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Master Thesis

Évaluation d'un protocole pour la régulation de la douleur thoracique au SAMU 74

Abstract : Chest pain is a frequent cause of calls to the emergency dispatch centre. The aim of telephone assessment by doctors at the dispatch centre is to send a doctor staffed ambulance to all persons in acute danger. All potential acute coronary syndromes (ACS) must be identified and dealt with rapidly. An algorithm for telephone assessment of non traumatic chest pain is used by the dispatch centre doctors in the Haute Savoie region of France. This study evaluated if after comparison with the final diagnosis, using the algorithm had allowed the doctors to correctly identify the level of risk of ACS, and if its use had saved time. The study was held from the 1/4/07 to the 31/10/07, 145 patients were included. The algorithm was correctly followed in 61% (89/145) of cases. Qualitatively the algorithm is quite sensitive as the majority of ACS, 81% (44/53), were identified rapidly, but it is not very specific as 53% (49/93) of those identified as high risk for ACS were false positives. The mean call duration for a rapid interview (stages 1-3) was 5.8 minutes, and for an in depth interview (stages 4-6) was 9.9 minutes (p≤0.0001). A doctor staffed ambulance was sent to the majority of ACS, 91% (48/53). The dispatch doctor advised 34% (50/145) of patients to take aspirin during the call. The algorithm can guide the dispatch doctor in making a decision and save a significant amount of time, but is no substitute for a medical opinion. Advising the use of aspirin faced with a suspicion of ACS is underused.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00631118
Contributor : Jean-Hugues Morneau <>
Submitted on : Tuesday, October 11, 2011 - 3:06:55 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
Long-term archiving on: : Thursday, January 12, 2012 - 2:31:34 AM

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  • HAL Id : dumas-00631118, version 1

Citation

Kathryn Milns. Évaluation d'un protocole pour la régulation de la douleur thoracique au SAMU 74. Médecine humaine et pathologie. 2009. ⟨dumas-00631118⟩

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