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Master Thesis

Évaluation de la prise en charge des réactions allergiques aux urgences adultes de l’Hôpital Pellegrin à Bordeaux, à travers deux études observationnelles

Abstract : Background : Anaphylaxis is a disease whose prevalence is increasing. Being responsible for more and more hospitalizations and deaths, it is essential for the patient care to be more adequate. The aim of this retrospective study was to evaluate the correlation between the treatment of allergy, carried out for emergencies, and the recent recommendations from the SFMU on this subject. Materials : Observational study, conducted between December 1st, 2014 and June 30th, 2015, repeated exactly a year later. Were included patients admitted for an allergy in the adult emergency Pellegrin Hospital (Bordeaux). The goal was to analyze and improve the management of allergy in these emergencies. Resultas : 203 patients were included (116 in the first group and 87 in the second). The average age of the subjects was 36 years old, with a higher rate of women. Patients presented predominantly mucocutaneous symptoms. Therapeutically, we found that 40 % of prescriptions are appropriate. By analysing the drug prescription between the two groups we noticed significant differences. Especially concerning antihistamines that are less well prescribed in step 1 in the second group (p <0.01), also adrenaline aerosols in case of angioedema (p = 0.02). However, it is observed that the corticosteroids prescription is more suited. It is less prescribed in case of urticaria in the second group (p <0.01). In about one out of four cases, standard laboratory tests are taken despite the absence of indication. Only 12 % of the exit orders are written without any errors, no significant difference between the 2 groups. The auto-injectable epinephrine pens are not prescribed in 10 % of cases. Half of the patients are unaware of the need for a consultation with an allergist. Conclusion : It was noticed during this study that a significant proportion of drug prescriptions are inadequate. Information for healthcare professionals and implementing pre-filled exit orders could improve the overall management of the allergy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01389644
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, October 28, 2016 - 6:20:35 PM
Last modification on : Wednesday, August 23, 2017 - 4:33:55 PM

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Célia Seguin. Évaluation de la prise en charge des réactions allergiques aux urgences adultes de l’Hôpital Pellegrin à Bordeaux, à travers deux études observationnelles. Médecine humaine et pathologie. 2016. ⟨dumas-01389644⟩

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