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Master Thesis

Étude prospective sur les traumatismes crâniens aux urgences pédiatriques de l’hôpital Robert Debré : épidémiologie, prise en charge, compliance à l’algorithme décisionnel PECARN et évaluation inter-individuelle du score de Glasgow

Abstract : Objectives: The evaluation of the risk of traumatic brain injury (TBI) in children for minor and moderate head trauma (HT) is difficult. Clinical decisions rules exist in order to evaluate the gravity of HT and to optimize their management. The concern is to limit the ionizing irradiation due to useless head computed tomography (hCT) without missing a TBI. PECARN rule is commonly use for the management of HT. We aim to describe the epidemiology of HT in children, to see to compliance of PECARN rule and to study the inter-individual evaluation of the Glasgow coma scale (GCS).
Methods: A prospective descriptive cohort study was realized. Patients aged from 0 to 18 who went to emergency department of Robert DEBRÉ (Paris) for HT between January and May 2014 were included. Information about management of patients was collected from a questionnaire and UrQual software (V5), the evaluation of the GCS was realized by 2 different evaluators and collected during the initial clinical evaluation.
Results: 106 patients were included. According to other studies, the principal mechanism of HT was a fall. The major part of patients had a minor HT. 15 hCT were realized (only 5 were abnormal). The PECARN rule was applied in 75.5% of the cases. Evaluation of GCS varies depending on evaluator’s experience.
Conclusion: The management of minor and moderate HT is still difficult despite the PECARN rule and it seems like it’s necessary to try to find objectives and early markers of TBI in order to limit useless irradiation exposition of children.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01147515
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Submitted on : Thursday, April 30, 2015 - 3:44:14 PM
Last modification on : Monday, October 19, 2020 - 11:06:34 AM
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Sorya Sieng. Étude prospective sur les traumatismes crâniens aux urgences pédiatriques de l’hôpital Robert Debré : épidémiologie, prise en charge, compliance à l’algorithme décisionnel PECARN et évaluation inter-individuelle du score de Glasgow. Médecine humaine et pathologie. 2014. ⟨dumas-01147515⟩

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