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Master Thesis

Évaluation de la prise en charge des patients graves par les Médecins Correspondants du SAMU : adéquation avec les recommandations de bonne pratique et pistes d’amélioration

Abstract : In France, MCS (Médecins Correspondants du SAMU) are general practitioners who provide emergency medical care when mobile emergency and resuscitation services (SMUR) cannot reach the patient within 30 minutes. The goal of this study is to determine if the level of care provided by MCS to patients in critical condition (cardio-respiratory arrest, ST elevation myocardial infarction, major trauma) is consistent with guidelines. Design: this is a multicenter prospective observational study that covers MCS interventions between February 2, 2019, and May 5, 2019, in the Northern French Alps. The primary evaluation criteria in the study measure the consistency of care when compared to guidelines. The level of care was evaluated by three independent observers: an intern, an expert emergency physician, and an expert MCS. Results: we included a total of 113 patients in the study. Care provided for these patients was considered optimal in 69% of all cases. Orotracheal intubation proved difficult in 50% of cases. The use of tranexamic acid and mannitol were not consistent with guidelines in 76.9% and 83.3% of cases respectively. A fascia iliaca block is used in 20% of cases that needed it. Conclusion: care for critical patients by MCS is consistent with current guidelines in 69% of cases. This percentage is higher than figures found in the literature. The study highlights the quality of work performed by MCS. We also identified those difficulties they encounter when performing technical procedures and making therapeutic decisions. These difficulties should be addressed more in depth in their continuing medical education programs and discussed in terms of strategies to apply.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02747292
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Submitted on : Wednesday, June 3, 2020 - 11:44:11 AM
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Orane Chalimon, Ugo Ledermann. Évaluation de la prise en charge des patients graves par les Médecins Correspondants du SAMU : adéquation avec les recommandations de bonne pratique et pistes d’amélioration. Médecine humaine et pathologie. 2020. ⟨dumas-02747292⟩

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