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Master Thesis

Analyse quantitative des procédés de sédation analgésie dans la réduction des luxations antérieures d’épaule : étude rétrospective au sein des urgences du GHT Normandie Centre de janvier à décembre 2018

Abstract : Introduction. Anterior shoulder dislocation is a frequent therapeutic emergency, which reduction justifies the use of procedural sedation analgesia (PAS) in the emergency department (ED), framed by the 2010 SfarSFMU recommendations. Objectives. To evaluate the prevalence of PAS use in the reduction of anterior shoulder dislocations in the GHT Centre Normandie Centre’s ED and secondly to evaluate the various professional practices with the aim of achieving a common management protocol. Method. Multicentric retrospective analysis of computerized medical records in the GHT Normandie Centre’s ED from January to December 2018. Results. The prevalence of PAS was 80.4%. 22 different associations were found, of which 3 were in line with the recommendations: Morphine-MEOPA (22.9%), Ketamine-Midazolam (4.3%) and PropofolMorphine (7.9%). The reduction success rate of the ED doctor was 81.3%. The reporting of the pre- and postreduction safety profile seemed to be generally insufficient, as well as the one of pain level or surveillance instructions issuance at exit. The level of analgesics delivered at the admittance seemed predominantly unsuitable to the pain intensity declared by patients. Conclusion. The frequency of use of PAS, the heterogeneity of practices, the lack of traceability of certain parameters, and the suboptimal management of pain would indicate the usefulness of a common protocol to be evaluated prospectively secondarily.
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Master Thesis
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Julie Dubus. Analyse quantitative des procédés de sédation analgésie dans la réduction des luxations antérieures d’épaule : étude rétrospective au sein des urgences du GHT Normandie Centre de janvier à décembre 2018. Médecine humaine et pathologie. 2019. ⟨dumas-02473918⟩

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