Analyse des pratiques professionnelles aux urgences du CHU de Pellegrin : respect des recommandations de la Société Française de Médecine d’Urgence (SFMU) 2012 concernant la prescription des scanners cérébraux chez les traumatisés crâniens légers, aux urgences de Pellegrin en 2017

Abstract : Light head injury (LHI) is a common reason for admission at the emergency unit and most of them lead to brain scan prescription. Over the years, several international recommendations have been established to set up a list of relevant criterias to help in brain scan prescription. In this study, we investigated whether our emergency unit was implementing those recommendations concerning imaging prescription in LHIs. We performed a one-year retrospective observational study in 2017. We included 2153 adults patients, over 18 years old, with a Glasgow Coma Scale over or equal to 13. The SFEU recommendations were followed in 1637 patients, ie 76% of the population, which represents a moderate agreement. 34.3% of brain scans were made without meeting the required criterias listed on the recommendations. Medical situations associated with brain scan overuse were : having a fight-related facial trauma, having a Glasgow Coma scale under 15, having a visible cranial injury or any visible trauma above the clavicles. When comparing the two groups of patients, overuse of brain scans versus compliance to french national recommendations, we couldn't find any difference in term of screening for intracranial hemorrhagic lesions, since their occurrence is low. This is a large-scale retrospective monocentric follow-up study at the emergency unit of Hospital of Bordeaux showing a moderate compliance with the national guidelines, with a tend to brain scan overuse that doesn't seem to improve patient's outcome in LHIs.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02062251
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Lucie Bonnet. Analyse des pratiques professionnelles aux urgences du CHU de Pellegrin : respect des recommandations de la Société Française de Médecine d’Urgence (SFMU) 2012 concernant la prescription des scanners cérébraux chez les traumatisés crâniens légers, aux urgences de Pellegrin en 2017. Médecine humaine et pathologie. 2018. ⟨dumas-02062251⟩

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