Trauma
Conditions
Brief summary
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.
Interventions
DIAGNOSTIC_TESTwhole-body computed tomography
whole-body computed tomography prescription in the emergency department : an identification tool for low risk patients
Sponsors
University Hospital, Rouen
Study design
Observational model
OTHER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* 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.
Exclusion criteria
* 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.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 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. | through study Phase 1 completion, an average of 1 year | The main judgment criterion is defined by the uselessness of the whole body scanner, evaluated from the SCE voucher which will contain the 15 criteria from phase I. |
| PHASE II: To quantify the effective reduction in SCE requests after the validated score is made available on the SCE prescription vouchers. | through study Phase 2 completion, an average of 1 year | The main judgment criterion is the prescription of an irrelevant whole-body scanner (a patient whose 15 safety criteria are validated). |
Countries
France
Contacts
Primary ContactDavid MALLET
Outcome results
None listed