
Dan BenhamouUniversity of Paris-Sud | Paris 11 · Hopital Bicetre
Dan Benhamou
MD
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979
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Introduction
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January 1999 - March 2016
Publications
Publications (979)
Background
The use of an observer tool (OT) has been shown to improve learning of technical skills through observation in simulation. The objective was to assess the impact of a non-technical OT on anaesthesia residents’ learning of non-technical skills (NTS) during simulation.
Methods
After consent, residents were randomised into 2 groups: OT+ (w...
Background
Simulation training in cardiopulmonary resuscitation (CPR) is effective but active practice time is limited given the large number of students and the learning effect size remains small. To improve learning during observation, the use of an observer tool (OT) has been advocated. The aim was to assess the value of OT to improve medical st...
Background
Simulation-based education in healthcare encompasses a wide array of modalities aimed at providing realistic clinical experiences supported by meticulously designed scenarios. The French-speaking Society for Simulation in Healthcare (SoFraSimS) has developed guidelines to assist educators in the design of scenarios for manikin- or simula...
Background and objectives
The subcostal transversus abdominis plane block (scTAPB) provides analgesia to the anterior abdominal wall but analgesic spread following a single injection remains modest and variable. The oblique scTAPB, which is performed with a continuous injection during needle progression into the TAP along the oblique subcostal line...
BACKGROUND AND OBJECTIVES
Cerebrospinal fluid (CSF) collections extending longitudinally at the anterior aspect of the spinal dura have been reported in association with various conditions and under multiple names. The aim of this study was to report cases associated with brachial amyotrophy (BA) and examine its relationship with other clinical var...
Background
Central venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for...
Background
Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, “the use of simulation for summative assessment”...
PurposeTo compare two teaching methods of a forearm cast in medical students through simulation, the traditional method (Trad) based on a continuous demonstration of the procedure and the task deconstruction method (Decon) with the procedure fragmenting into its constituent parts using videos.Methods
During simulation training of the below elbow ca...
Phenomenon: The urgency of having fair and trustworthy competency-based assessment in medical training is growing. Simulation is increasingly recognized as a potent method for building and assessing applied competencies. The growing use of simulation and its application in summative assessment calls for comprehensive and rigorously designed program...
Background:
Local anesthetics have anti-inflammatory effects. Because most previous experiments were performed with supra-therapeutic concentrations, we measured the effects of clinically relevant concentrations of bupivacaine on the TLR4- and TLR2-MyD88-NF-κB pathways.
Methods:
We measured TNF-α and PGE2 release, p38 MAP-kinase phosphorylation...
Background
The p38 protein is a ubiquitous mitogen-activated protein kinase involved in the proinflammatory signalling pathway and in the pain response after various noxious stimuli. Many p38 inhibitors have been developed and shown to provide effective analgesia in animal models. They are, however, mainly administered intrathecally or intravenousl...
Loss of consciousness suddenly occurred in 2 healthy and nonsmoking patients undergoing bipolar resection for intramural myomas under spinal anesthesia. One patient had nystagmus and emesis. In both cases, neurological symptoms were of short duration. All other usual causes were excluded. Initial venous carboxyhemoglobin concentrations were 7% and...
The epidural blood patch (EBP) is one of the most effective treatments for intracranial hypotension. Anesthesiologists are familiar with performing EBPs for the treatment of dural puncture-associated intracranial hypotension following spinal anesthesia, complicated epidural analgesia, diagnostic lumbar puncture. Increasingly, EBPs are used to treat...
Background
Active learning methods, including low-fidelity simulation, are useful but the incremental learning effect of each method is however limited. We designed this study to assess if combining flipped classroom and the modified Peyton’s « 4-steps» method during procedural simulation (intervention group [IG]) would provide better learning resu...
La fréquence de l’insuffisance d’analgésie pour la césarienne, à savoir échec complet ou bloc partiel, varie entre 0,5 à 17 % pour la rachianesthésie et 1,7 à 20 % pour l’extension d’analgésie péridurale. L’insuffisance d’analgésie peut être à l’origine de souffrances physiques et psychiques aux conséquences potentiellement graves comme l’état de s...
Background: An observer tool (OT) dedicated to technical skills could improve learning of medical knowledge during simulation. However, it remains uncertain whether non-technical skills learning outcomes might be improved by using an OT.
Methods: After consent, anesthesia residents enrolled to a crisis management training simulation were randomized...
Background:
Visceral and parietal peritoneum layers have different sensory innervations. Most visceral peritoneum sensory information is conveyed via the vagus nerve to the nucleus of the solitary tract (NTS). We already showed in animal models that intramuscular (i.m.) injection of local anesthetics decreases acute somatic and visceral pain and g...
Introduction
Clinical outcomes and critical care utilisation associated with Coronavirus Disease 2019 (COVID-19) in obstetric patients remain limited particularly in relation to severe cases.
Methods
A retrospective multicentre cohort study was conducted during the first wave of COVID-19 in France in 18 tertiary referral maternity units. Consecuti...
The incidence of acute pain during caesarean section varies between studies, with a reported rate ranging between 0.5%–17% for spinal anaesthesia and 1.7%–20% for epidural anaesthesia. Leaders from the French Club Anesthésie Réanimation en Obstétrique (CARO) convened to provide a clinical framework and practice bulletin to prevent, recognise and tr...
Introduction:
The growing number of learners implies that all of them cannot play an active role during high-fidelity scenarios. Studies suggest a positive educational value when learners are observers only, but it remains uncertain whether learning outcomes might be improved by using an observer tool (OT).
Methods:
Eighty-nine anesthesia reside...
Background:
A serious game (SG) is a useful tool for nurse training. The objectives of this study were to assess validity evidence of a new SG designed to improve nurses' ability to detect patient clinical deterioration.
Methods:
The SG (LabForGames Warning) was developed through interaction between clinical and pedagogical experts and one devel...
We report in this review our clinical strategy to perform ultrasound-guided scalp nerve blocks for cranial and neurosurgical cases.
( Eur J Anaesthesiol . 2019;36:755–762)
Currently about 80% of deliveries in France involve an epidural for labor analgesia. Epidural rates and programs have changed over time, but various authors have found that a programmed intermittent epidural bolus (PIEB) plus patient-controlled epidural analgesia (PCEA) demand dosing strategy for maintenance...
Background
The most recent recommendations support learning of external cardiac massage (ECM) through feedback devices.
Objectives
The objective was to compare the effects on immediate and 3-month retention of ECM technical skills when using feedback devices compared with training without feedback as part of a half-day training session in medical...
Data-driven approaches for creating virtual patient dialogue systems require the availability of large data specific to the language, domain and clinical cases studied. Based on the lack of dialogue corpora in French for medical education, we propose an annotated corpus of dialogues including medical consultation interactions between doctor and pat...
Introduction:
The use of cognitive aids (CAs) during critical events is thought to be useful. However, whether CAs are known and used by French and Canadian anaesthesia providers is not clear.
Methods:
A survey was emailed to French and Canadian anaesthesia providers in 2017 through their respective national societies. It consisted of 23 questio...
Résumé
Les compétences autres que techniques ou cliniques sont reconnues comme étant essentielles en chirurgie. La majorité des événements indésirables graves en santé sont liés à des défaillances dans ces compétences dites « non techniques » (CNT). Ces données ont suscité l’intérêt de former les chirurgiens aux CNT. Des échelles d’évaluation repro...
Skills other than technical or clinical competences are also recognized as essential in surgery. Most serious adverse events in health care are related to non-technical skill (NTS) failures. This has fostered interest in teaching surgeons about NTS. Reproducible evaluation scales, inspired by management strategies in the air transportation industry...
Background
Early detection and response to patient deterioration influence patient prognosis. Nursing education is therefore essential. The objective of this randomized controlled trial was to compare the respective educational value of simulation by gaming (SG) and a traditional teaching (TT) method to improve clinical reasoning (CR) skills necess...
Purpose
Animal models of regional anaesthesia are useful for studying the effects of blocks and improve their efficacy. The aim of our experiments was to validate a multi-site paravertebral block in the rat.
Material and methods
Dissection and indigo carmine dye injection were performed in five rats (3 rats were dissected and 2 were dye injected)....
Background:
Epidural analgesia may change the mechanics of childbirth. These changes are related to the concentration of the local anaesthetic used epidurally but probably also to its mode of delivery into the epidural space.
Objective:
To determine whether the administration of programmed intermittent epidural boluses (PIEB) improves the mechan...
In the medical domain, virtual patient or doctor dialogue systems help to train students autonomously to medical diagnosis via simulation. In this work, we exploited the semantic properties captured by distributed word representations to search for similar questions in the dialogue system of a medical conversational agent. We created two dialogue s...
Background and objectives:
The success rate and spread of thoracic paravertebral block (TPVB) are variable and difficult to predict. It is now recommended that an ultrasound guidance technique should replace the traditional landmark technique. The objective was to compare anatomical outcomes of both techniques on cadavers.
Methods:
A landmark te...
Importance
The use of cricoid pressure (Sellick maneuver) during rapid sequence induction (RSI) of anesthesia remains controversial in the absence of a large randomized trial.
Objective
To test the hypothesis that the incidence of pulmonary aspiration is not increased when cricoid pressure is not performed.
Design, Setting, and Participants
Rando...
Objectives:
Since pain and post-operative nausea and vomiting (PONV) are the main reasons for failed discharge after day-case surgery, assessing pain and PONV is important. The aim was to describe the perioperative pain and PONV management within selected day-case surgical procedures in France.
Methods:
The OPERA trial was carried out on given d...
Objectives:
Major abdominal surgery usually requires general anesthesia with tracheal intubation and may be supplemented with neuraxial anesthesia to provide intraoperative and postoperative pain relief. Attempts at using only neuraxial anesthesia for major abdominal surgery have often been shown to be poorly effective. This report demonstrates th...
Pain during and after pulmonary percutaneous radiofrequency ablation (RFA) may be severe enough to require opioids. Thoracic paravertebral block (TPVB) is a regional anesthetic technique that can relieve pain during and after abdominal or thoracic painful procedures. We report the use of TPVB to relieve postprocedural pain in a 50-year-old woman af...
Perioperative hyperglycaemia (>1.80g/L or 10 mmol/L) increases morbidity (particularly due to infection) and mortality. Hypoglycaemia can be managed in the perioperative period by decreasing blood sugar levels with insulin between 0.90 and 1.80g/l but it may occur more frequently when the goal is strict normoglycaemia. We propose continuous adminis...
Follow on from continuous intravenous administration of insulin with an electronic syringe (IVES) is an important element in the postoperative management of a diabetic patient. The basal-bolus scheme is the most suitable taking into account the nutritional supply and variable needs for insulin, reproducing the physiology of a normal pancreas: (i) s...
Ambulatory surgery can be carried out in diabetic patients. By using a strict organisational and technical approach, the risk of glycaemic imbalance is minimised, allowing the patients to return to their previous way of life more quickly. Taking into account the context of ambulatory surgery, with a same day discharge, the aims are to minimise the...
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk...
Diabetes mellitus is defined by chronic elevation of blood glucose linked to insulin resistance and/or insulinopaenia. Its diagnosis is based on a fasting blood-glucose level of ≥1.26g/L or, in some countries, a blood glycated haemoglobin (HbA1c) level of >6.5%. Of the several forms of diabetes, type-2 diabetes (T2D) is the most common and is found...
Résumé
Durant ces dernières années, un intérêt majeur a été porté à l’évaluation des apprenants lors de leur éducation médicale. Le noyau de la compétence médicale est le raisonnement clinique qui devrait être acquis par tous les acteurs en médecine. Son évaluation comprend la capacité d’intégrer et d’appliquer différents types de connaissances, de...
Background:
Venous thromboembolism (VTE) prophylaxis is not always part of the usual care of ambulatory surgery patients, and few guidelines are available.
Objectives:
To collect data on the application of VTE prophylaxis in ambulatory patients.
Design:
The OPERA study is a large national survey performed in 221 healthcare facilities.
Patient...
A patient should be referred to a diabetologist perioperatively in several circumstances: preoperative recognition of a previously unknown diabetes or detection of glycaemic imbalance (HbA1c <. 5% or >. 8%); during hospitalisation, recognition of a previously unknown diabetes, persisting glycaemic imbalance despite treatment or difficulty resuming...
Aim:
The increasing use of high-fidelity simulation is limited by the imbalance between the growing number of students and the human resources available in such a way that all residents cannot play a role during scenarios. The learning outcomes of observers need to be studied.
Methods:
This prospective randomised study was approved by the instit...