différents symptômes

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Transcription de la présentation:

Aider à soulager différents symptômes

Plaies compliquées Anxiété / dépression Delirium

Plaies compliquées

Plaies compliquées Conséquences: Douleurs spontanées, au changement de pansement Saignements/écoulements Odeur

Berna C, Rev Med Suisse 2013;1360-1365 Contrôler la douleur

Plaies compliquées Saignements/écoulements: Précautions lors du changement de pansement – humidifier ++++ Nettoyer la plaie avec NaCl 0.9% Adrenaline 1‰ ou sucralfate liquide, év. cp écrasés (Ulcar®) – pommade HEC® (acide tannique, phénazone, extrait hammamélis) Acide Tranexamique

Plaies compliquées Odeur -> honte Examiner la plaie sans grimacer «Le reflet que les patients voient d’eux- mêmes dans le regard du soignant renforce leur sens de la dignité. Il semble qu’en partie du moins la dignité se découvre dans l’œil de celui qui regarde»

Lutter contre les mauvaises odeurs Changement régulier du pansement Laver abondamment la plaie (NaCl 0.9%) Saupoudrer la plaie avec de la poudre de Métronidazole® (réduire les cp. en poudre) – Pas plus de 14 jours consécutifs Si néc. relai avec amoxicilline en poudre (ouvrir les gélules) Pas d’antibiotiques par voie générale (ø pénétration du produit)

Lutter contre les mauvaises odeurs

Anxiété / Dépression Réaction normale de la part du malade / des proches Ecouter – stimuler à exprimer la souffrance Répondre aux questions: matérielles / spirituelles Médicaments: Diazepam (Valium®)2.5 – 10 mg au coucher Bromazépam (Lexomil®) 1.5 mg matin et midi, 3 mg au coucher Chlorazepam (Tranxène®) 10 mg au coucher Mirtazapine 15 – 30 mg au coucher

Délirium Définition du delirium: perturbation de la conscience, de la perception, de la pensée et du sommeil Très fréquent: jusqu’à 80% des malades en fin de vie  Angoisse, malaise +++ des proches / des soignants

Delirium: causes

Delirium: traitement Corriger les causes accessibles Haloperidol (Haldol®):

These resources are developed as part of the Integrate 2 project Rwanda, whose goal is to strengthen and integrate palliative care into national health systems through a public health primary care approach Acknowledgement given to Cairdeas International Palliative Care Trust for their preparation and adaptation part of the teaching materials for the Palliative Care Toolkit training with modules as per the Training Manual can be used as basic PC presentations when facilitators are encouraged to adapt and make contextual