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Triage practices in stroke units: Physicians' perceptions and ethical issues.

Marion Yger Sophie Crozier 1 S Dubourdieu B Vivien 2 F Dolveck 3 Yves Samson 4
1 Service des Urgences Cérébro-Vasculaires [Paris]
2 Service d'Anesthésie Réanimation [CHU Necker]
3 SAMU 92-SMUR
4 NEMESIS-CRICM - Equipe NEMESIS - Centre de Recherches de l'Institut du Cerveau et de la Moelle épinière
CRICM - Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière
Abstract : We aimed to explore acute stroke admission decisions and to discuss ethical issues in triage practices in stroke units (SUs) in France. In this study, 337 questionnaires were sent to physicians involved in acute admission to SUs in Île-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. 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). 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.
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https://hal.inria.fr/hal-01253335
Contributor : Olivier Colliot <>
Submitted on : Saturday, January 9, 2016 - 6:49:49 PM
Last modification on : Thursday, May 27, 2021 - 5:08:03 PM

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CNRS | UPMC | ICM | SORBONNE-UNIVERSITE | SU-MEDECINE

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Marion Yger, Sophie Crozier, S Dubourdieu, B Vivien, F Dolveck, et al.. Triage practices in stroke units: Physicians' perceptions and ethical issues.. Revue Neurologique, Elsevier Masson, 2015, 172 (2), pp.146-151. ⟨10.1016/j.neurol.2015.09.001⟩. ⟨hal-01253335⟩

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