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Mémoires Année : 2012

Intoxications médicamenteuses volontaires‎ : analyse descriptive des filières de soins

Résumé

Introduction: DSP is a common situation in medical dispatching.Only little information is available about medical trajectories. We wanted to describe DSP's medical courses from medical dispatch to hospital admission. We also analyzed epidemiological, toxicological and clinical data of each course to identify severity criteria. Methods: We conducted a retrospective and monocentric study including all patients admitted for DSP after medical dispatch, from 01/01/08 to 31/12/10. We compared epidemiological, toxicological and clinical data between medical trajectories. Results: 2218 patients were included (62.3% are women). Median age was 41 y/o [30;49]. We identified 6 different courses of care. More than 90% had an appropriate trajectory. DSP with carbamates, neuroleptics, tricyclic, cardiotropes, and antiepileptic were more frequent in severe DSP and the number of ingested pills was higher. 5.6% of our population was transferred in an intensive care unit after emergency admission. There was no significant difference in terms of epidemiological and toxicological criteria between these patients and those from the severe group. 12% of ICU transferred patients arrived at hospital with mobile intensive care unit and had a lower Glasgow score than patients transported to hospital by a medical team and admitted to ED without requiring a higher level of care. The minimal GCS (p<0.001) recorded during the transport were also lower in this group. Conclusion: We identified different toxicological profile corresponding to different medical trajectories for DSP patients. Drugs related criteria seem to be major determinants of medical dispatch. GCS also seems to be a key factor in DSP patients'orientation.
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Dates et versions

dumas-00739111 , version 1 (10-12-2014)

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Anaïs Richard. Intoxications médicamenteuses volontaires‎ : analyse descriptive des filières de soins. Médecine humaine et pathologie. 2012. ⟨dumas-00739111⟩
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