Navegando por Palavras-chave "emergency medical services"
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- ItemSomente MetadadadosCharacterization of cardiac arrest in the emergency department of a Brazilian University Reference Hospital: A prospective study(Medknow Publications & Media Pvt Ltd, 2016) Vancini-Campanharo, Cassia Regina [UNIFESP]; Vancini, Rodrigo Luiz; Barbosa de Lira, Claudio Andre; Andrade, Marlia dos Santos [UNIFESP]; Lopes, Maria Carolina Barbosa Teixeira [UNIFESP]; Okuno, Meiry Fernanda Pinto [UNIFESP]; Batista, Ruth Ester Assayag [UNIFESP]; Atallah, Álvaro Nagib [UNIFESP]; Gois, Aecio Flavio Teixeira de [UNIFESP]Background & objectives: Sudden cardiac arrest (CA) represents one of the greatest challenges for medicine due to the vast number of cases and its social and economic impact. Despite advances in cardiopulmonary resuscitation (CPR) techniques, mortality rates have not significantly decreased over decades. This study was undertaken to characterize patients that have suffered CA and to identify factors related to mortality. Methods: This prospective study was conducted at Emergency Department of Sao Paulo Hospital, Brazil. Two hundred and eighty five patients were followed for one year after treatment for CA. The mean age was 66.3 +/- 17.2 yr, and they were predominantly male (55.8%) and Caucasian (71.9%). Mortality rate and factors associated with mortality were the primary and secondary outcome measures. Data were collected using an in-hospital Utstein-style report. A logistic regression analysis was used to determine which variables were related to mortality. Results: Regarding the characteristics of CPR, 76.5 per cent occurred in hospital, respiratory failure was the most common presumed immediate cause of CA (30.8%) and pulseless electrical activity was the most frequent initial rhythm (58.7%). All attempts at CPR utilized chest compressions and ventilation and the most utilized interventions were epinephrine (97.2%) and intubation (68.5%). Of all patients treated, 95.4 per cent died. Patients with pulseless electrical activity had a higher risk of death than those patients with ventricular fibrillation. Interpretation & conclusions: The findings of the study highlighted that the mortality rate among CA patients was high. The variable that best explained mortality was the initial CA rhythm.
- ItemSomente MetadadadosCorrelação das categorias de classificação de risco com aspectos clínicos e desfechos(Universidade Federal de São Paulo (UNIFESP), 2016-06-29) Oliveira, Gabriella Novelli [UNIFESP]; Batista, Ruth Ester Assayag Batista [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Due to overcrowding in Emergency Services, risk classification scales have become a mandatory tool for the assessment of patient severity and to prioritize care for the most severe. Welcoming with risk classification is a relatively new activity for nursing professionals, therefore understanding the context, scenery, actors, and the profile of the attended population is of great importance so that improvements are implemented, in order to provide greater safety for users and professionals involved in this activity. Objective: To correlate the risk classification categories with the clinical profile, outcomes and origin of the patients. Methods: A cross-sectional, analytical study carried out with 697 charts of patients 18 years old or older, from April to June 2014. The studied variables were age, gender, origin, signs and symptoms, laboratory tests, medical history, risk classification categories, medical specialty care and outcome. In order to associate the risk classification categories with origin, signs and symptoms, laboratory tests, medical history, medical specialty and outcome, the Chi-square test was used and the likelihood ratio when necessary. Results: Most patients were women, with a mean age of 44.5 years. The most frequently reported symptoms were pain and dyspnea, and the most common comorbidities were high blood pressure and diabetes mellitus. The classification categories green and yellow were the most frequent, and hospital discharge were the most common outcome. The main origin of the patients classified in the red category was the Mobile Urgency and Medical Ambulatory Care Service (SAMU, acronomyn in Portuguese from Serviço Móvel de Urgência) due to surgical reasons. Those classified as orange and red had a higher percentage of hospitalization and death. Conclusion: The correlation of the risk classification categories with the patients? clinical profile and outcomes can assist in solving the overcrowding issue in Emergency Services, thereby increasing patient safety.
- ItemRestritoNurses' training in prehospital care(Univ Sao Paolo, 2008-03-01) Gentil, Rosana Chami [UNIFESP]; Ramos, Lais Helena [UNIFESP]; Whitaker, Iveth Yamaguchi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The performance of nurses in prehospital care (PHC) assumes acquiring specific competences. the objectives of the present study were to verify nurses' opinion on theoretical knowledge and nursing skills necessary for the practice in pre-hospital setting and to analyze them according to their clinical practice. in this descriptive study, the opinion of nurses, from public pre-hospital care services of the City of São Paulo, was collected through a questionnaire and the data of the clinical practice using forms. Cardiopulmonary resuscitation was mentioned more often as basic knowledge (84%). and the most frequent procedure was oxygen therapy (15.5%). the analysis of nurses' opinion indicated that the basic topics were related to situations that demanded making decisions, readiness and skill under stress or caring for a specific population, making training important in this area.
- ItemSomente MetadadadosStroke awareness in Brazil - Alarming results in a community-based study(Lippincott Williams & Wilkins, 2008-02-01) Pontes-Neto, Octavio Marques; Silva, Gisele Sampaio [UNIFESP]; Feitosa, Marley Ribeiro; De Figueiredo, Nathalie Lobo; Fiorot Júnior, José Antonio [UNIFESP]; Rocha, Talitha Nery; Massaro, Ayrton Roberto [UNIFESP]; Leite, Joao Pereira; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Sch Med & Publ Hlth BahiaBackground and Purpose-Stroke is the leading cause of death in Brazil. This community-based study assessed lay knowledge about stroke recognition and treatment and risk factors for cerebrovascular diseases and activation of emergency medical services in Brazil.Methods-The study was conducted between July 2004 and December 2005. Subjects were selected from the urban population in transit about public places of 4 major Brazilian cities: S (a) over tildeo Paulo, Salvador, Fortaleza, and Ribeir (a) over tildeo Preto. Trained medical students, residents, and neurologists interviewed subjects using a structured, open-ended questionnaire in Portuguese based on a case presentation of a typical patient with acute stroke at home.Results-Eight hundred fourteen subjects were interviewed during the study period (53.9% women; mean age, 39.2 years; age range, 18 to 80 years). There were 28 different Portuguese terms to name stroke. Twenty-two percent did not recognize any warning signs of stroke. Only 34.6% of subjects answered the correct nationwide emergency telephone number in Brazil (# 192). Only 51.4% of subjects would call emergency medical services for a relative with symptoms of stroke. in a multivariate analysis, individuals with higher education called emergency medical services (P=0.038, OR=1.5, 95%, CI: 1.02 to 2.2) and knew at least one risk factor for stroke (P<0.05, OR=2.0, 95% CI: 1.2 to 3.2) more often than those with lower education.Conclusions-Our study discloses alarming lack of knowledge about activation of emergency medical services and availability of acute stroke treatment in Brazil. These findings have implications for public health initiatives in the treatment of stroke and other cardiovascular emergencies.