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Master Thesis

Élaboration d’un outil d’aide à la prise en charge des urgences de la main, 1ère étape : étude de l’hétérogénéité de la prise en charge par les médecins généralistes d’Aquitaine

Abstract : Introduction: hands emergencies represent 1.4 million of cases per year in France, 620.000 of which are at risk of sequela. The data in literature point to a heterogeneity in practices that are sometimes not in accordance with the recommendations. The objective of our study is to describe the medical care that is brought to urgent hand problems (wounds, paronychias, blunt traumas) by general practitioners with the intention of creating a free informatic tool to assist medical care. Materials and methods : multicenter, cross-sectional, descriptive epidemiological study to analyse practices. The general practitioners working in Nouvelle-Aquitaine who volunteered to participate in the study were questioned during a semi-structured phone interview, with no exclusion criteria. Results: 54 physicians were included from August 2018 to February 2019. 25 physicians were able to recall a patient being cared for a wound. Among them, 22% performed medical care in accordance with the recommendations. 19 physicians were able to recall a patient being cared for a blunt trauma. Among them, 89% performed medical care in accordance to recommendations. 52 physicians were able to describe their usual treatment of paronychias ; there seems to be an over prescription of antibiotics (P.O. or local) and 48% of physicians are used to make an incision when there is an accessible build-up. 93% of physicians said they were ready to use the informatic assisting medical care tool and their expectations were varied in terms of content. Discussion: despite a small population size, this study seems to confirm that the medical care brought to hand emergencies is heterogeneous and sometimes not in accordance with the recommendations (low-level evidence recommendations). The evaluation of practices around a specific case seems original compared to the evaluation of practices “generally” found in literature. These results will be used to develop the medical care tool that is currently the subject of a second thesis work.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02492170
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Submitted on : Wednesday, February 26, 2020 - 4:59:23 PM
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Charlotte Gachet. Élaboration d’un outil d’aide à la prise en charge des urgences de la main, 1ère étape : étude de l’hétérogénéité de la prise en charge par les médecins généralistes d’Aquitaine. Médecine humaine et pathologie. 2019. ⟨dumas-02492170⟩

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