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Master Thesis

Limitation et arrêt des traitements de suppléance vitale chez l’adulte dans le contexte de l’urgence : une enquête de pratique dans huit services des Alpes-Maritimes

Abstract : Introduction: The many end of life cases in emergencies and the evolution of French law have led to the evolution of recommendations concerning the implementation of limitations and discontinuation of therapies (LIT) in emergencies situation. We have studied the attitude of practitioners (emergency and resuscitators physicians) involved in these situations in our department.
Material and method: This vignette study is departmental (Alpes-Maritimes, France), multicentric, descriptive, prospective. A five-vignette questionnaire was developed based on simulated end-of-life support situations. The doctors included in this study are senior doctors in emergency and reanimation units who agree to answer the questionnaire. The main judgement criterion is the comparison of the physicians' practical attitude towards the limitations and interruption of therapeutic practices (LIT) decision for each situation between emergency physicians and resuscitators.
Results: Forty six physicians, mostly male, are included. The approach to the limitations and discontinuation of adult life support treatments in the context of emergency is shared between emergency and resuscitators physicians. Only two physicians are trained to palliative care. Differences are highlighted regarding the experience of more than 6 years and the presence of a LIT protocol in the service. The short hospitalization unit service is favored by emergency physicians when LIT decisions are made.
Conclusion: This study is of interest in implementing the recommendations of learned societies and the law at the local level.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02316678
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Submitted on : Tuesday, October 15, 2019 - 2:50:16 PM
Last modification on : Monday, October 12, 2020 - 10:28:05 AM

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Élise Jammet. Limitation et arrêt des traitements de suppléance vitale chez l’adulte dans le contexte de l’urgence : une enquête de pratique dans huit services des Alpes-Maritimes. Médecine humaine et pathologie. 2018. ⟨dumas-02316678⟩

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