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Master Thesis

Intérêt d'un bilan dynamique, 15 minutes avant l'arrivée, pour les traumatisés graves pris en charge par le SMUR et adressés au déchocage

Abstract : Introduction: To improve the quality of care, the North Alpine Network of Emergency had established a care organization type "trauma system" integrating the high level of expertise of USA. In the management of severe trauma, one sheet was passed resuscitator via regulation, causing an intermediary. The objective of this study was to investigate the feasibility and usefulness of a dynamic prehospital review and assess its impact on costs and quality of care of the patient record. Methods: We conducted a prospective study from January 2012 to April 2013 to study the feasibility and usefulness of a dynamic balance. Were included severe trauma patients having one or more criteria Vittel, supported either by the SMUR Voiron or Grenoble and transferred to DCA. A correlation test was used to show the interest of balance sheet and a Chi -2 test. Results: 108 patients were finally included in the 358 patients transported to the DCA. The results showed a perfect match between the dynamic review grade and grade on arrival at DCA for grades A and C, and a good agreement for grades B. The concordance was higher in case of dynamic balance, on duration of transport, means of transport, the original SMUR and interventions made during the day. But was reduced in the case of interventions night. No results were statistically significant. Only the transport time was a hindrance to the feasibility of dynamic balance (p = 0.015). The study also found that there was a trend for patients in 20.3% [12.7 to 27.9] cases, and a change in the preparation of DCA in 1 out of 6. Discussion: The realization of dynamic balance seems interesting in support of serious trauma even if results are not significant. Only the duration of transport is a barrier to achieving this balance. The realization of dynamic review is justified by the progress of patients during transport and by changing the preparation of DCA that follows.
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Master Thesis
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Cyril Desjeunes. Intérêt d'un bilan dynamique, 15 minutes avant l'arrivée, pour les traumatisés graves pris en charge par le SMUR et adressés au déchocage. Médecine humaine et pathologie. 2014. ⟨dumas-00997104⟩

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