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Master Thesis

Fréquence des limitations et arrêts des thérapeutiques en régulation médicale

Abstract : Background: In emergency departments, incidence of decision to withhold or withdraw life-sustaining can vary from 0.65 to 0.93%. In emergency call centers, laws and guidelines about end-of-life decisions apply as well. We have attempted to know the frequency of decisions to limit life-supporting therapies taken by the dispatch physician and to describe the characteristics of these decisions. Methods: We carried out a prospective, monocentric and observational study in the Emergency Call Center (Centre 15) of the Isère region in France. The period of inclusion spanned from June to August 2020. The investigator was positioned in double listening position and did not intervene during the regulation of the call. The characteristics of the patient, the dispatch physician and the call were collected, as well as the nature of the medical decision and the patient's outcome. In the case of LAT, the physician determined after the call the criteria that led him to this decision. Results: 143 calls were included. The frequency of decision to withhold or withdraw life sustaining was 8.4%. The most frequent complain was respiratory distress. Most of the LAT decisions concerned patients with no autonomy. The number of anticipated directives available to help the dispatch physician to take his decision were few. Close to 70 % of patients with LAT decision remained at home. Conclusion: Decisions to withhold or withdraw life-sustaining treatments taken by the dispatch physician in Emergency Call Centers are frequent and are an integral part of the emergency physicians’ work. Training and reflection on the handling of patients who are at the end of their life must be encouraged.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03369823
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Thursday, October 7, 2021 - 3:49:47 PM
Last modification on : Wednesday, October 27, 2021 - 7:38:17 AM

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Léa Gaboriau, Aurélie Guyotat. Fréquence des limitations et arrêts des thérapeutiques en régulation médicale. Médecine humaine et pathologie. 2020. ⟨dumas-03369823⟩

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