Tesis sobre el tema "Services médicaux urgents"
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Karboub, Kaouter. "Contribution à l'amélioration des performances des services médicaux urgents appliquant l'IoT et l'intelligence artificielle". Electronic Thesis or Diss., Université de Lorraine, 2022. http://www.theses.fr/2022LORR0093.
Texto completoInternet of Things (IoT) and Artificial Intelligence (AI)are two advancing technological areas utilizing the capabilities of performing hands free tasks and intelligent data analysis. These technologies are showing promising potentials of improving the Human-to-Machine interactions in clinical workflow, create a better foundation of clinical decision-making, and improve the accessibility of clinical data. The novel aspect, rapid advancement, and new application possibilities of IoT and AI are in the initial phases. Hence, the thesis research has the objectives of identifying and investigating the potential, challenges, and possibilities of using IoT and AI to assess clinical settings.From the other hand, Various organizations claim that increasing attention should be put on an efficient use of healthcare resources. The internationally rising life expectancy and population size is accompanied by hospitals that are relying more on short admissions, and thus on limited bed capacity. The international World Health Report published by the World Health Organization shows that 20-40% of all healthcare resources are not being sufficiently utilized. Thus, tools that benefit an efficient healthcare system is greatly relevant to the present society. The goal of this thesis is to expand methods in the field of IoT and AI and modeling and optimization to hospital patient flow with a view to provide management and planners with a range of decision tools for improving the utilization of hospital resources. We elaborate on several relevant hospital optimization problems which relate to decision making on both the strategic, tactical and operational level. In addition, we focus on various types of patient flow, from inpatient to outpatient admissions, which has led to many different research studies. Methodologically we mainly focus on evaluating the different instances of patient flow but specifically on patients with cardiovascular diseases (CVD) based on Markov chain modeling.Mainly, the focus was on separating the patient stay in the hospital into three main phases. Each phase in an interdependent, time varying and function of the other phase. The core of the contribution is to assess and give every step of the process of admitting, treating, and discharging patients with solutions that can help physicians take decisions in short time but also take them efficiently. These techniques used IoT in order to collect electrocardiogram signals (ECG) from patients with different CVD pathologies and to transfer these data into a platform that can preprocess it and store it. AI that is used to automatically classify these signals along with three MIT dataset and decide which patients have cardiovascular diseases with no physician intervention. Then AI was used to efficiently predict which patients need to be discharged based on their epidemiological, physiological signals and characteristics and also based on their Length of Stay (LOS) and on their admission and transfer history. Finally, comes the role of using metaheuristic optimization. This last one, into account the admission, treatment trajectory and first survival analysis of these patients to decide which patients will be allocated to a bed in which ward mainly in the Intensive Care Unit (ICU).The proposed system for studying and optimizing the patients flow in a health care facility show high performance based on the different performance metrics we are using in this research project
Durand-Aprile, Anne-Claire. "Les consultants"non-urgents" dans les services d'urgence : état des lieux et pistes de solutions". Thesis, Aix-Marseille, 2012. http://www.theses.fr/2012AIXM5029.
Texto completoEmergency Departments (ED) utilization has increased inducing ED overcrowding in many countries. The reasons for ED overcrowding are related partly to misuse of EDs on the part of patients who seek care for nonurgent (NU) problems, and inaccessibility to primary care services. Because the problem of NU ED visits is quite complex, the objective of this thesis was to conduct a critical review of the literature to better understand the conceptual and methodological questions of NU, and to explore why people with NU complaints choose to come to the EDs instead of their primary care provider. The proportion of NU ED visits would be around 30%. The review has highlighted the lack of reliability and reproducibility of methods of categorization. The profile of the consultant NU is not the expected one, as described usually in the collective social representations. The patient behaved as “rational person” when choosing to go to the ED. Among all health care resources available, the ED is the most suitable place and the most efficient provider for their medical needs. ED patients were willing to optimize their medical care by considering the most efficient health care resources. The lack of consensus on methods of categorization and criteria and the confusion between the concepts of NU and inappropriate ED visits explain the difficulty to identify the NU patient. Therefore none methods of categorization should be used to redirected patients outside the ED
Moreau, Julie. "L' urgence médicale". Aix-Marseille 3, 2004. http://www.theses.fr/2004AIX32064.
Texto completoDoulans, Lydie. "L'aide médicale urgente dans l'Orne". Caen, 1993. http://www.theses.fr/1993CAEN3059.
Texto completoPollet, Lucien. "L'accueil hospitalier en cas de catastrophe : plans et structures à propos de l'organisation de l'hôpital d'instruction des armées R. Picqué de Bordeaux". Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M154.
Texto completoDucarre, Pierre. "Le service d' aide médicale urgente de la Nièvre : bilan d' activité : perspective d' avenir : le centre 15". Clermont-Ferrand 1, 1987. http://www.theses.fr/1987CLF13052.
Texto completoSportouch, Alain. "Organisation du service des urgences du CHU de Montpellier". Montpellier 1, 1993. http://www.theses.fr/1993MON11096.
Texto completoBerteau, Christine. "Attitudes et opinions des usagers d'un service d'urgence : enquête réalisée au CHR de Bayonne". Bordeaux 2, 1996. http://www.theses.fr/1996BOR2M011.
Texto completoDebono, Gilles. "Aide médicale urgente dans le département de l'Hérault et le risque nucléaire". Montpellier 1, 1991. http://www.theses.fr/1991MON11215.
Texto completoSamin, Pierre. "Dossier patient informatisé aux urgences : expérience du service des urgences du centre hospitalier de Périgueux". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M037.
Texto completoLi-Thiao-Te, Nathalie. "Les urgences au centre hospitalier de Bagnols sur Cèze : bilan d'activité 1995". Montpellier 1, 1996. http://www.theses.fr/1996MON11052.
Texto completoCordoliani, Patrice. "Transports sanitaires héliportés : évolution et bilan d'activité du service d'aide médicale urgente du département du Gard". Montpellier 1, 1997. http://www.theses.fr/1997MON11011.
Texto completoPerot, Anne. "Proposition d'un nouveau dossier médical pour le service d'accueil des urgences du Centre Hospitalier Général de Mont-de-Marsan (Landes-France)". Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M200.
Texto completoDarraillans, Didier. "Activité du service médical d'accueil du centre hospitalier de Bourgoin Jallieu". Lyon 1, 1991. http://www.theses.fr/1991LYO1M397.
Texto completoAboueljinane, Lina. "Evaluation et amélioration des performances des Systèmes d'Aide Médicale Urgente : application au SAMU du département du Val de Marne". Thesis, Châtenay-Malabry, Ecole centrale de Paris, 2014. http://www.theses.fr/2014ECAP0037/document.
Texto completoThe research addressed in this thesis is one of the first studies to address the Emergency Medical Service in France, known as SAMU (which stands for the French acronym of Urgent Medical Aid Services). It is funded by the French National Research Agency and aims at improving the organizational processes of the Val-de-Marne department SAMU system in order to meet the population’s needs under limited resources. For this purpose, we develop a discrete event simulation model in order to assess the current performance of this complex system, as well as to investigate the effects of potential process changes that would lead to enhanced operational efficiency, in terms of response time performance (i.e. the period between the receipt of a call and the first arrival of a rescue team at the scene), which is a critical aspect for SAMU providers. This model was used as a decision-support tool for comparing the relative benefits of several scenarios mainly related to the needed resource levels and static location of rescue teams throughout the Val-de-Marne area and their assignment to incoming calls. Sensivity analyses were also performed by changing values of some input parameters such as arrival rates of calls, travel times and service times. Finally, we used two simulation optimization approaches to analyze the impact of rescue teams assignment to bases by considering temporal fluctuations of travel times and number of resources during a day. Experimental results of the two approaches were analyzed and compared regarding computational times and response time distribution
Sallaberry, Michel. "Organisation des services d'urgence dans les C. H. U. Français". Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M121.
Texto completoReuter, Paul Georges. "Télémédecine et urgences : pertinence de la réponse d'un centre de réception et de régulation des appels". Thesis, Sorbonne Paris Cité, 2018. http://www.theses.fr/2018USPCD035.
Texto completoThe principal objective of this study was to assess the adequacy of the response of an Emergency Medical Assistance (EMS) call reception and dispatch centre (CRDC) to telephone calls for medical emergencies. The study also aimed to evaluate the medico-economic consequences of call management by this type of call centre, as well as the impact of unusual public health events on the activities of the CRDC. With a view to this, prospective, comparative and observational clinical studies were conducted. The main results show that the recourse to telemedicine constitutes an appropriate response to emergency medical calls in terms of efficiency and satisfaction. With regard to benign but frequent indicator complaints, such as fever or gastroenteritis, or indeed severe pathologies which arise as part of rare medical conditions such as hereditary angio-oedema, distant telephone advice resulted in excellent patient compliance and was an appropriate response. Medico-economic analysis demonstrated a societal benefit from the medical telephone advice delivered by the CRDC. It was also shown that unusual public health situations could be detected through changes in the activity of a CRDC. Together these studies allow, for the first time, to objectively measure the appropriateness of medical call management. The results demonstrate a real benefit to patients, as well as a medicoeconomic efficiency in terms of healthcare use such as Emergency Department attendances or General Practice consultations. This study opens the path to future research into the efficiency of telemedicine
Fontanille, Eric. "Planification des secours médicaux : contribution des exercices de simulation à l'élaboration d'un plan rouge insulaire martiniquais". Lyon 1, 1993. http://www.theses.fr/1993LYO1M227.
Texto completoRoussel, Marie-José. "Prise en charge de la pathologie cardiovasculaire grave par le Centre Hospitalier général de Vichy durant l' année 1986 et rôle du SAMU 03 Vichy". Clermont-Ferrand 1, 1987. http://www.theses.fr/1987CLF13040.
Texto completoChevalier, Marie-Christine. "Les urgences pédiatriques pendant la saison estivale au CHG d'Arcachon en 1995". Bordeaux 2, 1996. http://www.theses.fr/1996BOR2M078.
Texto completoBen, Salah Fakher. "Service de présence adapté au contexte des communications d'urgence médicale pré-hospitalière". Mémoire, Université de Sherbrooke, 2009. http://savoirs.usherbrooke.ca/handle/11143/1472.
Texto completoRiesgo, García Alba. "Diferencias de género en el abordaje de la patología cardiovascular: una aproximación desde la perspectiva de la asistencia médica urgente". Doctoral thesis, Universitat de Barcelona, 2012. http://hdl.handle.net/10803/91287.
Texto completo“GENDER DIFFERENCES IN THE APPROACH OF CARDIOVASCULAR DISEASE: AN APPROXIMATION FROM THE PERSPECTIVE OF MEDICAL EMERGENCY” Cardiovascular disease is the leading cause of death in industrialized countries has traditionally been considered a predominantly male disease. Women with cardiovascular disease had always been treated in the image of men, but in recent years several studies have shown the existence of significant differences in the physiopathology of the disease and the response to treatment and the professional attitude to these pathologies. Many studies describe these differences in the management of cardiovascular disease more prevalent in hospitalized patients. Until now it has not been asked about whether there are differences at the level of emergency care in emergency departments. The aim of this thesis is to determine whether there are gender differences in the treatment of four highly prevalent cardiovascular disease in Spanish emergency services: chest pain, acute coronary syndrome without ST segment elevation, heart failure and atrial fibrillation. To do this we conducted 4 separate studies in which different population samples were taken for Spanish emergency departments. In general, women were older and had more comorbidity, were more hypertensive, more diabetic and higher prevalence of valvular disease, while men more often had a history of ischemic heart disease and smoking. In view of the results we can conclude that there are, broadly speaking, differences in the initial treatment of these four diseases in the Spanish hospital emergency departments. Although we found variations for some subset of patients and pathology in particular, it seems that these differences are not based on the gender of the patient, but in different clinical profile presented.
Gourgues, Thierry. "Devenir des personnes âgées aprés intervention du SAMU : [ Service d'aide médicale d'urgence ]". Bordeaux 2, 1990. http://www.theses.fr/1990BOR25252.
Texto completoAndrieu, Eric. "Epiglottite aigue : à propos de 9 cas pris en charge par le Service d'aide médicale d'urgence (S.A.M.U. 34)". Montpellier 1, 1989. http://www.theses.fr/1989MON11319.
Texto completoWolff, Valérie. "La grande précarité au rythme de l’urgence : mobilisation du personnel autour du patient sans-abri dans un service hospitalier d’urgences". Thesis, Strasbourg, 2014. http://www.theses.fr/2014STRAG036.
Texto completoFor many homeless people, emergency hospital services open to all continuous represent a privileged channel of recourse in seeking care, assistance or accommodation. However, due to overcrowding in emergency events, health policies are moving towards a restriction of the welcome to the kernel serious pathologies. The example of patient precarious situation then pushes its climax tensions that occur in these services, torn between their skills to treat life- threatening emergency and traditional hospitality function "all-comers". A fieldwork conducted in a hospital emergency department, shows the diversity of personal forms of mobilization around homeless patients in their dimensions both moral and organizational
Wargon, Mathias. "Gestion des flux par les services d'urgence modélisation, prédiction et applications pratiques". Paris 6, 2010. http://www.theses.fr/2010PA066547.
Texto completoVallee, Laurent. "Relevage et réanimation préhospitalière des plaies du cou : à propos de 111 cas pris en charge par le service médical d'urgence de la brigade de sapeurs-pompiers de Paris en 1992 et 1993". Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M174.
Texto completoGentile, Stéphanie. "Analyse des attitudes et comportements des consultants ayant recours au service des urgences pour des motifs relevant de la médecine générale". Aix-Marseille 2, 2004. http://www.theses.fr/2004AIX20678.
Texto completoSeveral studies have shown a growth in the number of visits to emergency department (ED) with a high proportion of inappropriate utilization (nonurgent patients). This aim of this work is to analyse ED increase and factors that significantly influence ED use and possible determinant of non urgent ED use. Few studies realised in Marseilles North Hospital ED. Methods were based on comprehensive approaches combined qualitative and quantitative tools. Results: The proportion of inappropriate visits is smaller. Pain plays a functional role in social representation and constitutes an urgent medical problem for patient. Analysis data showed different groups de patients: those who decide themselves ED recourse and those who came for structural reason. In fine, two temporality perception of health status: large temporality for patient to care about their health and a short for them to deny it
Cullet, Céline. "Etude prospective des courriers des patients reçus dans une structure d'Urgences". Antilles-Guyane, 2007. http://www.theses.fr/2007AGUY0173.
Texto completoAim : To study the content of referral letters to an emergency Department. Method : 304 referral letters to the emergency department of Basse-Terre hospital,Guadeloupe, were collected and reviewed during two months. The analysis of these letters was based on criteria definde by the high Authority of Health. Moreover, an analysis was made according to the speciality of the practitioner who whrote the letter, to the discipline of referral (medical,surgical or orthopaedic) and to the patient's date of birth. Results : Most of the letters were one-page long, handwritten and legible. The most mentionned criteria were the pratitioner's identity (99%), the date is was written (99,7%), the patient identity (99%) and the reason for referral (98%). The medical criteria were the least mentioned informations : recent medical information (57%), medical history (47%), medical examination (39%), chronicle medications (32%) and medications of the actual symptoms (14%). The least complete referral letters were written by general practioner. The most detailed ones were about a medical discipline, and about patients over 75. Conclusion : During this study, we noticed that recommandations concerning referral letters were differently applied. Those results could be improved by using pro-forma letter and adding the computerized medical file
Palenstijn, Vincent. "Prise en charge de la douleur aiguë dans le service d'accueil et d'urgence médicale : étude rétrospective et prospective au pavillon Pasteur des Hôpitaux Universitaires de Strasbourg". Strasbourg 1, 1995. http://www.theses.fr/1995STR1M019.
Texto completoHappe, Marie-Hélène. "Evaluation de la prise en charge de la douleur dans un service d'accueil et d'urgences d'un centre hospitalier périphérique". Montpellier 1, 1995. http://www.theses.fr/1995MON11043.
Texto completoDelfarguiel, Francis. "Assistance médicale des victimes d'accidents de montagne dans le massif du Mont-Blanc, participation du service de santé des Armées". Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M105.
Texto completoLescloupe, Olivier. "Profil des attachés travaillant dans les services d'urgence de l'Assistance Publique - Hôpitaux de Paris/ par Olivier Lescloupe". Bordeaux 2, 1998. http://www.theses.fr/1998BOR2M098.
Texto completoLaurent, Alexandra. "Les répercussions psychologiques des interventions médicales urgentes sur les intervenants SAMU". Dijon, 2006. http://www.theses.fr/2006DIJOL014.
Texto completoFirst aid and ambulance staff (in France, referred to as the SAMU) are required to undertake many operations which ma be traumatic in nature (involving violent death, serious injuries, natural catastrophes, etc. ). Emergencies, unpredictability and serious illness therefore form part of their everyday professional lives. As part of a related study conducted by the Service d’Aide Médical Urgent (SAMU) in Paris, we asked the question of whether this specific professional activity has emotional and psychological consequences which may have an effect on the physical health of such emergency medical staff. The study involved 69 SAMU staff: doctors, nurses, ambulance staff and medical students. Our research made use of a qualitative study (clinical interview for research purposes) to address the psychological experiences resulting from medical interventions as well as a quantitative study of professional stress (Spielberger's Professional Stress Inventory), professional burnout (Maslach Burnout Inventory), stress in everyday life (Cohen & al. 's Perceived Stress Scale), psychological distress (Goldberg's General Health Questionnaire), acute stress states (Weiss and Marmar's Impact of Event Scale - Revised) and post-traumatic pathology (Watson & al. 's Post-Traumatic Stress Questionnaire). In order to reveal the specific nature of the stress situations facing emergency staff and their psychological reactions, we also formed a control group of 51 subjects coming from three other medical services (gastro/hepatology, endocrinology and colonic surgery). Contrary to our expectations, this study revealed that emergency medical staff exhibit low levels of professional stress, professional burnout, acute stress and psychological distress when compared to personnel from the gastro/hepatology, endocrinology and colonic surgery services. Out of all the emergency medical staff we studied, we observed only a single case of post-traumatic stress. It would appear that it is not the most exceptional interventions that are the most stressful and that the situations of professional stress frequently encountered by emergency staff are often perceived as stimulating. In the light of these results, we considered the capabilities called on by these staff in confronting difficult professional situations. The identification of defensive strategies during the clinical interviews shed some light on this question. There are many such strategies which operate at group level and seem to be essential in enhancing the response to stress situations
Aubat, Thierry. "Collaboration psychiatre et S. A. M. U. - S. M. U. R. 34 face aux troubles aigus du comportement". Montpellier 1, 1988. http://www.theses.fr/1988MON11221.
Texto completoJacquet, Marc. "Prise en charge pré-hospitalière des malades nécessitant l'admission en service de réanimation". Saint-Etienne, 1995. http://www.theses.fr/1995STET6224.
Texto completoOustry, Jean-Michel. "La place d'un service d'urgence d'un centre hospitalier, "Le Grau-du-roi", station balnéaire, pendant la saison estivale". Montpellier 1, 1995. http://www.theses.fr/1995MON11116.
Texto completoTritschler, Jean-Albert. "L'expérience du centre 15 dans les Landes". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M196.
Texto completoJeay, Philippe. "Etude épidémiologique, nosologique, et évolutive des malades observés dans le service des urgences de l'hôpital Nord". Aix-Marseille 2, 1991. http://www.theses.fr/1991AIX20155.
Texto completoCourret, Jean-Paul. "Prise en charge préhospitalière de 187 "sans abri" par le service médical de la brigade de sapeurs pompiers de Paris". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M068.
Texto completoFaure, Gilles. "Etude de l'activité du service d'hébergement temporaire dit service porte au sein des urgences du C. H. De Sète de 1990 à 1993". Montpellier 1, 1994. http://www.theses.fr/1994MON11176.
Texto completoBisset-Mouret, Martine. "Analgésie pré-hospitalière : expérience du S.A.M.U. 34". Montpellier 1, 1990. http://www.theses.fr/1990MON11178.
Texto completoCervoise, Hélène. "Etude des admissions au service des urgences du centre hospitalier universitaire de Fort-de-France". Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M077.
Texto completoRoux, Patrick. "Evaluation d'un protocole de diazanalgesie dans le traitement de la douleur en médecine pré-hospitalière au sein du service médical d'urgence de la brigade des sapeurs-pompiers de Paris : à propos de 110 cas". Toulouse 3, 1992. http://www.theses.fr/1992TOU31077.
Texto completoBernal, Nathalie. "Le transport héliporté au niveau du SAMU de Carcassonne". Montpellier 1, 1990. http://www.theses.fr/1990MON11158.
Texto completoFarbos, Jean-Paul. "Etude comparée de l'organisation des secours médicalisés lors des fêtes populaires : villes de Mont-de-Marsan, Dax et Bayonne, année 1998". Bordeaux 2, 2000. http://www.theses.fr/2000BOR2P048.
Texto completoFallacher, Marie-Hélène. "Etude qualitative des interventions héliportées du SMUR de Dordogne d'avril 1998 à janvier 1999 : utilisation d'outils d'évaluation simples". Bordeaux 2, 2000. http://www.theses.fr/2000BOR2M091.
Texto completoMarchadour-Soubeyrand, Annie. "Evolution de la structure hospitalière de la ville de Sète : repercussions sur la chaîne des urgences". Montpellier 1, 1988. http://www.theses.fr/1988MON11103.
Texto completoFrétard, Jean-Luc. "Évacuations sanitaires aériennes lourdes longue et moyenne distances : aspects médicaux, logistiques et techniques, expérience du SAMU de l'ile de la Réunion de 1980 à 1989". Bordeaux 2, 1990. http://www.theses.fr/1990BOR25207.
Texto completoMangon, Hervé. "Création de l'unité lits-porte du centre hospitalier général de Pau : analyse du premier semestre d'activité". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M165.
Texto completo