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Decisions to limit and stop active therapeutics are common in the emergency unit. They are framed by the Leonetti law of 22 April 2005 recommending the refusal of unreasonable obstinacy and care of the patient's pain in later life. The pain assessment is an issue for these patients whose in majority, are not communicating. Moreover, no specific tool and the teams in charge, not knowing the patient make the recognition and treatment of pain symptoms very complex. This is the potential interest of directly involving the family or the person of confidence in this management , the first step being the detection and evaluation of pain.
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| Measure | Description | Time Frame |
|---|---|---|
| simplified verbal scale | A simplified verbal scale with 5 levels used by caregivers and family to evaluate the intensity of pain, "painless", "little sore", "moderately painful", "very painful", "extremely painful". Compare the pain assessment by the family or the person of trust and care teams within a population of non-communicating patients for whom a decision of limiting and stopping active treatment is taken emergency ward. | admission time in ER (Day 1) |
| Measure | Description | Time Frame |
|---|---|---|
| simplified verbal scale | A simplified verbal scale with 5 levels used by caregivers and family to evaluate the intensity of pain, "painless", "little sore," "moderately painful", "very painful", "extremely painful ". Compare the pain assessment by the family or the person of trust and care teams within a population of non-communicating patients 24 hours after the decision of limiting or stopping active treatment in emergencies |
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Inclusion Criteria:
Exclusion Criteria:
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non communicating patients admitted in emergency ward
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Laurent JACQUIN, MD | Contact | (0)4 72 11 00 48 | +33 | laurent.jacquin@chu-lyon.fr |
| Julien BERTHILLER | Contact | (0) 4 72 11 80 67 | +33 | julien.berthiller@chu-lyon.fr |
| Name | Affiliation | Role |
|---|---|---|
| Laurent JACQUIN, MD | ER unit Hospital Edouard Herriot, Hospices Civils de Lyon | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ER unit Hospital Edouard Herriot, Hospices Civils de Lyon | Recruiting | Lyon | 69003 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31686289 | Derived | Douplat M, Daoud K, Berthiller J, Schott AM, Potinet V, Le Coz P, Tazarourte K, Jacquin L. Poor Involvement of General Practitioners in Decisions of Withholding or Withdrawing Life-Sustaining Treatment in Emergency Departments. J Gen Intern Med. 2020 Jan;35(1):177-181. doi: 10.1007/s11606-019-05464-y. Epub 2019 Nov 4. |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| 24 hours after the decision of limiting or stopping active treatment in emergencies |
| Algoplus scale | Comparison of pain assessment between families and caregivers with support will be made using Algoplus scale defining a pain when the score is greater than 2. Compare the pain assessment by the family or the person of trust and care teams with the support of a rating scale in a population of non-communicating patients for whom a decision of limiting or stopping active treatment in emergencies. | at admission (Day 1) |
| PAINAD scale | Comparison of pain assessment between families and caregivers with support will be made using PAINAD scale rated from 0 to 10, defining the intensity of pain. Compare the pain assessment by the family or the person of trust and care teams with the support of a rating scale in a population of non-communicating patients for whom a decision of limiting or stopping active treatment in emergencies | at admission (Day 1) |
| CAESAR scale | Assess the feelings of nursing teams on the family involvement in the assessment of pain and not communicating patient discomfort for which is a determination of limiting or stopping active treatment in emergencies. | 24 hours after admission |
| CAESAR scale | The experience of the family will be described based on the questionnaire adapted from CAESAR scale ( rating scale of the quality of the care of the dying in intensive care) . Assess the feelings of nursing teams on the family involvement in the assessment of pain and not communicating patient discomfort for which is a determination of limiting or stopping active treatment in emergencies. | 3 weeks after admission |