Relevance of Whole-body Computed Tomography Prescription in the Emergency Department : an Identification Tool for Low Risk Patients
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: whole-body computed tomography.
- Кому может быть актуально
- Состояния в реестре: Trauma. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Франция
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Pertinence de la PREscription du Scanner Corps-Entier Aux Urgences : un Outil d'Identification Des Patients à Bas Risque
Обзор
The whole-body scanner (SCE) is a powerful examination that guides the management of patients severely traumatized. However, the systematic use of this examination in emergency departments is responsible for a large proportion of normal examinations. In addition to the non-negligible direct cost, the average irradiation of 20 mSv would give an adult a 1 in 1000 risk of developing a cancer. The Vittel score makes it possible to categorize pre-hospital patients as seriously traumatized to guide the sending of resources and direct them to a center equipped with a suitable technical platform. The use of this score to condition the prescription of the ECS is at the origin of an over-triage important since one out of two patients who validates at least one criterion has no lesion on imaging. The purpose of this research project is to validate a decision support tool to objectively guide the emergency physician in its use of the ECS. At the same time, the economic impact of such a procedure will be analysed.
Вмешательства
- Диагностический тест whole-body computed tomography
whole-body computed tomography prescription in the emergency department : an identification tool for low risk patients
Первичные конечные точки
- PHASE I: Assess the negative predictive value of a 15-criteria score to exclude the traumatized patient from a whole-body CT (SCE) imaging strategy to emergencies. [Срок оценки: through study Phase 1 completion, an average of 1 year]
- PHASE II: To quantify the effective reduction in SCE requests after the validated score is made available on the SCE prescription vouchers. [Срок оценки: through study Phase 2 completion, an average of 1 year]
Критерии участия
Критерии включения
- Any adult patient undergoing an SCE as part of a post-traumatic lesion assessment during a stay in the emergency room.
- Mechanism of injury: road accident or fall.
- Patient having read and understood the information letter and given his oral consent.
Критерии исключения
- Neurological impairment defined by a Glasgow score of less than 8.
- Respiratory failure with SpO2 < 90% on oxygen or with the use of ventilatory assistance.
- Hemodynamic failure with vascular filling greater than 1000 cc or recourse to catecholamines.
- Acute alcoholism.
- Taking narcotics.
- History of cognitive disorders.
- Current pregnancy.
- Suicidal patient.
- Trauma related to a brawl
- Penetrating trauma.
- Hemophilia.
- Known thrombocytopenia at the time of inclusion.
- Heart, lung, liver or kidney transplant patient.
- Person deprived of liberty by an administrative or judicial decision or person placed under legal safeguard / sub-tutorship or curatorship.
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Дизайн исследования
- Модель наблюдения
- Другое
Центры проведения
Франция · 1 центр
- Services des Urgences Adultes — Rouen
Идентификаторы
NCT: NCT05588791 · 2020/0425/HP