title: [Emergency caesarean sections in primary care maternity: Impact of a color code].
abstract: OBJECTIVE
  To estimate the impact of the introduction of color code on the decision to birth-delay (DDB) used to prioritize the emergency caesarean sections in a primary care maternity.
  
  
  METHODS
  All patients who had an emergency caesarean section, for a single fetus, were included. The obstetrician, the anesthesiologist and the nurse of operating theatre were not on call in the maternity in nighttime. The study was divided into phase I corresponding to the period before the introduction of the color code and phase II, the period after introduction of the color code. The DDB was studied for each phase and for each color code in phase II, and depending on the day or night period.
  
  
  RESULTS
  Two hundred and seventy-six patients were included. In phase I, the average DDB was 54minutes against 44minutes in phase II (P=0.0003). The average time between the decision and caesarean birth for the green code was 62minutes, 42minutes for orange code, 22minutes for red code (P<0.001). There was no action on the time of caesarean decision on the choice of color code. There was no time difference between daytime and nighttime either in phases I or II.
  
  
  CONCLUSIONS
  The introduction of color code for emergency caesarean sections was a benefit in reducing the DDB. There was no observed difference between day or night periods regarding DDB or color codes.
authors.affiliation: Maternité, CHRU de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; Université de Lorraine, 34, cour Léopold, 54000 Nancy, France. Electronic address: christelle.linck@club.fr.
authors.forename: C
authors.initials: C
authors.lastname: Linck
authors.affiliation: Maternité, CHRU de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; Université de Lorraine, 34, cour Léopold, 54000 Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Choserot
authors.affiliation: Clinique de l'Arc-en-Ciel, 11, avenue Rose-Poirier, 88000 Épinal, France.
authors.forename: S
authors.initials: S
authors.lastname: Cristinelli
authors.affiliation: Maternité, CHRU de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; Université de Lorraine, 34, cour Léopold, 54000 Nancy, France.
authors.forename: R
authors.initials: R
authors.lastname: Callec
authors.affiliation: Maternité, CHRU de Nancy, 10, rue du Docteur-Heydenreich, 54000 Nancy, France; Université de Lorraine, 34, cour Léopold, 54000 Nancy, France.
authors.forename: O
authors.initials: O
authors.lastname: Morel
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D000066491:Clinical Decision-Making; D004630:Emergencies; D005260:Female; D005602:France; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy; D011320:Primary Health Care / Q000706:statistics & numerical data*; D013997:Time Factors
keywords: Caesarean section; Code couleur; Color code; Césarienne; Decision to birth-delay; Délai décision-naissance; Emergency; Maternité de type 1; Primary care maternity; Urgence