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Master Thesis

Intervenir ou ne pas intervenir médicalement en situation d’arrêt cardiaque extrahospitalier

Abstract : Out-of-hospital cardiac arrest (OHCA) is a potential situation faced by all actors of the prehospital rescue chain. The prehospital emergency physician is the last link in this chain of survival and must decide to continue or stop initial resuscitation. The situation is further complex because the out-of-hospital environment does not provide physicians with the usual benchmarks of the in-hospital environment. Finally, the family or other bystanders are most often present and assist in the resuscitation attempts.
OHCA is a pathology that requires invasive, sometimes aggressive medical gestures to restart the cardiac pump. The physician, first confronted with the choice of resuscitation, must then explain the situation to the family, and finally make the announcement of death to the relatives when it occurs. The objective of this study is to explore the physician’s initial choice to act or not to act medically upon arrival at the bedside of a patient with OHCA.
Qualitative research involving semi-structured interviews with prehospital physicians was conducted in February 2020. A total of 13 military and civilian physicians were interviewed. Nine interviews were analyzed due to the unprecedented COVID-19 health crisis.
Our preliminary results suggest that physicians perform “technical” gestures while waiting for objective information in terms of prognosis, in a personal impulse of hope in life, in an approach of protection toward the family, against a possible “medico-legal risk,” or for “oneself” in the face of the violence of a direct confrontation with death. The doctor legitimizes his or her actions for the principle of beneficence. However, the “technical” gesture does not always appear to be proportionate to the residual stakes and would seem to offer a reprieve to the practitioner to make a verbal announcement of the patient’s death to his or her relatives.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03232036
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Submitted on : Tuesday, May 25, 2021 - 2:01:15 PM
Last modification on : Friday, December 3, 2021 - 11:43:51 AM

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  • HAL Id : dumas-03232036, version 1

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Sabine Lemoine. Intervenir ou ne pas intervenir médicalement en situation d’arrêt cardiaque extrahospitalier. Ethique. 2020. ⟨dumas-03232036⟩

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