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Master Thesis

Échographie pré-hospitalière en pédiatrie : utilisation, intérêt et formation des praticiens

Abstract : Introduction: pre-hospital ultrasound is still rarely used in pediatrics. The aims of this study were: 1) to describe its interest and use in pediatrics, 2) to evaluate focused cardiac and abdominal ultrasound learning for untrained EMS pediatricians. Materials and methods: from july 2018 to january 2019, we prospectively included patients treated by the neonatal and pediatric EMS at Bordeaux University Hospital for: polytrauma, need for hemodynamic support, pulmonary hypertension, suspected congenital heart disease. We evaluated: the benefit of ultrasound reported by practitioners for diagnosis, treatment and patient orientation; causes of non-realization of the ultrasound when indicated; patients with an ultrasound indication managed by untrained physicians. A theoretical training course and 15 training ultrasounds were proposed to 5 untrained SMUR pediatricians. A pre and post-training evaluation was carried out with a study of their progress. Results: of the 423 patients treated, 37 (9%) had an indication for pre-hospital ultrasound. Nine (2%) had ultrasound performed, 10 (2.5%) had a typical clinical examination, and 18 (4%) were cared by an untrained doctor. When an ultrasound was performed, a benefit was observed in 8 out of 9 cases. When it had not been performed, hemodynamic support was modified upon arrival in intensive care unit after performing ultrasound in 57% of cases. During training ultrasounds, the diagnosis was correct in 97% of cases and views in 84% of cases. Conclusion: emergency ultrasound in pediatrics has limited indications, but concerns patients with critical condition. Learning this technique requires short training and should be developed in pediatrics.
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https://dumas.ccsd.cnrs.fr/dumas-02418460
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Submitted on : Wednesday, December 18, 2019 - 6:39:41 PM
Last modification on : Saturday, January 18, 2020 - 1:30:19 AM
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Marion Hebert. Échographie pré-hospitalière en pédiatrie : utilisation, intérêt et formation des praticiens. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02418460⟩

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