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Master Thesis

Évaluation des pratiques professionnelles concernant la prise en charge diagnostique de la douleur thoracique aux urgences suspecte de SCA : phase pré-interventionnelle et analyse critique des pratiques

Abstract : Introduction: chest pain is a common reason for consultation. In France, 5 to 10% of emergency room visits are for chest pain. Some of these pains are of coronary origin. The management of these patients is the challenge of the emergency department because of the need for early diagnosis of acute coronary syndrome. Objective: to assess whether the management of patients admitted with typical non-traumatic chest pain with less than 3 hours of suspected non-ST+ ACS in the emergency room of the Arcachon hospital (PSA) complies with the guidelines. Method: a descriptive, retrospective and quantitative observational study was conducted from January 1, 2018 to February 28, 2018. It included any adult patient with typical chest pain (constrictive, medio-thoracic, retro-sternal, resting, and lasting at least 20 minutes), who started less than 3 hours ago. They were consulting in the emergency room of the PSA. The data were collected using the Terminal Urgences and Biowin software. Results: the ECG was performed within the recommended 10 minutes for only 48% (n=21) of patients. The first troponin was collected on average after one hour and 13 minutes after patients arrived in the emergency room. The result of the first troponin was obtained on average after one hour and 2 minutes after the arrival of the sample in the laboratory, and on average 2 hours and 18 minutes after the patient's arrival in the emergency room. The second troponin sample was taken from 80% (n=35) of the patients in our workforce. The second troponin was collected on average 4 hours and 17 minutes after patients arrived in the emergency room. The result of the second troponin was obtained on average 52 minutes after the arrival of the sample at the laboratory, and on average in 5 hours and 36 minutes after the arrival of patients in the emergency room. Conclusion: optimization of the diagnostic management of patients suspected of having ACS with typical non-traumatic chest pain could be provided to the emergency rooms of the PSA. This would allow faster action for patients with actual acute coronary syndrome.
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Master Thesis
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Submitted on : Friday, January 17, 2020 - 4:22:57 PM
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Laurie Dutartre. Évaluation des pratiques professionnelles concernant la prise en charge diagnostique de la douleur thoracique aux urgences suspecte de SCA : phase pré-interventionnelle et analyse critique des pratiques. Médecine humaine et pathologie. 2019. ⟨dumas-02444178⟩

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