Évaluation du dispositif Medpack® en médecine d’urgence préhospitalière

Abstract

Introduction: The MEDPACK® workstation, which won the Lépine competition in 2018, was created with the aim of improving nursing practices in terms of hygiene and ergonomics in pre-hospital emergency care. With an adapted nomenclature, it aims to provide the majority of care by itself, thus lightening the intervention bag.Method: We carried out a monocentric observational prospective study from 23/06/2018 to 01/03/2019 in the 6 resuscitation ambulances of the Paris Fire Brigade. A self-administered data collection notebook was filled in by the nurses after each intervention. It included an assessment of the hygiene and ergonomics of care with MEDPACK®, as well as a list of the medical devices and medicines used in the intervention bag, in addition to those used in MEDPACK®.Results: Seventy-two percent of the nurses felt that their care was more in line with good hygiene practices, with 76% perceiving an ergonomic gain when using MEDPACK®. The MEDPACK® was used in 69% of Vascular Access Placement (VAPP) procedures, while the intervention bag was useless in 75% of procedures. When the bag was used, it was used in 34% of cases for intubation equipment and in 15% of cases for onboard biology equipment. Forty-eight percent of the materials in the intervention bag were used in less than 1% of the interventions.Discussion: The MEDPACK® enables pre-hospital emergency paramedical care to be carried out in a way that is more in line with hygiene requirements, with ergonomics more suited to this context. An adjusted nomenclature of MEDPACK® makes it possible to carry out a large proportion of interventions and to rethink the materials making up the intervention bag. A period of adaptation to its use is necessary to modify nursing practices in order to allow its acceptance and appropriation. Moreover, its nomenclature is modular, which is why it could be adapted to fields other than pre-hospital emergency care, such as private practice or disaster medicine.:The MEDPACK® enables pre-hospital emergency paramedical care to be carried out in a way that is more in line with hygiene requirements, with ergonomics more suited to this context. An adjusted nomenclature of MEDPACK® makes it possible to carry out a large proportion of interventions and to rethink the materials making up the intervention bag. A period of adaptation to its use is necessary to modify nursing practices in order to allow its acceptance and appropriation. Moreover, its nomenclature is modular, which is why it could be adapted to fields other than pre-hospital emergency care, such as private practice or disaster medicine.