Limb InjuryDARIONCT05669157
X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse:
A study testing Radiography request by nurse and Radiography request by physician in people with Limb Injury, run by Centre Hospitalier Régional d'Orléans at 1 site in France.
Trial summary
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… Read more about this study
- Who is it for?
- Ages 15 to 80 years
- Conditions the study is for
- Limb Injury
- What is being tested?
- Radiography request by nurse and Radiography request by physician
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 400 participants
- Where
- 1 siteFrance
- Study dates
- 16 Jan 2023to 25 Jun 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 15 to 80 years
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- 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.
Who cannot join
- 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)
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- 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 locations and contacts
1 site in 1 country.
About this study
Official title: X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse: X-TRAIN Study
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.
Read the detailed 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.
- Conditions
- Limb Injury
- Being tested
- Radiography request by nurse, Radiography request by physician
- Keywords
- Traumatology, Personnel delegation, Nurse specialists, Radiography, emergency department, intake and referral nurse
- Medical subject headings
- Emergencies
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Radiography request by nurseProcedure or surgery
Intervention group with radiography requested by the IRN instead of the physician. The radiography will be interpreted by the physician afterwards, according to current practice
Radiography request by physicianProcedure or surgery
The physician prescribed the X-ray, the X-ray technician carries out the imagery and the physician interprets it afterwards
| Study group | Role | What they receive |
|---|---|---|
| Current practice: radiography request by physician | Experimental | No interventions will be performed. There is no change in current practice. Receives: Procedure: Radiography request by physician |
| Radiography request by the nurse | Experimental | the intake and referral nurse will request a radiography if required according to the local cooperation protocol Receives: Procedure: Radiography request by nurse |
What is being measured
The primary outcome is the main question the study is designed to answer.
Duration between triage and exit of emergency unit
Total duration in minutes in the emergency department with or without anticipated request of X-ray
Measured: immediatly after the procedure
Secondary outcomes (6)
Total duration of the stay
Total duration in minutes in the emergency department
Measured: immediatly after the procedure
Number of additional X-ray prescribed by the physician after physician assessment.
Number of new X-ray images taken after physician assessment.
Measured: immediatly after the procedure
Appropriateness of the X-rays requested by the IRN as per guidelines
Number of new X-ray images taken after physician assessment.
Measured: immediatly after the procedure
IRN's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Quality of life questionnaire. Min: not satisfied; max : satisfied
Measured: immediatly after the procedure
X-ray technician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Quality of life questionnaire. Min: not satisfied; max : satisfied
Measured: immediatly after the procedure
Physician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire) Physician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Quality of life questionnaire. Min: not satisfied; max : satisfied
Measured: immediatly after the procedure
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Dec 2022
- Study start16 Jan 2023
- Primary completion25 Jun 2023
- Study completion25 Jun 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Limb InjuryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 400 participants (actual)
Sponsor and investigators
- Lead sponsor
- Centre Hospitalier Régional d'Orléans
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Vincent GARROUSTE, MD, Principal investigator, Regional Hospital center of ORLEANS
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05669157
- Sponsor's protocol ID
- CHRO-2022-08
- Acronym
- DARIO
- Status last verified
- Jul 2023
- First submitted
- 12 Dec 2022
- Last updated
- 1 Aug 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lindley-Jones M, Finlayson BJ. Triage nurse requested x rays--are they worthwhile? J Accid Emerg Med. 2000 Mar;17(2):103-7. doi: 10.1136/emj.17.2.103.
PubMed 10718230Garrouste V, Malcuit L, Muller G, Jouffroy R, Boulain T. Nurse-Initiated X-Ray Requests for Extremity Trauma in the Emergency Department: A Single-Center, Prospective, Before-and-After Cohort Study. J Emerg Nurs. 2025 Jul;51(4):587-596. doi: 10.1016/j.jen.2025.03.019. Epub 2025 May 14.
PubMed 40372320
Study at a glance
From the registry record, last updated by the sponsor on 1 Aug 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- X-rays Trauma Request's by the Triage And Intake Nurse Intake and Referral Nurse: X-TRAIN Study
- ClinicalTrials.gov ID
- NCT05669157
- Acronym / sponsor ID
- DARIO / CHRO-2022-08
- Conditions
- Limb Injury
- Keywords
- Traumatology, Personnel delegation, Nurse specialists, Radiography, emergency department, intake and referral nurse
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 400 participants (actual)
- Lead sponsor
- Centre Hospitalier Régional d'OrléansUniversity, hospital or other
- Study start
- 16 Jan 2023 (actual)
- Primary completion
- 25 Jun 2023 (actual)
- Study completion
- 25 Jun 2023 (actual)
- First posted
- 30 Dec 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed 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.
Study design
- Primary purpose
- Health services research
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Current practice: radiography request by physician | Experimental | Procedure: Radiography request by physicianNo interventions will be performed. There is no change in current practice. |
| Radiography request by the nurse | Experimental | Procedure: Radiography request by nursethe intake and referral nurse will request a radiography if required according to the local cooperation protocol |
Who may qualify
- Ages
- 15 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (1 listed)
- 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.
Key exclusion criteria (11 listed)
- 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
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Radiography request by nurseIntervention group with radiography requested by the IRN instead of the physician. The radiography will be interpreted by the physician afterwards, according to current practice | Procedure or surgery | Radiography request by the nurse |
| Radiography request by physicianThe physician prescribed the X-ray, the X-ray technician carries out the imagery and the physician interprets it afterwards | Procedure or surgery | Current practice: radiography request by physician |
Primary outcome
Duration between triage and exit of emergency unit
Time frame: immediatly after the procedure
Total duration in minutes in the emergency department with or without anticipated request of X-ray
6 secondary outcomes
Total duration of the stay
Time frame: immediatly after the procedure
Number of additional X-ray prescribed by the physician after physician assessment.
Time frame: immediatly after the procedure
Appropriateness of the X-rays requested by the IRN as per guidelines
Time frame: immediatly after the procedure
IRN's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Time frame: immediatly after the procedure
X-ray technician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Time frame: immediatly after the procedure
Physician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire) Physician's feeling about the anticipated request for X-ray (assessed as per anonym Quality of Life at Work questionnaire)
Time frame: immediatly after the procedure
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Aug 2023.
- Background: PubMed 10718230Lindley-Jones M, Finlayson BJ. Triage nurse requested x rays--are they worthwhile? J Accid Emerg Med. 2000 Mar;17(2):103-7. doi: 10.1136/emj.17.2.103.
- Derived from this study: PubMed 40372320Garrouste V, Malcuit L, Muller G, Jouffroy R, Boulain T. Nurse-Initiated X-Ray Requests for Extremity Trauma in the Emergency Department: A Single-Center, Prospective, Before-and-After Cohort Study. J Emerg Nurs. 2025 Jul;51(4):587-596. doi: 10.1016/j.jen.2025.03.019. Epub 2025 May 14.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Vincent GARROUSTE, MD principal investigator
Regional Hospital center of ORLEANS
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Radiography request by nurse and Radiography request by physician in people with Limb Injury, run by Centre Hospitalier Régional d'Orléans at 1 site in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 1 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Duration between triage and exit of emergency unit (time frame: immediatly after the procedure). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05669157, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Aug 2023.