Article

We aimed to explore acute stroke admission decisions and to discuss
ethical issues in triage practices in stroke units (SUs) in France. METHODS: In this study,
337 questionnaires were sent to physicians involved in acute
admission to SUs in Ile-de-France (neurologists and physicians from emergency
medical services). The questionnaires comprised questions about physicians'
perceptions of the reasonable allocation of SU beds and admission criteria for
patients in SU in clinical vignettes illustrating complex situations. RESULTS: In total,
162 questionnaires were fully completed. There were some discrepancies in
perceptions and reporting practices between emergency physicians and neurologists
concerning patient admission criteria. Triage choices were more frequently
declared by emergency physicians than by neurologists and were related to the
difficulty of obtaining a positive response for the admission of certain complex
patients (particularly those with comorbidities).
CONCLUSIONS: Despite
recommendations stating that all patients with stroke should be admitted to SUs,
this study has shown that triage practices exist in stroke admission decisions.
The triage depends on the role and perceptions of each physician in acute stroke
management. These decisions suggest reflections on the applicability of
distributive justice theories and on ethical issues in triage practices in
medicine.
CI - Copyright (c) 2015. Published by Elsevier Masson SAS.
- Triage en Unité neurovasculaire

Langue : ANGLAIS