Vi D'Orio

Centre Hospitalier Universitaire de Liège | CHU de Liège · Service des urgences

In mid-2020, the University of Liège (ULiège, Belgium) commissioned the ULiège Video Game Research Laboratory (Liège Game Lab) and the AR/VR Lab of the HEC-Management School of ULiège to create a serious game to raise awareness of preventive measures for its university community. This project has its origins in two objectives of the institutional p...

Background The role played by large-scale repetitive SARS-CoV-2 screening programs within university populations interacting continuously with an urban environment, is unknown. Our objective was to develop a model capable of predicting the dispersion of viral contamination among university populations dividing their time between social and academic...

Objectives:Due to the persistent primary care physicians shortage and the substantial increase in their workload, the organization of primary care calls during out-of-hours periods has become an everyday challenge. The SALOMON algorithm is an original nurse telephone triage tool allowing to dispatch patients to the best level of care according to t...

Objectives: Primary care treatable visits in the Emergency Department (ED) are part of the different factors leading to the overcrowding. Their triage and diversion to alternative care centers could potentially help manage the increasing E inflow provided the establishment of an advanced triage to ensure patients’ safety. We aim to suggest a new tr...

Oral presentation at the 2021 SESAM annual meeting - Presentation of the ODISSEE platform

Development of new technologies in the healthcare system is acurrent and exciting concern for many physicians. Management ofunscheduled primary and emergency care is one of the many areasin which technological innovations are starting to emerge.We developed a French-language self-triage platform, called ODISSEE (Outil Décisionnel et Informatif des...

The COVID-19 pandemic has imposed significant challenges on hospital capacity. While mitigating unnecessary crowding in hospitals is favorable to reduce viral transmission, it is more important to prevent readmissions with impaired clinical status due to initially inappropriate level of care. A validated predictive tool to assist clinical decisions...

Background The coronavirus infectious disease 19 (COVID-19) pandemic has resulted in significant morbidities, severe acute respiratory failures and subsequently emergency departments’ (EDs) overcrowding in a context of insufficient laboratory testing capacities. The development of decision support tools for real-time clinical diagnosis of COVID-19...

In March 2020, the COVID-19 pandemic started to spread among the Belgian territory. Our university hospital was confronted to the very need of specific reorganizations guided by the implementation of the Hospital Emergency Plan.This article aims to describe the experience of the University Hospital of Liège (CHU Liège) during the COVID-19 outbreak...

Since December 2019, a novel coronavirus (SARS-Cov2) disease emerged in China with the evidence of multiple cases of severe pneumonia. Since then, various clinical findings and complications related to that infection have been described. Recently, studies reported various cases of thrombotic events complicating SARS-Cov2 infections. Particularly, t...

Objectives: Since the beginning of the novel coronavirus outbreak, different strategies have been explored to stem the spread of the disease and appropriately manage patient flow. Triage, an effective solution proposed in disaster medicine, also works well to manage Emergency Department (ED) flow. The aim of this study was to describe the role of a...

New method to regulate uNscheduled urgeNt care : the odissee iNteractive self-triage platform summary : The regulation of the unscheduled care takes part of the different methods engaged to better organize the global demand for unscheduled urgent care among the different levels of care. Indeed, the first level of care equally with the emergency dep...

La maladie de moyamoya est une vasculopathie cérébrale souvent méconnue. Sa découverte est majoritairement brutale dans les suites de la survenue d’un accident vasculaire ischémique ou, dans certains cas, hémorragique. L’artériographie est l’examen de choix pour confirmer le diagnostic. Différentes approches thérapeutiques ont été proposées, qu’ell...

L’objectif de notre étude est d’apporter une réponse originale à la problématique de la permanence médicale de première ligne liée au vieillissement médical et à la charge de travail croissante. Nous proposons, à cet effet, la mise en place d’une interface de régulation des appels en période critique (nuit profonde) au moyen d’un outil algorithmiqu...

Moyamoya disease is a rare cerebral vasculopathy. Disease onset is mainly sudden presenting as an ischemic stroke but also sometimes as a brain hemorraghe. Cerebral angiography is the gold standard to confirm the diagnosis. Different therapeutic approaches have been described such as conservative management or endoscopic and surgical approaches. We...

Facing the aging of primary care practitioners and their still increasing duties, we implemented a new and original solution to maintain the continuity of primary care in the area surrounding of our university hospital. Thereby, we created a new model of nurse telephone triage for the regulation of out-of-hours primary care calls, the SALOMON algor...

Heart transplantation remains undoubtedly the most effective treatment for end-stage heart failure, whatever its cause. Last decade has witnessed significant improvements in terms of morbidity and mortality following heart transplant. The 5-year survival rate is now beyond 70 %. However, the shortage of potential donors limits its use and requires...

Objectives: For years, general practitioners (GP) shortage and patients’ increasing demand for acute care have been associated with Emergency Department (ED) crowding. Indeed, EDs admissions for non-emergency care seem to constantly increase. Surprisingly, the rationale for patients own decision to directly reach EDs over primary care have been poo...

Certificat Inter-universitaire en Education Thérapeutique du Patient Insuffisant cardiaque : une expérience en Belgique francophone Présenté au JFIC-CAT à Rennes, 19 et 20 septembre 2019

Objective To investigate the factor structure of the Clock-In-the-Box (CIB), a cognitive screening measure, and compare it to the original CIB subscores (Working Memory and Planning/Organization) that were created based on clinical observations. The new factor structure was used to determine the predictive validity of the CIB subscores, in predicti...

European Journal of Case Reports in Internal Medicine - Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered, among other factors, by some viral infections, although its pathophysiology remains unclear...

Parsonage-Turner syndrome, also known as neuralgic amyotrophy, is a rare disorder characterized by painful clinical manifestations mainly involving the upper limbs. This syndrome seems to be triggered, among other factors, by some viral infections, although its pathophysiology remains unclear. Moreover, it has rarely been related to hepatitis E vir...

Background: The Trauma-Induced Coagulopathy Clinical Score (TICCS) was developed to be calculable on the site of injury to discriminate between trauma patients with or without the need for damage control resuscitation and thus transfusion. This early alert could then be translated to in-hospital parameters at patient arrival. Base excess (BE) and...

We report a case of left ventricular pseudo-aneurysm and we take the opportunity to briefly review the literature concerning etiologies, diagnosis and management of this pathology, emphasizing some differences with the true aneurysm.

Background: Heart transplantation (HT) from donation after circulatory death (DCD) has yet to achieve wide clinical application despite the encouraging resultsreported recently. In this study we describe 2 cases of successful adult DCD HT performed at our institution using an original protocol. Methods: Our local abdominal DCD protocol was updat...

Introduction: Triage systems for out-of-hours primary care physician (PCP) calls have been implemented empirically but no triage algorithm has been validated to date. A triage algorithm named SALOMON (Système Algorithmique Liégeois d’Orientation pour la Médecine Omnipraticienne Nocturne) was developed to guide triage nurses. This study assessed the...

https://www.intensive.org/1/m3I1.asp - Abstract list - Poster P309 - Full Poster on March 19, 2019

https://www.intensive.org/1/m3I1.asp - Abstract list - Poster P308 - Full Poster on March 19, 2019

Abstract P309

Abstract P308

Emergency Department (ED) overcrowding gave rise to many investigations to understand its fundaments and find strategies to alleviate it. More recently, researches focused on patients flows. In this study, we aimed to investigate “How” patients came to the ED, “When” they arrived and finally “Why” they choose ED over other healthcare alternatives.

Background: The evidence of the Trauma Induced Coagulopathy Clinical Score (TICCS) accuracy has been evaluated in several studies but the potential effect of its use on patient outcomes needs to be evaluated. The primary objective of this study is to evaluate the impact on mortality of a prehospital discrimination between trauma patients with or wi...

Pulmonary embolism (PE) is the third most common cardiovascular disease in industrialized countries. Multiple clinical presentations and non-specific symptoms lead to frequents misdiagnosis. Using and plan therapeutic and admission versus discharge strategies.

To cope with overcrowding, a consequence of their constant growth, emergency departments have implemented operational strategies based on triage systems. Despite its interest, nurse triage has been limited by several hindrances, and new strategies are emerging. Among those, advanced nurse triage, allowing a nurse to initiate the diagnostic process...

Acute heart failure is a common cause of admission in emergency department. Management requires rapid support when haemodynamic or respiratory parameters are altered. Identifying enabling factors and their specific treatment is an integral part of management. The most common clinical presentation is volume overload, whose treatment remains the comb...

The endothelium plays a vital role as part of the cardiovascular continuum. Risk factors such as hypertension and dyslipidemia unbalance angiotensin II - bradykinin homeostasis, leading to endothelial dysfunction and changes in vascular structure that promote atherosclerosis and thrombosis. When dealing with risk factors, treatment should focus on...

Introduction Evidence supporting the use of Thromboelastography (TEG®) and rotational thromboelastometric (ROTEM®) in the trauma setting remains limited. We present the results of a practical evaluation of the potential interest of ROTEM® in the diagnosis of acute coagulopathy and the need for emergent blood product transfusion in the general traum...

Background: Identifying trauma patients that need emergent blood product transfusion is crucial. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure score developed to meet this medical need. We hypothesized that TICCS would assist in identifying patients that need a transfusion in a large cohort of severe trauma patients f...

Although angioneurotic oedema (AE) is a rare entity, it sometimes leads to devastating consequences. We report the case of an oro-pharyngeal angioneurotic attack following the initiation of a fibrinolysis therapy by alteplase and relay by heparin in a patient with severe acute pulmonary embolism. In view of this original case, we propose to highlig...

Numerous epidemiological studies have shown that a high resting heart rate is associated with an increased cardiovascular morbidity and mortality, particularly in heart failure. The resting heart rate is not only a risk marker in heart failure, but it is also a risk factor, i.e., modifying heart rate also modifies the risk. Chronotropic drugs have...

Heart failure is a major public health problem in industrialized countries. Its prognosis remains poor. The new European recommendations for heart failure management allow validation of the latest advances in the field. This article focuses on the definition, classification and treatment of chronic heart failure. Indeed, there are new aspects to co...

Short presentation of the study protocol of the future multicenter RCT named ”STTTOPPP the bleeding RCT”.

La pratique aux urgences nous confronte, de temps à autre, à des cas de vomissements incoercibles et de douleurs abdominales sans substrat organique retrouvé. Ces patients se présentent généralement de manière répétée pour ces symp-tômes. Les examens complémentaires réalisés aux urgences n'apportent classiquement aucune information. Une anam-nèse q...

The neck is characterized by a relatively complex anatomy and a very compact content. It therefore forms an extremely vulnerable part of the human body. Although uncommon, aero-digestive tract injuries caused by trauma present a challenging situation for both the emergency doctor and the head and neck surgeon. Clinical presentations may vary from s...

Sometimes, the emergency department is confronted with cases of repetitive vomiting and abdominal pain without organic causes. These patients come back again and again for this problem. All diagnostic tests are systematically negative. A well conducted history taking reveals a chronic cannabis addiction and the disappearance of symptomatology by ta...

On the basis of the case report of a pregnant woman with acute pleuritis, this article describes the diagnostic modalities of dyspnea during pregnancy. The utility and effectiveness of bedside ultrasound examination by the emergency physician ("POCUS") are reviewed in view of recent literature data. The ultrasound in this case is considered to be t...

Turning purple-blue urine is an alarming phenomenon uncommonly seen in patients with chronic urinary catheterization. Such discoloration, often misdiagnosed as haematuria, frequently causes concerns for the nurses, the doctor, the patient and his family.

Objectives: The ALERT algorithm, a telephone cardiopulmonary resuscitation (CPR) protocol, has been shown to help bystanders initiate CPR. Mobile phone communications may play a role in emergency calls and improve dispatchers' understanding of the rescuer's situation. However, there is currently no validated protocol for videoconference-assisted C...

Objectives: Ventilator-associated pneumonia diagnosis remains a debatable topic. New definitions of ventilator-associated conditions involving worsening oxygenation have been recently proposed to make surveillance of events possibly linked to ventilator-associated pneumonia as objective as possible. The objective of the study was to confirm the ef...

Chronic consumption of soda energizing caffeine has known a growing success. Its deleterious effects, however, are often ignored. We report a case of tetraparesis associated with chronic excessive consumption of cola. The development of muscle weakness is variable, resulting from a hyperpolarization of excitable membranes. The outcome is most often...

Medical regulation represents an essential tool for emergency medical assistance. Even if it is essentially based on a 1964 law, our medical regulation is constantly evolving to meet the present needs and to follow the medical and technological advances. In this article, we shall outline its major components and evoke some long-awaited developments...

Arrhythmogenic right ventricular dysplasia is a rare, but not exceptional pathology combining the occurrence of potentially fatal arrhythmias with a gradual deterioration of the structure and function of the right ventricle. In this article, we discuss the etiopathology of the disease and emphasize the diagnostic approach.

Confronté au problème de surpopulation, conséquence de leur fréquentation sans cesse croissante, les services d'urgence ont mis en place des stratégies opérationnelles basées sur des filières de soins organisées au départ de systèmes de triage des patients. Pareils outils ont démontrés leur intérêt mais s'avèrent aujourd'hui insuffisant, raison pou...

Heart failure in the elderly represents a major public health problem.In this population, the general objective of therapy, defined by current guidelines, does not differ from that proposed for younger patients: the aims are to decrease symptoms, to improve quality of life, to decrease hospitalizations, and to increase survival. However, in this ca...

The prolongation of life expectancy can only increase the proportion of elderly people in the future. The Emergency Departments being the main gateway to our hospitals, they will often have to admit such patients with their distinct characteristics. These individuals present with a more or less marked geriatric profile; it will be essential to dete...

Primary prehospital Helicopter Emergency Medical Service (HEMS) interventions may play a role in timely reperfusion therapy for patients with ST-segment elevation myocardial infarction (STEMI). We designed a prospective study involving patients with acute myocardial infarction aimed at the evaluation of the potential benefit of such primary HEMS in...

Methemoglobinemia is a rare disorder preferentially affecting children. The outcome may be dramatic when the disorder remains unidentified, however early recognition using unspecific exams allows prompt therapy. We report the case of a 14-month-old baby who presented with a sudden access of cyanosis resulting from acute methemoglobinemia. Careful i...

The ALERT algorithm, a simple and effective compression-only telephone CPR (t-CPR) protocol, has been previously demonstrated to help bystanders initiate CPR. According to their worldwide availability, mobile phone communications may play an increasing role in emergency calls. Preliminary studies suggest that they might improve dispatcher's underst...

Sudden cardiac arrest is an event associated with a very low survival rate. The latter is inversely proportional to the duration of the cardiovascular arrest. The chain of survival concept is a sequence of 4 events to be carried out as fast as possible with a view to ensure the patient's survival. This sequence consists of early access to and activ...

Training methodology having emerged primarily over the last two decades, simulation in health care has arisen from the idea that students should never practice on the patient for their "first time". Simulation makes it possible to try out the errors and to repeat the skills over and over, in a reproducible way and in the most realistic possible env...

Overcrowding in emergency departments (ED) leads to reductions in quality of care. Consequently, several different triage tools have been developed to prioritise patient intake. Differences in emergency medical services in different countries have limited the generalisation of pre-existing triage systems; for this reason, specific algorithms corres...

Phone cardiopulmonary resuscitation (CPR) assists any cardiac arrest witness, previously trained or not, through standardized instructions given by phone. These instructions are intended to guide the bystander in checking for responsiveness, opening the airway and checking for adequate breathing, and to initiate chest compressions in case of appare...

Objectives: Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of t...

Perthes syndrome, or traumatic asphyxia, is a clinical syndrome associating cervicofacial cyanosis with cutaneous petechial haemorrhages and subconjonctival bleeding resulting from severe sudden compressive chest trauma. Deep inspiration and a Valsalva maneuver just prior to rapid and severe chest compression, are responsible for the development of...

Emergency department (ED) overcrowding is a major international problem with a negative impact on both patient care and providers. Among validated methods of measurement, emergency physicians have to choose between simple and complex scores [1,2]. The aim of the present study was to compare the complex National Emergency Department Overcrowding Sca...

Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OOH-CA). The ALERT algorithm, a simple and effective compression-only telephone CPR protocol, has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol...

Emergency departments are frequently overcrowded due to the imbalance between need and availability of care. It results that influx patients should be regulated by using a triage tool located at the entrance area. This process has been in development for almost 15 years.We propose a new algorithm of triage (ELISA or Liège Scale of severity index at...

Sudden cardiac arrest is the leading cause of death in the industrialized world. Early bystander's CPR has been recognized as one of the most effective interventions in improving outcome and as an essential link of the survival's chain. However, despite large-scale community training programs, citizen-CPR rates have been persistently low. In order...

AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health car...

Peak first derivative of femoral artery pressure (arterial dP/dtmax) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dtmax is reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced sho...

We report a case of non fatal accidental boric acid intoxication at potentially fatal doses. After 5 days without symptoms, the patient was released from hospital. Gastric lavage in the emergency unit was his only treatment. Recent literature data on this kind of intoxication will be reviewed.

Valve dysfunction is a common cardiovascular pathology. Despite significant clinical research, there is little formal study of how valve dysfunction affects overall circulatory dynamics. Validated models would offer the ability to better understand these dynamics and thus optimize diagnosis, as well as surgical and other interventions. A cardiovasc...