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Master Thesis

Évaluation du recours à la thrombolyse dans la prise en charge extra hospitalière des syndromes coronariens aigus avec sus décalage du segment ST par les médecins correspondants du SAMU

Abstract : Introduction : Local guidelines for ST-segment elevation myocardial infarction (STEMI) treated by Primary Care Physicians (PCP) propose using systematically fibrinolysis. The study aims at assessing the using of fibrinolysis by PCP. Methods : The study is about patients supported by PCP with diagnosis of STEMI, within the four departments of Northern Alps, from 2008 to 2018. There were three periods defined by Métalyse® endowment : from 2008 to 2015, from december 2015 to december 2017 and 2018. The primary outcome was the use of fibrinolysis to treat a STEMI. Prevalence of patients whom benefit of fibrinolysis or not where calculated for each period. The Chi2 test was used to compare numbers between the second and third period. Dealing with ethic point, all the data were part of RESURCOR registry, which are declarated to the CNIL (French National Comission for Computing Liberties). Results : 296 patients were included. 18 benefit of fibrinolysis (25%) during the first period, 30 (22%) during the second period and 31 (35%) during the third period, with a statistically significative difference between the second and the third period (p = 0.028). Conclusion : PCP’s are a fundamental link of the public emergency medical care, above all for the STEMI. Above all Generalist Practician, they deal with their multiple skills. However, trainings by high-fidelity simulation although trainings with regulator doctor could rise the use of fibrinolysis.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02303856
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Submitted on : Wednesday, October 2, 2019 - 4:26:46 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM

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Flore Attia, Ounissa-Liliane Belkacem. Évaluation du recours à la thrombolyse dans la prise en charge extra hospitalière des syndromes coronariens aigus avec sus décalage du segment ST par les médecins correspondants du SAMU. Médecine humaine et pathologie. 2019. ⟨dumas-02303856⟩

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