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Master Thesis

Fin de vie aux urgences ; coordination entre le service d’accueil des urgences et la médecine ambulatoire

Abstract : The emergency department (ED) is often confronted with end-of-life care. We searched if the missing information identifying patients as needing palliative care was detrimental for the emergency care. We conducted an analytical retrospective study at the ED of European Georges Pompidou Hospital (Paris), including 99 patients for whom a means’ limitation decision had been taken. We created a composite criterion of detrimental care. The palliative care information was present in the chart for one fourth of patients. Care was more often detrimental in the non-identified as palliative group (62 patients (85%) vs. 9 (35%) (p<0.001)).Then, we questioned the general practitioner or retirement home practitioner of deceased patients, in order to know if they agreed with the limitation decision taken at the ED, and if they had accepted to take care of the end-of-life of returning home patients. 95% of practitioners agreed with the limitation decision. 70% of practitioners considered end-of-life at home care as “feasible”, and 80% as “normal”. We revealed a lack of foresight and a failure in the initiation of palliative care, as well as a default in the EDoutpatient care coordination for the returning home of patients.
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https://dumas.ccsd.cnrs.fr/dumas-01614935
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Guillaume Fons. Fin de vie aux urgences ; coordination entre le service d’accueil des urgences et la médecine ambulatoire. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01614935⟩

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