X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse: (DARIO)

Centre Hospitalier Régional d'Orléans

Status: Completed

Conditions: Limb Injury

Treatments: Procedure: Radiography request by nurse; Procedure: Radiography request by physician

Study type: Interventional

Funder types: Other

Identifiers

NCT05669157

CHRO-2022-08

Details and patient eligibility

About

The number of consultations in emergency departments is increasing day by day, and the time to treat patients is getting longer. Different French studies have shown a significant reduction in the time spent in the emergency department after the implementation of the national protocol for the delegation of early radiography prescriptions. The investigators hypothesised that an early request for a standard X-ray by the intake and referral nurse in the case of isolated trauma to the extremities of a limb (from the knee to the toes and from the shoulder to the fingers) enables a reduction in medical management time and, consequently, in the time spent in the emergency department for the patient.

Full description

This study is divided into two steps to three month.

• The first step of the study corresponds to the current standard of care (SoC) in the emergency department of Orléans. In this first step, the intake and Referral Nurse (IRN) will carry out the usual triage and refer the participant to the appropriate emergency department before being appointed by the physician. The radiography will be requested after the medical consultation.
• In the second step, the intake and referral nurse will carry out the usual triage and then request one, or more, radiography(ies) depending on the standard protocol. This ensures that the physician has access to the imaging before the consultation with the patient. If necessary, the X-ray technician is authorized to refuse the exams or complete the request, the choice of the incidence is up to him/her according to the intake and referral nurse.

Enrollment: 400 patients

Sex: All

Ages: 15 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient older than 15 years and 3 months admitted in adult emergency department of regional hospital center of ORLEANS with a simple and isolated trauma having occurred less than 48 hours prior to admission of a limb extremity (from the knee to the toes or from the shoulder to the fingers), and with no previous imagery assessment within 48 hours prior to admission in the emergency department.

Exclusion criteria

• Multiple trauma
• Patient with at least one Vittel criteria (except age)
• Patient refusing the protocol
• Hemodynamic instability and/or disorder of consciousness
• Sensory and/or vascular disorders downstream of the traumatized area
• Protected population (under guardianship or curators)
• Patient under court protection
• Pregnant or breastfeeding woman or one who declares herself to be pregnant or breastfeeding
• Patient with an expired blood alcohol level > 0.4 mg/L and/or positive blood alcohol level
• Patient with diagnosed dementia
• Patient hospitalized after being taken in charge

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

Current practice: radiography request by physician

Experimental group

Description:

No interventions will be performed. There is no change in current practice.

Treatment:

Procedure: Radiography request by physician

Radiography request by the nurse

Experimental group

Description:

the intake and referral nurse will request a radiography if required according to the local cooperation protocol

Treatment:

Procedure: Radiography request by nurse