ANAESTHESIA, INTENSIVE CARE, BRAIN-DAMAGED PATIENTS UNIT, HOSPITAL COORDINATION
Functional Rehabilitation, and Unit for the Brain-damaged patients
Hôpital de La Seyne sur Mer
Lead Consultant: Dr Laurent DUCROS
- Dr COSTES Olivier
- Dr RIVERA Joëlle
Functional Rehabilitation, and Unit for the Brain-damaged patients – Consultations, inpatient and outpatient care
- Dr Joëlle RIVERA Monday, Tuesday, Wednesday and Thursday from 2:30pm to 3:30pm
- Dr. Olivier COSTES Tuesday and Wednesday from 2:40pm to 5:20pm
One Friday a month with Dr Franck LAUNAY (Orthopaedic Surgeon for children at La Timone - Marseille) from 1pm to 5pm
To book an appointment contact the reception desk: 04 94 11 31 50
The department consists of 3 units:
- A 12-bed unit dedicated to the management of brain-damaged patients discharged from the intensive care units, which corresponds to what is formally called "an awakening unit";
- A 18-bed unit, managing brain-damaged patients whose conditions have evolved a little compared to the awakening unit and who are able to participate more actively in their rehabilitation and reintegration into the family, social and professional environment.
- A rehabilitation platform composed of physiotherapists, occupational therapists, speech therapists and psychomotor therapists, with specific equipment for neurological rehabilitation (but no balneotherapy).
In the awakening unit all of the patients are taken care of in single rooms. Each room has oxygen, suction facilities and electric beds with preventive mattresses for bedsores or curative mattresses if necessary for patients with limited mobility.
In the unit, two rooms have been completely reorganised in order to serve as "shower rooms" for patients who can't move out of their beds.
The nursing or caregiver staff, takes care of the patients on a daily basis, they also might take care of putting the patient in the chair and helping him/her getting up. Every room is equipped with a flat screen TV.
There are currently 8 beds in double rooms in the rehabilitation unit, the other rooms are single rooms. Each room is equipped with toilets and a walk-in shower. These are for patients who are more independant than those of the awakening unit, and the staff, nurses and caregivers are there to help them readjust to daily life acts (washing, dressing, meals). All roms are equipped with flat screen TVs.
The department is directed towards brain-damaged patients who have most often stayed in the intensive care unit of the Toulon areas, for the most part, it is either a head injury or a stroke that is dealt with. We are dealing with people who are either still in a coma or are starting to wake up and need very specialised care to help and guide them in relearning life. Many patients are treated in the department with a tracheotomy, a gastric feeding tube (GPE in French) and require frequent daily care. Once the patients' conditions have evolved and once they are able to participate more actively in their care, they can be admitted in the rehabilitation unit which purpose is to accompany the patients towards reintegration into their family, social environment and, at best, prepare for professional reintegration.
It should be known that head injuries are one of the only illnesses associating physicial deficiencies (motor disorders such as hemiplegia or tetraplegia) with an impairment of higher functions (attention disorders, memory disorders, difficulties in performing tasks, difficulties in programming gestures, etc.)
It is therefore a very specific rehabilitation that can take up to several weeks or even up to several months.
Strokes usually present more stereotypical pictures than head injuries and we are dealing either with patients who have a right hemiplegia often associated with speech disorders (aphasia) or with patients who have a left hemiplegia often associated with neglect of this left side.
The department is accustomed to taking care of this type of ptients since we have been carrying out this only activity since 1991.
Finally, some patients come from the intensive care units for what are called "polyneuropathies", that is to say without any real damage on the brain functions levels but with motor difficulties linked either to very agressive resuscitations, or to neurological disorders related to deficiencies or to a Guillain-Baré type disease. These patients are treated like other patients and accompanied in their recovery.
Lastly, the department receives less serious head injuries, in particular patients who, after their arrival at the emergency ward, require monitoring for a few days with a CT scan check, usually on the 2nd or 3rd day. At this point, they receive a complete physical and functional evaluation before leaving the department.
The department obvioulsy works in close collaboration with all CHITS structures and can ensure the follow-up of all detected problems (ophtalmic, ENT, orthopaedic, cardiac, neurological, etc.)
The department is currently composed of 2 practitioners, Dr Olivier COSTES and Dr Joëlle RIVERA (both are specialised in Physical Medicine and Rehabilitation). They ensure the daily visits, the reception of families and they are present on weekends for the patients of the department. They also carry out consultations after discharge to enable the long-term care of these disabled patients.
In addition to the staff mentioned above, we also have specific staff attached exclusively to our department such as a clinical psychologist for the care of both patients and their families, a social worker to enable everyone to best manage social and administrative problems, and a medical-administrative assistant to manage the medical records but also transports, she will receive you in the department and guide you in all your needs.