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1.
Arch. argent. pediatr ; 121(4): e202202772, ago. 2023. tab, graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1442549

ABSTRACT

Introducción. Durante la internación, los pacientes pueden presentar un deterioro clínico significativo y requerir el ingreso no programado a la unidad de cuidados intensivos pediátricos (UCIP). Esto puede conllevar un aumento de la morbilidad y la mortalidad. Frecuentemente, estos eventos están precedidos por una fase de deterioro que podría pasar desapercibida. Objetivo. Determinar la frecuencia, analizar las causas, describir las características clínicas y los resultados de los traslados no programados en pacientes pediátricos hospitalizados, desde el área de internación general pediátrica (IGP) a la UCIP, y analizar las diferencias entre traslados urgentes y emergentes. Población y métodos. Estudio descriptivo prospectivo; se analizaron todos los traslados no programados desde IGP a la UCIP ocurridos entre el 1 de enero de 2014 y el 31 de diciembre 2019. Resultados. Se constataron 212 traslados no programados (21 traslados cada 1000 ingresos). El 76 % de los pacientes trasladados presentaban una comorbilidad asociada ­la más frecuente fue la patología oncológica (36 %)­ y llevaban más de 24 horas internados en IGP. Las causas más frecuentes de traslado fueron dificultad respiratoria (43 %), sepsis (20 %) y complicaciones neurológicas/neuroquirúrgicas (20 %). La tasa de mortalidad global fue del 8,96 % (19 pacientes). Conclusiones. El análisis de los traslados no programados es un elemento esencial en la evaluación de la calidad de atención y seguridad del paciente de un área, y debe constituir un indicador integrado al tablero de control. La interpretación de los traslados no programados como un evento prevenible constituye un cambio de paradigma clave.


Introduction. During hospitalization, patients may develop significant clinical deterioration and require unplanned admission to the pediatric intensive care unit (PICU). This may result in increased morbidity and mortality. These events are often preceded by a deterioration phase that may go unnoticed. Objective. To determine the frequency, analyze the causes, and describe the clinical characteristics and outcomes of unplanned transfers of hospitalized pediatric patients from the general pediatric ward (GPW) to the PICU, and analyze the differences between urgent and emergent transfers. Population and methods. Prospective, descriptive study; all unplanned transfers from the GPW to the PICU occurring between January 1st, 2014 and December 31st, 2019 were analyzed. Results. There were 212 unplanned transfers (21 transfers per 1000 admissions). An associated comorbidity was present in 76% of transferred patients ­being cancer the most frequent one (36%)­ and they had been hospitalized for more than 24 hours in the GPW. The most frequent causes of transfer were respiratory distress (43%), sepsis (20%), and neurological/neurosurgical complications (20%). The overall mortality rate was 8.96% (19 patients). Conclusions. The analysis of unplanned transfers is a critical component in the assessment of the quality of care and patient safety of an area, and should be an indicator integrated into the control panel. The interpretation of unplanned transfers as a preventable event is a key paradigm shift.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Intensive Care Units, Pediatric , Patient Transfer/methods , Patients' Rooms , Prospective Studies , Hospitalization
2.
Guatemala; MSPAS. UGR; 22 mayo 2020. 11 p. ilus.
Non-conventional in Spanish | LILACS, LIGCSA | ID: biblio-1096879

ABSTRACT

Fecha de actualización: 22 de mayo 2020. Dispone procedimientos para el adecuado traslado de pacientes sospechosos y confirmados con Coronavirus COVID-19 desde las viviendas y entre los servicios de salud para minimizar el contagio y preservar el estado de salud y bienestar de la población guatemalteca y del personal de salud, a nivel nacional y de todas las instituciones de salud que intervienen.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Patient Care Management/methods , Patient Transfer/methods , Coronavirus Infections/prevention & control , Betacoronavirus , Personal Protective Equipment/standards , Guatemala
3.
Rev chil anest ; 49(3): 416-424, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1510869

ABSTRACT

BACKGROUND: The aeromedical evacuation in the Chilean Air Force has had an important development in the last 15 years. The coronavirus disease declared as a global pandemic by the WHO has generated the challenge of transferring highly infectious patients to centers of greater complexity. The objective of this article is to report our experience in the transfer of COVID ­ 19 patients in constant attention and medical monitoring. CLINICAL CASE REPORTS: The aeromedical evacuation of 2 COVID-19 patients was performed from the Hanga Roa Hospital, Rapa Nui, to the National Thorax Institute, Metropolitan Region, in a Lockheed Hercules C-130, which corresponds to a pressurized fixed-wing airplane. The transfer was carried out with the corresponding personal protection elements and in individual isolation capsules with advanced negative pressure life support (ISO ­ POD), in order to reduce the level of contagion to the aero sanitary crew and minimize the impact on the flight material used. DISCUSSION: The transfer was carried out achieving all the objectives set out under a strict security protocol and the two COVID-19 patients were transferred successfully. The negative pressure isolation capsule system was safe and reliable, since no crew member presented symptoms or was infected by COVID -19, and also allowed the transfer of highly contagious patients during an 8-hour flight operation.


INTRODUCCIÓN: La evacuación aeromédica en la Fuerza Aérea de Chile ha tenido un importante desarrollo en los últimos 15 años. La enfermedad por coronavirus declarada como pandemia mundial por la OMS ha generado el desafío de trasladar pacientes altamente infecciosos a centros de mayor complejidad. El objetivo de este artículo es reportar nuestra experiencia en el traslado de pacientes COVID ­ 19 en constante atención y monitorización médica. REPORTE DE CASOS CLÍNICOS: Se realizó la evacuación aeromédica de 2 pacientes COVID ­ 19 desde el Hospital de Hanga Roa, Rapa Nui, hacía el Instituto Nacional del Tórax, Región Metropolitana, en un Lockheed Hércules C-130, que corresponde a un avión de ala fija presurizado. El traslado se realizó con los elementos de protección personal correspondientes y en capsulas de aislamiento individual con soporte vital avanzado a presión negativa (ISO ­ POD), con la finalidad de reducir el nivel de contagio a la tripulación aero sanitaria y minimizar el impacto en el material de vuelo utilizado. DISCUSIÓN: El traslado se desarrolló logrando todos los objetivos planteados bajo un estricto protocolo de seguridad y los dos enfermos COVID-19 fueron trasladados de manera exitosa. El sistema de cápsulas de aislamiento a presión negativa fue seguro y confiable, ya que ningún miembro de la tripulación presento sintomatología o resultó contagiado por COVID -19, y además permitió trasladar pacientes altamente contagiosos durante una operación de vuelo de 8 horas.


Subject(s)
Humans , Male , Female , Middle Aged , Young Adult , Patient Isolation/methods , Patient Transfer/methods , Air Ambulances , COVID-19 , Patient Isolation/instrumentation , Personal Protective Equipment , COVID-19/prevention & control
4.
Rev. gaúch. enferm ; 40(spe): e20180398, 2019. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1004107

ABSTRACT

Resumo OBJETIVO Descrever a implantação de um fluxograma de transferência do cuidado de pacientes em pós-operatório, a partir de um modelo de classificação de risco. MÉTODO Relato de experiência sobre a implantação de projeto piloto entre sala de recuperação pós-anestésica e unidade de internação cirúrgica, desenvolvido entre dezembro/2016 e março/2017, visando a transferências do cuidado de pacientes com baixo risco de mortalidade pós-operatória, em um hospital universitário do Sul do Brasil. RESULTADOS O projeto possibilitou agilizar a alta do paciente da Sala de Recuperação Pós-Anestésica para a unidade de internação cirúrgica, qualificar os registros quanto aos cuidados de enfermagem e otimizar o tempo dos enfermeiros, em ambas unidades, para as atividades assistenciais. CONCLUSÃO A implementação de um fluxograma de transferência do cuidado a partir da classificação de risco para pacientes em pós-operatório contribuiu para uma comunicação mais efetiva, culminando em melhorias na segurança do paciente.


Resumen OBJETIVO Describir la implantación de un diagrama de flujo de transferencia del cuidado de pacientes en postoperatorio a partir de un modelo de clasificación de riesgo. MÉTODO Relato de experiencia sobre la implantación de un proyecto piloto entre sala de recuperación postanestésica y unidad de internación quirúrgica, desarrollado entre diciembre/2016 y marzo/2017, con vistas a transferencias del cuidado de pacientes con bajo riesgo de mortalidad postoperatoria, en un hospital universitario del sur de Brasil. RESULTADOS El proyecto posibilitó mayor agilidad del alta del paciente para la unidad de internación quirúrgica, calificación de los registros y cuidados de enfermería referentes al cuadro clínico del paciente, y optimización del tiempo de los enfermeros, en ambas unidades, para las actividades asistenciales. CONCLUSIÓN La implementación de un diagrama de flujo de transferencia del cuidado a partir de la clasificación de riesgo para pacientes en postoperatorio contribuyó a una comunicación más efectiva, culminando en mejoras en la seguridad del paciente.


Abstract OBJECTIVE Describe the implementation of care transfer flow chart in postoperative, based on a risk classification model. METHOD Experience report on the implementation of a pilot project between the post-anesthetic recovery room and the surgical hospitalization unit, developed between December/2016 and March/2017, aimed at transferring s the care of patients with low risk of postoperative mortality, in a university hospital in the South of Brazil. RESULTS The project made it possible to expedite the discharge of the patient from the Post-Anesthetic Recovery Room to the surgical hospitalization unit, to qualify the records regarding nursing care and to optimize the time of nurses in both units for care activities. CONCLUSION The implementation of a care transfer flow chart from the risk classification for postoperative patients contributed to a more effective communication, culminating in improvements in patient safety.


Subject(s)
Humans , Hospitals, University/organization & administration , Postoperative Care/nursing , Postoperative Care/mortality , Recovery Room , Software Design , Brazil , Pilot Projects , Hospital Records , Nursing Records , Risk , Patient Transfer/methods , Hospital Units
5.
Rev. bras. enferm ; 71(supl.5): 2264-2271, 2018. tab, graf
Article in English | LILACS, BDENF | ID: biblio-977647

ABSTRACT

ABSTRACT Objective: To define the safe transition process from hospital to community of patients with chronic mental disorders and their families. Method: This was an action research study included in the constructivist paradigm. The participants in the study were nurses from a psychiatry service and from primary healthcare services. Results: After the identification of causes of continuity fragmentation, the following items emerged from the participants' speeches: a) two criteria categories for safe transition (those associated with health status, dependence level, and self-care capacity of patients, and those associated with knowledge and competence level of informal caregivers); b) the design of an algorithm to facilitate clinical decision-making. Final considerations: In order to promote adherence to therapeutic treatment in the hospital-community transition, treatment plans must include patients and their families, and improve communication networks and support among care levels.


RESUMEN Objetivo: Definir el proceso de transición segura del hospital a la comunidad de la persona con enfermedad mental crónica y su familia. Método: Estudio de investigación-acción, inserto en el paradigma constructivista. Participaron los enfermeros de un servicio de psiquiatría y de atención primaria de salud. Resultados: Luego de identificarse las causas de fragmentación de la continuidad, surgieron del discurso de los participantes: a) Dos categorías de criterios para la transición segura (los asociados a condición de salud, grado de dependencia y capacidad de autocuidado del paciente, y los asociados al conocimiento y nivel de competencia del cuidador informal); b) El diseño de un algoritmo para facilitar la toma de decisión clínica. Consideraciones finales: Para estimular la adhesión al régimen terapéutico en la transición hospital-comunidad, el proyecto terapéutico debe incluir a la persona y a su familia, y mejorar las redes de comunicación y soporte entre niveles de cuidado.


RESUMO Objetivo: Definir o processo de transição segura do hospital para a comunidade da pessoa com doença mental crônica e sua família. Método: Este é um estudo de investigação-ação, inserido no paradigma construtivista. Teve como participantes os enfermeiros de um serviço de psiquiatria e dos cuidados de saúde primários. Resultados: Após a identificação das causas da fragmentação da continuidade, emergiram do discurso dos participantes: a) duas categorias de critérios para a transição segura (os associados à condição de saúde, ao grau de dependência e à capacidade de autocuidado do cliente e os associados ao conhecimento e ao nível de competência do cuidador informal); b) o desenho de um algoritmo para facilitar a tomada de decisão clínica. Considerações finais: Para promover a adesão ao regime terapêutico na transição hospital-comunidade, o projeto terapêutico tem de incluir a pessoa e a sua família e melhorar as redes de comunicação e suporte entre níveis de cuidado.


Subject(s)
Humans , Teaching/standards , Patient Transfer/methods , Mental Disorders/therapy , Portugal , Primary Health Care/methods , Psychiatric Nursing/methods , Program Evaluation/methods , Family/psychology , Patient Transfer/standards , Continuity of Patient Care/trends , Qualitative Research , Education, Nursing, Baccalaureate/methods , Mental Disorders/psychology
6.
Journal of Korean Academy of Nursing ; : 39-49, 2016.
Article in Korean | WPRIM | ID: wpr-227333

ABSTRACT

PURPOSE: This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. METHODS: Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers' muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. RESULTS: Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. DISCUSSION: Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Caregivers , Knee Joint/physiology , Muscle, Skeletal/physiology , Nursing Homes , Patient Transfer/methods , Posture , Shoulder Joint/physiology
7.
Rev. chil. cardiol ; 33(3): 228-233, dic. 2014. ilus
Article in Spanish | LILACS | ID: lil-743827

ABSTRACT

Introducción: El balón intraaórtico de contrapulsación (BIAC) puede utilizarse como soporte circulatorio en pacientes cuyo tratamiento definitivo no está en el hospital de ingreso y es necesario hacer un traslado pensando en el mejor resultado final para el paciente. No existen reportes nacionales de este tipo de traslado Presentación del caso: Paciente mujer de 62 años con múltiples antecedentes mórbidos fue trasladada desde Tocopilla al Hospital Regional de Antofagasta (HRA), consultando por cuadro de disnea progresiva y dolor en hemiabdomen superior de 72 horas de evolución. Se planteó un síndrome coronario agudo y se solicitó co-ronariografía que reveló una estenosis de la arteria descendente anterior en su 1/3 medio en un 80%. Se realizó una angioplastía con Stent DES. Al llegar a UCI destaca soplo pansistólico en foco mitral solicitándose ecocar-diograma Doppler Color que mostró una comunicación interventricular (CIV) (Figura 1). Se instaló un balón de contrapulsación intra aórtico (Figura 2) y se planificó el traslado aéreo al Hospital Gustavo Fricke (HGF) que se efectuó sin incidentes (Figura 3). Tres días después se cerró la CIV manteniendo el balón de contrapulsación intra aórtico. Un ecocardiograma de control mostró una CIV residual de 0,7 mm y la evolución clínica posterior fue satisfactoria. Al 13er día post operación se constató una infección de la herida operatoria. Se trató con an-tibióticoterapia y aseo quirúrgico en 4 oportunidades, evolucionando satisfactoriamente. Se trasladó de regreso al Hospital de Antofagasta sin complicaciones y finalmente se dio de alta.


Introduction: Intra-aortic balloon counterpulsation (IABC) has been used for many years. IABC serves as circulatory support in patients where definitive care is not in the admission hospital. There are not reports of air transport with IABC in our national reality. Case report: A 62 year old patient with multiple morbid history was derived from Tocopilla to Antofagasta's Regional Hospital (ARH), she consulted for progressive dyspnea and abdominal pain 72 hours ago. We diagnosed acute coronary syndrome and the coronariography informs coronary stenosis of the anterior descending artery in the middle third about 80%. Angioplasty with stent is performed. The patient arrived to UCI, in the physical examination stands mitral pansystolic murmur. Color doppler echocardiography was requested: highlight interventricular comunication (IVC). Counterpulsation balloon is positioned and we planned the air transport to Gustavo Fricke Hospital (HGF). Transfer HRA-HGF was performed uneventfully with stable patient. 3 days after, IVC is closed and maintains IABC. Control echocardiography reports 0.7 mm residual IVC with satisfactory clinical course. At the 13th post-surgical day, the wound becomes infected and she is treated with antibiotic therapy and surgical toilet in 4 opportunities to evolve successfully. The HGF-HRA transfer is done without complications, his recuperation is satisfactory and she is discharged from the ARH. Discussion: There is evidence that the air tranfers with BIAC are safe, always considering factors such as the expansion of gases and electronic failures.


Subject(s)
Humans , Female , Middle Aged , Air Ambulances , Intra-Aortic Balloon Pumping , Heart Injuries/etiology , Heart Injuries/therapy , Transportation of Patients/methods , Constriction, Pathologic/etiology , Emergency Medical Services , Myocardial Infarction/complications , Heart Septum/injuries , Patient Transfer/methods
8.
Rev. Hosp. Clin. Univ. Chile ; 25(3): 246-252, 2014.
Article in Spanish | LILACS | ID: lil-795852

ABSTRACT

Critical care transport is a raising need in health care because patients who have medical conditions that exceed the capabilities of the initial treating facility require timely safe transport to referral centers. Therefore, indications for inter-hospital transfer include the need for specialist intervention, a critical bed not available or ongoing support not provided in the referring hospital. The aim of transferring a critically ill patient to a reference center is to improve prognosis, and this potential benefit must outweigh potential harm derived of eventual complications or adverse events that could happen during transportation, because critically ill patients have a high risk of morbidity and mortality during transport. The most frequent indications of transfer involve time-dependent pathologies, such as Cardiovascular and Neurologic Emergencies. Pre-transport evaluation and stabilization is critical, as it contributes to minimize in-transport risks, and it must consider aspects as adequate monitoring, transportation times and conditions...


Subject(s)
Humans , Male , Female , Critical Care/standards , Critical Care/trends , Patient Transfer/classification , Patient Transfer/methods , Patient Transfer/standards , Patient Transfer/organization & administration , Patient Transfer/trends , Patient Transfer
9.
Rev. bras. cardiol. invasiva ; 20(4): 361-366, out.-dez. 2012. ilus, tab
Article in Portuguese | LILACS, SES-SP | ID: lil-666133

ABSTRACT

INTRODUÇÃO: Atrasos decorrentes da transferência para realização de intervenção coronária percutânea (ICP) primária impactam negativamente os benefícios do procedimento. MÉTODOS: Registro prospectivo objetivando comparar os resultados da ICP primária entre pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAMCSST) admitidos ou transferidos para hospital equipado com laboratório de intervenção. RESULTADOS: Entre fevereiro de 2009 e dezembro de 2011 foram incluídos 319 pacientes, com média de idade de 59,8 ± 12 anos, 28,5% do sexo feminino e 22,3% diabéticos. Pacientes transferidos para realização de ICP primária (n = 201) apresentaram tempo porta-balão mais longo (86,4 ± 26,6 min vs. 69 ± 22,6 min; P < 0,0001), diminuição não-significativa da resolução do supradesnivelamento do segmento ST (83,5% vs. 90,4%; P = 0,18), do fluxo final TIMI 3 (90,1% vs. 94,1%; P = 0,30), do blush miocárdico grau 3 (74,3% vs. 78,8%; P = 0,22) e do sucesso angiográfico (90,1% vs. 94,1%; P = 0,30), e incremento não-significativo de sangramento grave (2% vs. 0,9%; P = 0,20) e mortalidade hospitalar (6,5% vs. 4%; P = 0,29). CONCLUSÕES: O encaminhamento do paciente com IAMCSST diretamente a hospital com laboratório de intervenção associa-se a menor tempo porta-balão e melhora não-significativa dos marcadores de reperfusão e da mortalidade.


BACKGROUND: Delays resulting from the transfer to perform primary percutaneous coronary intervention (PCI) have a negative impact on the benefits of the procedure. METHODS: Prospective registry aimed at comparing the results of primary PCI in patients with ST-segment elevation myocardial infarction (STEMI) admitted or transferred to an interventional cath lab equipped hospital. RESULTS: Between February 2009 and December 2011, 319 patients were included in the study with mean age of 59.8 ± 12 years, 28.5% were female and 22.3% were diabetics. Patients transferred for primary PCI (n = 201) had longer door-to-balloon time (86.4 ± 26.6 min vs 69 ± 22.6 min; P < 0.0001), a non-significant decrease in ST-segment elevation resolution (83.5% vs 90.4%; P = 0.18), final TIMI 3 flow (90.1% vs 94.1%; P = 0.30), myocardial blush grade 3 (74.3% vs 78.8%; P = 0.22) and angiographic success (90.1% vs 94.1%; P = 0.30), and a non-significant increase in major bleeding (2% vs 0.9%; P = 0.20) and hospital mortality (6.5% vs 4%; P = 0.29). CONCLUSIONS: The referral of patients with STEMI directly to an interventional cath lab equipped hospital is associated with shorter door-to-balloon time and non-significant improvement of reperfusion markers and mortality.


Subject(s)
Humans , Male , Female , Middle Aged , Angioplasty/methods , Angioplasty , Myocardial Infarction/complications , Myocardial Infarction/diagnosis , Reperfusion/methods , Reperfusion , Patient Transfer/methods , Risk Factors , Mortality
11.
West Indian med. j ; 54(4): 220-224, Sep. 2005.
Article in English | LILACS | ID: lil-472963

ABSTRACT

Head-injured patients are often transferred to the University Hospital of the West Indies (UHWI) for tertiary care. There is no standardized, agreed protocol governing their transfer. During the three-year period January 1998 to December 2000, 144 head injured patients were transferred to the UHWI from other institutions. They were 70male, had a mean age of 34 years and spent a mean of 13 days in hospital. Eighteen per cent were admitted to the Intensive Care Unit, where they spent a mean of nine days. On arrival, mean pulse rate was 92 +/- 22 beats/minute, mean systolic blood pressure was 130 +/- 27 mmHg and mean diastolic was 76 +/- 19mmHg. Twenty-eight per cent of patients had a pulse rate above 100/min on arrival and 13.8had systolic blood pressure below 60 mmHg. The Glasgow Coma Scale score was unrecorded at the referring institution in 70of cases and by the receiving officers at the UHWI in 23of cases. Intubation was done on only half of those who were eligible. Junior staff members initiated and carried out transfers whenever this was documented. The types of vehicles and monitoring equipment used could not be determined in most instances. Fifty-eight per cent of patients had minor head injuries, 12, severe injury and 33, associated injuries requiring a variety of surgical procedures by multiple specialties. Most patients (80.6) were discharged home but 11.8died in hospital. Transfer of head-injured patients, many with multiple injuries is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardized protocol for the transfer of such patients in Jamaica.


Los pacientes con heridas en la cabeza son a menudo transferidos al Hospital Universitario de West Indies (UHWI) para su cuidado terciario. No existe ningún protocolo acordado en relación con las normas que deben regir la transferencia. En el trienio de enero de 1998 a diciembre 2000, 144 pacientes con heridas de cabeza, fueron transferidos al HUWI desde otras instituciones. El 70% de ellos eran varones de 34 años de edad promedio, y el período de permanencia en el hospital fue 13 días como promedio. El 18% fue ingresado en la Unidad de Cuidados Intensivos, donde permaneció un promedio de 9 días. Al llegar al hospital, su pulso medio era de 92 ± 22 pulsaciones/minuto, la presión arterial sistólica media era de 130 ± 27 mmHg, y la media diastólica de 76 ± 19 mmHg. El 28% de los pacientes tenía un ritmo de pulsaciones por encima de 100/min al momento del ingreso, y un 13.8% tenía la presión arterial sistólica por debajo de 60 mmHg. No había constancia de la aplicación de la Escala de Coma de Glasgow en las instituciones que remitieron a los pacientes en el 70% de los casos, ni por parte de los funcionarios médicos que recibieron a los pacientes en el HUWI en el 23% de los casos. La entubación se realizó solamente en la mitad de los pacientes elegibles. El personal subalterno inició y llevó a cabo las transferencias en todos los casos docu-mentados. En la mayor parte de los casos no fue posible determinar los tipos de vehículos ni el equipo de monitoreo utilizados. El 58% por ciento de los pacientes presentaba heridas menores de la cabeza, el 12% tuvo heridas graves, y un 33% acudió con heridas asociadas que requerían diversos procedimientos quirúrgicos de múltiples especialidades. La mayoría de los pacientes (80.6%) regresó de alta a sus casas, pero el 11.8% murió en el hospital. La transferencia de pacien-tes con heridas en la cabeza – muchos de ellos con lesiones múltiples – no se está realizando de manera consistente con la práctica médica moderna...


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged, 80 and over , Craniocerebral Trauma , Patient Transfer/statistics & numerical data , Craniocerebral Trauma , Injury Severity Score , Cross-Sectional Studies , Hospitals, University , Jamaica/epidemiology , Clinical Protocols , Registries , Patient Transfer/methods , Patient Transfer/standards
12.
Rev. Esc. Enferm. USP ; 36(3): 231-239, set. 2002. graf, tab
Article in Portuguese | LILACS, BDENF | ID: lil-510640

ABSTRACT

Os distúrbios osteomusculares relacionados ao trabalho, particularmente a dor e as lesões na região lombar, representam um risco para os trabalhadores de enfermagem. Esses profissionais são especialmente suscetíveis a problemas vertebrais pelo fato de terem que movimentar e transportar pacientes regularmente. O objetivo desta pesquisa foi descrever o desenvolvimento de um instrumento para avaliar os riscos ergonômicos durante os procedimentos de movimentação e transferência de clientes. Para ser desenvolvido teve como referencial teórico a ergonomia, o que abrange a interação entre os equipamentos, as atividades, o ambiente e o próprio trabalhador.


Nursing personnel are at a high risk from work-related musculoskeletal disorders, especially back symptoms. Handling patients has been attributed as one of the factors playing an important role in the aetiology of occupational low back pain. The aim of the study was to construct an instrument to evaluate the ergonomic risks during patient-handling tasks. The instrument was developed with an ergonomic approach involving the equipment, the tasks, the environment and the personnel.


Los disturbios osteomusculares relacionados al trabajo, particularmente al dolor y lesiones en la región lombar, representam risco para los trabajadores de enfermeria. Esos profissionales son especialmente suscetibles a problemas vertebrales por el hecho de tener que mobilizar y trasporta regularmente a .los clientes. El objetivo de este estudio es descrevir el desarrollo de un aparato para evaluar los riscos ergonomicos durante el procedimiento de movimentación y transferenciade clientes. Para su desarrollo tuvimos como referencial teorico la ergonomia la que engloba la interación entre losequipamientos, las actividades, el ambiente y el proprio trabajador.


Subject(s)
Humans , Low Back Pain , Ergonomics , Occupational Health , Patient Transfer/methods
13.
Rev. Esc. Enferm. USP ; 35(3): 249-256, set. 2001. tab
Article in Portuguese | LILACS, BDENF | ID: lil-513480

ABSTRACT

Com o objetivo de avaliar aspectos ergonômicos na transferência de pacientes com a utilização de maca e cadeira de rodas, observou-se 249 transferências realizadas por trabalhadores da Seção de Escolta de um Hospital Universitário. Os resultados sugerem que a existência dessa equipe é uma iniciativa que deve ser estimulada mas que esses trabalhadores precisam de treinamento específico sobre movimentação e transporte de pacientes e de terem à disposição materiais auxiliares e equipamentos mecânicos.


The purpose of this study was to evaluate ergonomic aspects involved in using a stretcher and a wheel chair to transfer patients. 249 transfers carried out by the workers of a university hospital lifting sector were observed. The observations showed that the idea of having a team to transfer patients has to be stimulated but the members of the team require specific training in handling and transferring patients. Mechanical equipment and other devices should also be available.


Com el objetivo de avaliar aspectos ergonómicos de transferencia de enfermos com utilización de maca y silla de ruedas, observarán se 249 transferencias realizadas por trabajadores de la Sección de Escolta (Acompañamiento) de un Hospital Universitário. Los resultados sugerem que la existencia desse equipo es una iniciativa que debrá ser estimulada. Pero esos trabajadores necessitan entrenamiento especifico sobre mobilizacion y transporte de enfermos e necessitam tener a disposicion materiales auxiliares y equipamentos mecânicos.


Subject(s)
Humans , Ergonomics , Patient Transfer/methods , Brazil , Hospitals, University
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