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Master Thesis

Évaluation des pratiques professionnelles concernant la prise en charge du sujet âgé chuteur aux urgences du Centre Hospitalier de Mont-de-Marsan

Abstract : Objective: as the population ages, the number of elderly people using emergency services increases, particularly because of the reason for the fall. The main objective of our study is to evaluate the management of the elderly patient in the emergency room. Methods: all patients aged 75 and over, who called the fire brigade, were regulated by the SAMU and were referred for a fall to the Emergency Department (SAU) of the Layné Hospital in Mont de Marsan were retrospectively included from 01/01/2017 to 30/04/2017. The study was conducted as a retrospective analytical observational practice evaluation. The main composite endpoint is the search for risk factors for falls in accordance with the recommendations of the High Authority of Health (HAS) on the management of patients over 75 years of age who fall, published in 2009, and the geriatric evaluation by the Mobile Geriatric Team (EMOG). Results: of the 108 patients (mean age 86.6 years, 56.4% female), 22% (n=24) received an EMOG assessment. Considering only patients fully managed by emergency physicians (n=51), i.e. discharged from SAU or referred to HTCD (very short-term hospitalization), 35% (n=18) received an assessment by EMOG. The exhaustive search for all the risk factors for falls according to the HAS was not carried out in any file. On average, out of the 24 risk factors, 10.5 factors were identified in each case. Conclusion: elderly patients who are admitted to the SAU for a reason for a fall are not optimally managed. A minority of patients benefit from geriatric evaluation by EMOG and the risk factors for falls, with regard to the recommendations of the HAS, are insufficiently researched. Our study shows that a reorganization of the emergency rooms and the implementation of a protocol are necessary in order to improve the care of these elderly people who fall.
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Master Thesis
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Anne-Charlotte Dubos. Évaluation des pratiques professionnelles concernant la prise en charge du sujet âgé chuteur aux urgences du Centre Hospitalier de Mont-de-Marsan. Médecine humaine et pathologie. 2019. ⟨dumas-02510545⟩



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