Accueil des traumatisés sévères en salle d'accueil des urgences vitales : apport de l'analyse vidéo dans le cadre d'une évaluation des pratiques professionnelles

Abstract : Introduction: The objective of this study was to evaluate professional practices regarding the processing of individuals with severe trauma (IST) in the emergency room trauma center (ERTC) of a Level 1 traumatology center by video analysis. Method: This was a prospective monocenter study analysing the sequence of events in processing of IST by examination of video recordings from a wide-angle camera installed in an ERTC. A preliminary study phase of 9 months allowed 130 recordings to be analysed that led to the identification of 15 objective criteria to be used in the evaluation of professional practices (EPP). The EPP then took place over two periods of analysis, each lasting three months, with an interval of 8 months for training initiatives. Results: During the first period of the EPP, only five criteria out of fifteen achieved the compliance target of 80% completion: chest X-ray (90.8%), pelvic X-ray (82.1%), e-FAST ultrasound (95.4%), administration of tranexamic acid (86.7%), and proper direction of the patient after the ERTC (96.7%). Analysis of the second period established that 12 criteria had met the compliance threshold. Only three criteria remained perfectible: the presence of a senior anesthetist-resuscitator (AR) (66.7%), the presence of a nurse anesthetist (56.7%), and protecting against hypothermia (76.7%). Overall, this EPP has shown a clear improvement in the rate of fulfilment of the criteria of the study after implementation of the training initiatives. Conclusion: Due to its objectivity, the analysis of videos is a useful instrument for evaluation of professional practices in traumatology and for identifying areas of improvement for the teams.
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https://dumas.ccsd.cnrs.fr/dumas-01953049
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Submitted on : Wednesday, December 12, 2018 - 3:47:52 PM
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Julien Lesaca. Accueil des traumatisés sévères en salle d'accueil des urgences vitales : apport de l'analyse vidéo dans le cadre d'une évaluation des pratiques professionnelles. Sciences du Vivant [q-bio]. 2018. ⟨dumas-01953049⟩

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