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Master Thesis

Évaluation de la prise en charge de la douleur en secours en montagne‎ : étude prospective observationnelle de 49 patients pris en charge par l'unité médicale héliportée de l'Alpe d'Huez, du 20/12/2008 au 30/04/2009 (SAMU 38 et association nationale des médecins et sauveteurs en montagne)

Abstract : Introduction : The main purpose of this prospective observational study was to evaluate the efficiency of prehospital analgesia practiced in mountain rescue. It is a first professional practices evaluation in this field, characterized by particularly difficult work conditions. Methods : We recruited during winter season 2009, patients managed by the medical heliport unit, who had traumatic pain. We compared pain intensity by verbal rating scale (VRS), at practitioner arrival next to the injured person, at evacuation, on the hospital dropping zone and at the arrival in the emergency department. Results : Intravenous opioids are main analgesic medications used (sufentanyl first), without any side effect reported. Our study shows a pain decrease between the beginning of medical management (median VRS is 8 ± 0,5) and the arrival to the hospital (3 ± 0,4). However, we notice a pain outbreak when VRS is recorded by the nurse at welcome in the emergency department (5 ± 0,6). This pain outbreak was not observed in patients who benefit from a locoregional anesthesia (ALR). Conclusions : Prehospital analgesia practiced in mountain rescue leads to a traumatic pain intensity decrease, which allows a transport in good conditions inspite of hostility surrounding and meteorological constraints. Pain outbreak at welcome in the emergency department should lead to corrective measures. ALR realisation for patients who suffer from femoral fracture seems to prevent this phenomenon.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00631201
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Submitted on : Tuesday, October 11, 2011 - 4:26:09 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:03 AM
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Élophe Dubie. Évaluation de la prise en charge de la douleur en secours en montagne‎ : étude prospective observationnelle de 49 patients pris en charge par l'unité médicale héliportée de l'Alpe d'Huez, du 20/12/2008 au 30/04/2009 (SAMU 38 et association nationale des médecins et sauveteurs en montagne). Médecine humaine et pathologie. 2009. ⟨dumas-00631201⟩

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