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1.
Rev. colomb. cir ; 37(2): 184-193, 20220316. tab, fig
Article in Spanish | LILACS | ID: biblio-1362887

ABSTRACT

Introducción. La resucitación hemostática es una estrategia para compensar la pérdida sanguínea y disminuir el impacto de la coagulación inducida por trauma. Debido a que la disponibilidad de transfundir una razón equilibrada de hemocomponentes es difícil de lograr en el entorno clínico, la sangre total ha reaparecido como una estrategia fisiológica, con ventajas logísticas, que le permiten ser accesible para iniciar tempranamente la resucitación hemostática. El objetivo de este estudio fue evaluar las propiedades celulares, coagulantes y viscoelásticas de la sangre total almacenada por 21 días. Métodos. Las unidades de sangre total fueron obtenidas de 20 donantes voluntarios sanos. Se procesaron mediante un sistema de leucorreducción ahorrador de plaquetas y fueron almacenadas en refrigeración (1-6°C) sin agitación. Se analizaron los días 0, 6, 11 y 21. Las bolsas fueron analizadas para evaluar las líneas celulares, niveles de factores de coagulación y propiedades viscoelásticas mediante tromboelastografía. Resultados. El conteo eritrocitario y la hemoglobina se mantuvieron estables. El conteo de plaquetas tuvo una reducción del 50 % al sexto día, pero se mantuvo estable el resto del seguimiento. Los factores de coagulación II-V-VII-X, fibrinógeno y proteína C se mantuvieron dentro del rango normal. La tromboelastografía mostró una prolongación en el tiempo del inicio de la formación del coágulo, pero sin alterar la formación final de un coágulo estable. Conclusiones. La sangre total leucorreducida y con filtro ahorrador de plaquetas conserva sus propiedades hemostáticas por 21 días. Este es el primer paso en Colombia para la evaluación clínica de esta opción, que permita hacer una realidad universal la resucitación hemostática del paciente con trauma severo.


Background. Hemostatic resuscitation is a strategy to compensate blood loss and reduce the impact of trauma-induced coagulopathy. However, balanced resuscitation presents challenges in its application in the clinical setting. Whole blood has re-emerged as a physiologic strategy with logistical advantages that offer the opportunity for early initiation of hemostatic resuscitation. The study aims to evaluate the cellular, coagulation, and viscoelastic properties of whole blood preserved for 21 days. Methods. Whole blood units were donated by 20 healthy volunteers. These units were processed using a platelet-sparing leukoreduction filtration system. Units were stored under refrigeration (1-6°C) without agitation and were sampled on days 0, 6, 11, 16, and 21. The units were tested to assess its cellular properties and coagulation factors levels. In addition, viscoelastic features were tested using tromboelastography.Results. Red blood cells count and hemoglobin levels remained stables. Platelet count had a 50% reduction on day 6, and then remained stable for 21 days. Factors II-V-VII-X, fibrinogen, and protein C remained within normal range. Tromboelastrography test showed that the reaction time of clot formation is prolonged, but the final clot formation is not altered. Conclusion. Whole blood retains its hemostatic properties for 21 days. This is the first step to evaluate the use of whole blood in the resuscitation protocols for Colombia allowing hemostatic resuscitation become a universal reality.


Subject(s)
Humans , Resuscitation , Blood Preservation , Shock, Hemorrhagic , Blood , Blood Transfusion , Hemostasis
2.
Med. U.P.B ; 40(1): 46-54, 03/03/2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1177497

ABSTRACT

El trauma sigue siendo una de las principales causas de morbimortalidad mundial. Entre las causas de muerte de estos pacientes cabe destacar el paro cardiaco traumático (PCT). Múltiples autores afirman que, a pesar de los avances médicos, los esfuerzos de resucitación de estos pacientes pueden llevar a malos desenlaces, ya que aquellos que sufren PCT tienen gran mortalidad y pronóstico neurológico poco alentador. Este artículo hace una recopilación de la evidencia disponible, que, a pesar de ser poca, señala los avances recientes en el enfoque y manejo de estos pacientes. Se busca que con esta revisión se logre un consenso sobre el abordaje de los pacientes en paro en el contexto de trauma, basado en la literatura y evidencia más reciente.


Trauma is still one of the main causes of morbidity and mortality worldwide. Traumatic cardiac arrest (TCA) stands out among the causes of death of these patients. Multiple authors claim that, despite medical advances, resuscitation efforts in these patients may lead to poor outcomes, since those suffering from TCA have high mortality rates and poor neurological prognosis. This article compiles the available evidence, which despite being limited, points to recent advances in the management and approach of these patients. The aim of this review is to reach a consensus on the approach to patients in cardiac arrest in the context of trauma, based on the most recent literature and evidence.


O trauma continua sendo uma das principais causas de morbimortalidade em todo o mundo. Dentre as causas de óbito nesses pacientes, vale destacar a parada cardíaca traumática (PCT). Vários autores afirmam que, apesar dos avanços médicos, os esforços de ressuscitação nesses pacientes podem levar a resultados ruins, uma vez que aqueles que sofrem de PCT apresentam alta mortalidade e prognóstico neurológico ruim. Este artigo faz uma compilação das evidências disponíveis, que, apesar de poucas, apontam para avanços recentes na abordagem e manejo desses pacientes. O objetivo desta revisão é chegar a um consenso sobre a abordagem do PCT com base na literatura e nas evidências mais recentes.


Subject(s)
Heart Arrest , Resuscitation , Wounds and Injuries , Indicators of Morbidity and Mortality , Cause of Death , Death , Consensus , Emergencies
3.
Rev. bras. ginecol. obstet ; 43(2): 145-147, Feb. 2021. graf
Article in English | LILACS | ID: biblio-1156090

ABSTRACT

Abstract Transmediastinal gunshot wounds (TGWs) may lead to life-threatening injuries of vital organs such as large vessels, the esophagus, and lungs. Although they are not commonly encountered in pregnant women, additional caution should be given to these patients. Physical examination for the diagnosis and the choice of treatment modality contain controversial points in hemodynamically stable patients, and resuscitation has excessive importance due to physiological changes in pregnancy. We present a hemodynamically stable 26-week pregnant woman brought to the emergency department for TGW. She had a 1-cm diameter of bullet entrance hole on the right anterior 4th intercostal space, 2 cm lateral to the sternum, and a 3-cm diameter exit hole on the right posterior 12th intercostal space on the midscapular line.With our conservative approach, she had an uncomplicated pregnancy period, and gave birth to a healthy baby at term.


Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications/diagnosis , Thoracic Injuries/diagnosis , Wounds, Gunshot/diagnosis , Pregnancy Complications/therapy , Pregnancy Trimester, Second , Resuscitation , Thoracic Injuries/therapy , Wounds, Gunshot/therapy , Diagnosis, Differential , Emergency Service, Hospital , Hemodynamics
4.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 960-965, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1254848

ABSTRACT

Objetivo: validar critérios de um instrumento para avaliação da capacitação de enfermeiros em ressuscitação cardiopulmonar. Método: estudo metodológico para validação de critério de um instrumento previamente validado quanto ao conteúdo. Realizou-se a aplicação de um instrumento pré e pós-teste de uma capacitação com 20 enfermeiros de um hospital do interior do Estado de São Paulo. Resultados: realizou-se a análise das respostas do pré e pós-teste sobre o entendimento dos participantes antes e após a realização de teoria atrelada a simulação sobre ressuscitação cardiopulmonar. Foram avaliadas as variáveis objetividade, simplicidade, clareza e pertinência, destacando-se que os participantes concordaram que os critérios citados foram atendidos. Conclusão: o instrumento investigado possui relação com os padrões definidos, sendo comprovadamente validado. Ao utilizar-se deste instrumento durante a avaliação de capacitações em ressuscitação cardiopulmonar, as equipes de trabalho, alunos e pacientes serão beneficiados, garantindo a padronização e melhor efetividade no atendimento a PCR


Objective: to validate criteria of an instrument for assessing the qualification of nurses in cardiopulmonary resuscitation. Method: methodological study for criterion validation of a previously validated instrument for content. The application of a pre and post test instrument of a training with 20 nurses from a hospital in the interior of the state of São Paulo was performed. Results: pre and post test answers were analyzed on the participants' understanding before and after the theory of the cardiopulmonary resuscitation simulation. The variables objectivity, simplicity, clarity and relevance were evaluated, highlighting that the participants agreed that the criteria mentioned were met. Conclusion: the instrument investigated is related to the defined standards and has been validated. By using this instrument during the assessment of training in cardiopulmonary resuscitation, workteams, students and patients will benefit through standardization and effectiveness of care


Objetivo: validar los criterios de un instrumento para evaluar la calificación de las enfermeras en reanimación cardiopulmonar. Método: estudio metodológico para la validación de criterios de un instrumento previamente validado para el contenido. Se realizó la aplicación de un instrumento de prueba previa y posterior a una capacitación con 20 enfermeras de un hospital en el interior del estado de São Paulo. Resultados: las respuestas previas y posteriores a la prueba se analizaron según la comprensión de los participantes antes y después de la teoría de la simulación de reanimación cardiopulmonar. Se evaluaron las variables objetividad, simplicidad, claridad y relevancia, destacando que los participantes estuvieron de acuerdo en que se cumplieron los criterios mencionados. Conclusión: el instrumento investigado está relacionado con los estándares definidos y ha sido validado. Al utilizar este instrumento durante la evaluación de la capacitación en reanimación cardiopulmonar, los equipos de trabajo, los estudiantes y los pacientes se beneficiarán mediante la estandarización y la eficacia de la atención


Subject(s)
Humans , Male , Female , Adult , Resuscitation/nursing , Cardiopulmonary Resuscitation , Validation Studies as Topic , Inservice Training , Nurses
5.
Article in English | AIM, AIM | ID: biblio-1292750

ABSTRACT

Introduction : Depuis mars 2020, les premiers cas de pneumonie causée par la maladie à coronavirus 2019 ont été signalés à Tizi-Ouzou. Les informations sur les caractéristiques cliniques et paracliniques des patients infectés nécessitant des soins intensifs sont limitées. L'objectif de ce travail est de décrire les caractéristiques des patients atteints de la maladie à coronavirus 2019 (COVID-19) nécessitant une prise en charge dans une unité de soins intensifs au centre hospitalo-universitaire de Tizi-Ouzou. Matériels et méthodes : Il s'agit d'une étude descriptive rétrospective, relevant les données cliniques et paracliniques, la prise en charge et l'évolution des patients. Les données ont été obtenues par examen des dossiers médicaux des patients atteints de Covid-19 admis aux soins intensifs au centre hospitalo-universitaire de Tizi-Ouzou entre le 22 mars et le 15 octobre 2020. Résultats : 119 patients ont été inclus dans l'étude, l'âge moyen était de 64 (34-88) ans, dont 79 (66%) étaient des hommes. La présence d'une comorbidité concernait 77% des patients et parmi ces derniers 63% étaient diabétiques. Tous les patients ont été admis pour insuffisance respiratoire hypoxémique avec un rapport PaO2 / FIO2 moyen de 170 (122-230), dont 97 (81%) avaient bénéficié d'une ventilation mécanique avec intubation orotrachéale. L'insuffisance rénale concernait 47% de nos patients, dont 12% avaient nécessité des séances d'hémodialyses. Le taux de décès était de 78%. Conclusion : L'identification des facteurs de gravité en pratique clinique semble importante à la fois pour mieux sélectionner les patients avant leur admission en réanimation, mais également pour améliorer la qualité de leur prise en charge une fois admis en réanimation.


Subject(s)
Disease Management , COVID-19 , Resuscitation , Algeria , Emergency Medical Services
6.
Article in Chinese | WPRIM | ID: wpr-879847

ABSTRACT

A healthy full-term female neonate, aged 3 days and born by vaginal delivery (with a 1-minute Apgar score of 10 and a 5-minute Apgar score of 10), had unexpected cardiac and respiratory arrests in the early morning on day 3 after birth and recovered to spontaneous breathing and heartbeat after a 10-minute resuscitation. The child had poor response and convulsion after resuscitation. Blood gas analysis showed metabolic acidosis, and amplitude-integrated EEG showed a burst-suppression pattern. She was diagnosed with sudden unexpected postnatal collapse but improved after hypothermia and symptomatic/supportive treatment. This article reports the first case of sudden unexpected postnatal collapse in China and summarizes related risk factors, pathophysiological mechanisms, and preventive and treatment measures of this disorder.


Subject(s)
Apgar Score , Child , Child, Preschool , China , Female , Humans , Infant, Newborn , Pregnancy , Resuscitation , Risk Factors
7.
Article in Chinese | WPRIM | ID: wpr-879802

ABSTRACT

Drowning is a leading cause of accidental injury in children and has a great impact on family and society. The prevention and treatment of drowning is of great importance for reducing mortality rate. This consensus reviews the literature on the epidemiology, rescue, resuscitation, and acute clinical management and prevention of drowning. The panel determines the score of available evidence according to the criteria of Oxford Centre for Evidence-Based Medicine and then makes recommendations on evidence based on such criteria, so as to provide a basis for further reducing the mortality and disability rates caused by drowning.


Subject(s)
Child , Consensus , Drowning/prevention & control , Humans , Resuscitation
8.
Article in Chinese | WPRIM | ID: wpr-888469

ABSTRACT

OBJECTIVE@#To study whether there are differences in the resuscitation process and early outcomes between the extremely preterm infants delivered on off-hours (6 pm to 8 am of working days, weekends, and national holidays) and those delivered on working hours.@*METHODS@#A retrospective analysis was performed on the medical data of extremely preterm infants who were born in the Peking University Third Hospital from January 1, 2010 to December 31, 2020 and transferred to the neonatal intensive care unit (NICU). According to the time of birth, they were divided into two groups:working hours (@*RESULTS@#Compared with the working hours group, the off-hours group had a significantly lower proportion of infants with the use of full-dose dexamethasone before delivery (@*CONCLUSIONS@#Extremely preterm infants delivered on off-hours tend to have a low Apgar score at 1 minute after birth, with a higher proportion of infants requiring positive pressure ventilation or tracheal intubation during resuscitation than those delivered on working hours, and they tend to develop neonatal respiratory distress syndrome and intrauterine pneumonia. This suggests that it is important to make adequate preparations in terms of personnel and supplies for resuscitation of extremely preterm infants after birth and that NICUs should develop a detailed management plan for extremely preterm infants at each period of time before, during, and after birth.


Subject(s)
Humans , Infant , Infant, Extremely Premature , Infant, Newborn , Intensive Care Units, Neonatal , Respiratory Distress Syndrome, Newborn , Resuscitation , Retrospective Studies
9.
Gac. méd. Méx ; 156(6): 495-501, nov.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1249958

ABSTRACT

Resumen Introducción: La sepsis es una de las principales causas de consulta en los servicios de urgencias médicas. Objetivo: Identificar la prevalencia de la sepsis en servicios de urgencias médicas de México. Método: Estudio transversal con seguimiento a 30 días de los pacientes con diagnóstico de sepsis o choque séptico; se analizaron las variables demográficas, el manejo y los desenlaces. Resultados: En 68 servicios de urgencias médicas analizados se atendió a 2379 pacientes, de los cuales 307 presentaron sepsis. La prevalencia de la sepsis fue de 12.9 %, con mortalidad global de 16.93 %, que en los casos de sepsis fue de 9.39 % y en los de choque séptico, de 65.85 %; no se identificaron diferencias significativas en las variables demográficas o tipo de hospital. Se observó balance hídrico alto en las primeras tres horas y falta de apego a las recomendaciones internacionales de reanimación superior en los pacientes que fallecieron. Conclusiones: Se encontró alta prevalencia de la sepsis en los servicios de urgencias médicas mexicanos. La mortalidad de los pacientes con choque séptico fue similar e, incluso, mayor a la reportada internacionalmente.


Abstract Introduction: Sepsis is one of the main reasons for consultation at emergency departments. Objective: To identify the prevalence of sepsis in emergency departments of Mexico. Method: Cross-sectional study with a 30-day follow-up of patients diagnosed with sepsis or septic shock; demographic variables, management and outcomes were analyzed. Results: In 68 emergency departments analyzed, 2379 patients were attended to, out of whom 307 had sepsis. The prevalence of sepsis was 12.9 %, and overall mortality was 16.93 %, which in the cases of sepsis was 9.39 %, and in those of septic shock, 65.85 %; no significant differences were identified in demographic variables or type of hospital. A significantly higher fluid balance was observed within the first three hours in those patients who died, as well as a lack of adherence to international resuscitation recommendations. Conclusions: A high prevalence of sepsis was found in Mexican emergency departments. Mortality of patients with septic shock was similar and even higher than that internationally reported.


Subject(s)
Humans , Male , Female , Middle Aged , Sepsis/epidemiology , Emergency Service, Hospital/statistics & numerical data , Resuscitation , Shock, Septic/mortality , Shock, Septic/therapy , Shock, Septic/epidemiology , Severity of Illness Index , Prevalence , Cross-Sectional Studies , Follow-Up Studies , Sepsis/mortality , Sepsis/therapy , Guideline Adherence , Mexico/epidemiology
10.
Arch. argent. pediatr ; 118(5): e491-e494, oct 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1122539

ABSTRACT

Los pólipos pilosos nasofaríngeos son tumores benignos poco frecuentes. Se presenta el caso de esta patología en una paciente recién nacida, quien presentó cianosis y dificultad respiratoria por obstrucción de la vía aérea superior, durante las primeras 24 horas de vida. La paciente requirió maniobras de reanimación e intubación endotraqueal. Estudios diagnósticos confirmaron la presencia de una masa en la pared lateral de la faringe. Se realizó la extirpación quirúrgica exitosa con evolución satisfactoria de la paciente


Nasopharyngeal hairy polyps are rare benign tumors. We present a newborn case with a hairy polyp mass causing cyanosis and respiratory distress due to obstruction of the upper airway during the first 24 hours of life. The patient required resuscitation and endotracheal intubation. Diagnostic studies confirmed the presence of a mass in the lateral pharyngeal wall. Surgical treatment and removal of the mass was performed with satisfactory evolution of the patient


Subject(s)
Humans , Female , Infant, Newborn , Nasal Polyps/diagnostic imaging , Resuscitation , Nasal Polyps/surgery , Nasopharyngeal Diseases , Cyanosis , Airway Obstruction , Intubation, Intratracheal , Neoplasms
11.
Medicina (B.Aires) ; 80(2): 150-156, abr. 2020. ilus, graf
Article in Spanish | LILACS | ID: biblio-1125056

ABSTRACT

Los resultados generales del tratamiento de la lesión renal aguda en los últimos años han mejorado casi de manera constante, aunque sin una comprensión completa de su fisiopatología. La respuesta a este interrogante radicaría en la comprensión del rol proactivo en lo que hace a la administración / remoción de los fluidos, abarcando todo el proceso de reanimación de los pacientes críticos, es decir no limitándose a la administración sino también al momento oportuno de la remoción de los mismos, buscando como principal objetivo mejorar la perfusión tisular. Se discute entre otros el papel clave que ejerce la integridad vascular en la sobrecarga de fluidos, haciendo hincapié en el papel del glicocálix endotelial. Las maniobras de des-resucitación activa con diuréticos o con terapias de soporte renal, podrían ser instrumentos cada vez más reconocidos en la aplicación de la sobrecarga de fluidos, en particular en aquellos pacientes con lesión renal aguda.


In the last few years the general results in the treatment of acute kidney injury has improved constantly, without a complete comprehension of its pathophysiology. With this paradigm in mind, in these last few years we have seen an evolving comprehension of the possible answers that may be based on recognizing the more proactive role of fluid management in the resuscitation of critical patients, not limited only to the delivery of fluids, but also to their active removal, having as the principal objective the improvement of tissue perfusion. The key role of vascular integrity in fluid overload is discussed, emphasizing the role of the endothelial glycocalyx. Active des-resuscitation maneuvers with diuretics or with renal support therapies could be increasingly recognized instruments in the management of fluid overload, particularly in those patients with acute kidney injury.


Subject(s)
Humans , Resuscitation , Acute Kidney Injury/etiology , Fluid Therapy/adverse effects , Acute Kidney Injury/physiopathology , Acute Kidney Injury/therapy , Hemodynamics
12.
Rev. Col. Bras. Cir ; 47: e20202378, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1136567

ABSTRACT

RESUMO Objetivo: Este estudo objetivou analisar o uso potencial Balão de Oclusão Endovascular da Aorta para Ressuscitação (REBOA) em um hospital brasileiro. Métodos: Foi realizada uma revisão da literatura e uma análise retrospectiva de todas as avaliações cirúrgicas de emergência para pacientes com suspeita de hemorragia maciça internados em um hospital brasileiro, de 1 de abril de 2017 a 31 de março de 2018. Os critérios de elegibilidade do REBOA foram: origem abdominal e/ou pélvica, choque hemorrágico e acima de 18 anos de idade. Os critérios de exclusão foram: acima de 70 anos e doença terminal pré-existente ou comorbidades significativas. Resultados: No período, foram solicitadas 90 avaliações. Em 14 ocasiões (15,6%) havia indicação para o uso do REBOA. Os casos em que isso foi possível foram devidos a causas ginecológicas/obstétricas em 11 casos (78,6%) e cirurgia oncológica eletiva em três casos (21,4%). Conclusões: O REBOA é ainda pouco utilizado em nosso país, mas pode ser uma ferramenta de extrema importância, e talvez o último recurso em pacientes extremamente graves, até que o tratamento definitivo, cirúrgico, endovascular ou endoscópico seja efetuado.


ABSTRACT Aim: To evaluate the potential use of REBOA in a Brazilian hospital. Methods: We performed a retrospective analysis of all requests for emergency surgical evaluation for patients with suspected massive hemorrhage, hospitalized in a private Brazilian general hospital, from April 1, 2017 to March 31, 2018. Inclusion criteria for REBOA eligibility were: suspected abdominal and/or pelvic bleeding, hemorrhagic shock and older than 18 years of age. Exclusion criteria were: older than 70 years of age, and pre-existing terminal disease or significant comorbidities. Results: 90 evaluations were requested during the study period. However, according to our inclusion/exclusion criteria, only on 14 occasions (15.6%) there was a recommendation for the use of REBOA. Gynecological/obstetric conditions were the indication in 11 cases (78.6%) and elective oncologic surgery in three cases (21.4%). Conclusions: The use of REBOA is not common in our country, but it can be an essential tool, and perhaps the last resource in extremely severe conditions until the definitive surgical, endovascular or endoscopic treatment is performed.


Subject(s)
Humans , Adolescent , Shock, Hemorrhagic , Balloon Occlusion , Endovascular Procedures , Aorta , Resuscitation , Brazil , Retrospective Studies
13.
Rev. cuba. pediatr ; 92(supl.1): e1201, 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1156615

ABSTRACT

La parada cardiorrespiratoria no es un evento frecuente en pediatría, pero para aquellos que la sufren, representa un serio problema por la elevada mortalidad o el riesgo de secuelas. La causa más frecuente es la hipoxia, por tanto, las intervenciones respiratorias son imprescindibles durante la reanimación cardiopulmonar. Debido a la pandemia de la COVID-19, el abordaje de la vía aérea durante la resucitación ha sido analizada teniendo en cuenta el alto riesgo de contagiosidad del virus SARS-CoV-2 por la aerosolización de las secreciones respiratorias. Se recomienda el uso de equipos de protección, limitar el personal necesario para la resucitación, preferir la ventilación por tubo endotraqueal si hay personal entrenado y extremar la vigilancia del paciente pediátrico en riesgo para compensar la demora por la colocación de los medios de protección. Es imprescindible conocer cada una de las intervenciones en los distintos eslabones de la cadena de supervivencia para lograr la recuperación del paciente con el menor número de secuelas posibles y sin contagio en el personal de la salud(AU)


Cardiorespiratory arrest is a not a frequent event in pediatrics, but it is a serious problem for those who suffer it due to its high mortality rates and the risk of sequelaes. Hypoxia is its most frequent cause that is why respiratory interventions are essential during cardiopulmonary resuscitation. Due to COVID-19 pandemic, tackling the air ways during resuscitation has been subject of analysis taking into account the high risk of contagion of the virus SARS-COV-2 by the aerosolization of respiratory secretions. It is recommended the use of protection equipment, to limit personnel to the just needed for resuscitation, to choose ventilation by endotracheal intubation if there is trained personnel, and to maximize the surveillance of paediatric patients at risk in order to compensate the delay due to the placing of protection means. It is essential to know each of the interventions in the different links of the survival chain in order to achieve the patient's recovery with the lower number of possible sequelaes and without contagions among the health personnel(AU)


Subject(s)
Humans , Resuscitation , Cardiopulmonary Resuscitation , Coronavirus Infections , Equipment and Supplies , Heart Arrest , Intubation, Intratracheal
14.
Rev. cientif. cienc. med ; 23(1): 8-14, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1126273

ABSTRACT

INTRODUCCIÓN: la resucitación cardiopulmonar es un conjunto de maniobras que deben realizarse en forma sistemática y simultánea, para salvar vidas. El que las realice, debe tener un sólido conocimiento teórico-práctico de la técnica a usar. OBJETIVO: determinar la diferencia en el conocimiento teórico-práctico de Reanimación Cardio Pulmonar según el tipo de intervención educativa en estudiantes de medicina del Perú. MÉTODOS: estudio de intervención de tipo educativo, realizado en estudiantes de dos universidades peruanas. La variable principal fue medir el cambio del nivel de conocimiento teórico-práctico según el tipo de instrucción (Teórico, teórico ­ practico o Practico), medida con un cuestionario previamente validado 1. Se utilizó las pruebas estadísticas de chi cuadrado para las variables categóricas y ANOVA para el análisis de variables numéricas versus las categóricas, ajustado por la prueba de Barlett. RESULTADOS: según el tipo de intervención recibida, la diferencia entre los promedios finales teóricos no fue significativa (p>0,05), pero los promedios finales prácticos sí mostraron diferencias entre los grupos (p<0,001). En el análisis multivariado se encontró diferencias en el conocimiento práctico del grupo de instrucción práctica (p=0,020) y teórico-práctica (p=0,001) respecto al grupo de instrucción teórica exclusiva. CONCLUSIÓN: la instrucción tipo práctica y teórico-práctica genera un cambio significativo en el nivel de conocimientos. Esto debe tomarse en cuenta para la generación de programas de instrucción, ya que, muchas veces los conocimientos solo teóricos resultan insuficientes para este tipo de aprendizaje.(AU)


INTRODUCTION: cardiopulmonary resuscitation is a set of maneuvers that must be performed systematically and simultaneously, to save lives. The person who performs them must have a solid theoretical and practical knowledge of the technique to be used. Objective: To determine the difference in theoretical-practical knowledge of Cardiopulmonary Resuscitation according to the type of educational intervention in medical students in Peru. METHODS: study of educational intervention, conducted in students from two Peruvian universities. The main variable was to measure the change in the level of theoretical-practical knowledge according to the type of instruction (theoretical, theoretical-practical or practical), measured with a previously validated questionnaire 1. We used the statistical chi-square test for categorical variables and ANOVA for the analysis of numerical variables versus categorical variables, adjusted by the Bartlett test. RESULTS: according to the type of intervention received, the difference between theoretical final averages was not significant (p>0.05), but practical final averages did show differences between groups (p<0.001). In the multivariate analysis, differences were found in the practical knowledge of the practical instruction group (p=0.020) and theoretical-practical knowledge (p=0.001) with respect to the exclusive theoretical instruction group. CONCLUSION: practical and theoretical-practical instruction generates a significant change in the level of knowledge. This must be taken into account when generating instruction programs, since many times only theoretical knowledge is insufficient for this type of learning.(AU)


Subject(s)
Analysis of Variance , Cardiopulmonary Resuscitation , Resuscitation , Universities , Education, Higher
15.
Acta Paul. Enferm. (Online) ; 33: eAPE20180134, 2020. tab
Article in Portuguese | LILACS-Express | LILACS, BDENF | ID: biblio-1124009

ABSTRACT

Resumo Objetivo Verificar as variáveis obstétricas e neonatais relacionadas à necessidade de reanimação de recém-nascidos (RN) prematuros moderados e tardios em sala de parto. Métodos Estudo transversal que incluiu 151 RN prematuros moderados e tardios de um hospital universitário do sul do Brasil. Participaram do estudo, todos os RN moderados e tardios, que nasceram no período de maio de 2016 a maio de 2017. A coleta aconteceu por meio dos prontuários dos participantes, utilizando instrumento próprio para coleta de dados. Os resultados foram apresentados por meio de frequências, comparação de frequência [Qui-Quadrado] para análise entre a variável dependente [necessidade de reanimação] e as independentes. O estudo seguiu as recomendações éticas. Resultados Os fatores obstétricos associados a necessidade de reanimação em RN moderados e tardios foram a gestação de risco (p=0,007), intercorrências durante o parto (p=0,031), cesariana (p=0,005) e amniorrexe prematura (p=0,01). Quanto a associação dos fatores neonatais, destaca-se as desproporções de peso para idade gestacional (p<0,001), a menor idade gestacional (p<0,001) e a malformação fetal (p=0,047), como fatores relacionados a necessidade de reanimação. Conclusão Para população de prematuros moderados e tardios, fatores como amniorrexe prematura, menor idade gestacional e intercorrências gestacionais e no parto são fatores relacionados a necessidade de reanimação. Reconhecer esses fatores contribui para a gestão do cuidado nas salas de parto.


Resumen Objetivo Verificar las variables obstétricas y neonatales relacionadas con la necesidad de reanimación de recién nacidos (RN) prematuros moderados y tardíos en sala de parto. Métodos Estudio transversal que incluyó 151 RN prematuros moderados y tardíos de un hospital universitario del sur de Brasil. En el estudio participaron todos los RN moderados y tardíos que nacieron en el período de mayo de 2016 a mayo de 2017. La recolección se realizó a través de las historias clínicas de los participantes, con un instrumento propio para la recolección de datos. Los resultados se presentaron por medio de frecuencias, comparación de frecuencia (ji cuadrado) para el análisis entre la variable dependiente (necesidad de reanimación) y las independientes. El estudio cumplió las recomendaciones éticas. Resultados Los factores obstétricos relacionados con la necesidad de reanimación de RN moderados y tardíos fueron embarazo de riesgo (p=0,007), complicaciones durante el parto (p=0,031), cesárea (p=0,005) y rotura prematura de membranas (p=0,01). Respecto a la relación de los factores neonatales, se destacan la desproporción de peso para la edad gestacional (p<0,001), la menor edad gestacional (p<0,001) y la malformación fetal (p=0,047), como factores relacionados con la necesidad de reanimación. Conclusión En la población de prematuros moderados y tardíos, factores como rotura prematura de membranas, menor edad gestacional y complicaciones gestacionales y en el parto están relacionados con la necesidad de reanimación. Reconocer esos factores contribuye para el manejo del cuidado en las salas de parto.


Abstract Objective To verify the obstetric and neonatal variables related to the need for resuscitation of moderate and late premature NBs in the delivery room. Methods A cross-sectional study that included 151 moderate and late preterm NBs from a university hospital in southern Brazil. All moderate and late NBs born from May 2016 to May 2017 participated in the study. The collection took place through the participants' medical records, using their own data collection instrument. Results were presented using frequencies, frequency comparison [Chi-Square] for analysis between the dependent variable [need for resuscitation] and the independent ones. The study followed ethical recommendations. Results The obstetric factors associated with the need for resuscitation in moderate and late NBs were risk pregnancy (p=0.007), complications during delivery (p=0.031), cesarean section (p=0.005) and premature amniorrhexis (p=0.01). Regarding the association of neonatal factors, we highlight the disproportion of weight for gestational age (p<0.001), lower gestational age (p<0.001) and fetal malformation (p=0.047) as factors related to the need for resuscitation. Conclusion For the population of moderate and late preterm NBs, factors such as premature amniorrhexis, early gestational age and gestational and delivery complications are factors related to the need for resuscitation. Recognizing these factors contributes to delivery room care management.


Subject(s)
Neonatal Nursing , Delivery Rooms , Premature Birth , Nursing Care , Resuscitation , Cross-Sectional Studies
16.
Article in English | AIM, AIM | ID: biblio-1258614

ABSTRACT

Background: The accuracy of drug dosing calculations during medical emergencies in children has not been evaluated extensively. The objectives of this study were to evaluate the accuracy of drug dose calculations using the Broselow tape, the PAWPER XL tape plus its companion drug-dosing guide, a custom-designed mobile phone app and no drug-dosing aid (control group). Methods: This was a prospective study in which 32 emergency medicine volunteers participated in eight simulations of common paediatric emergency conditions, using children models. The participants used the three methods to estimate the children's weight and calculate drug doses. The accuracy of and time taken for the drug dose determinations were then evaluated for each of the methods. Results: The overall accuracy of drug dose determinations was extremely and potentially dangerously low in the control group in which no dosing guide was used as well as in the Broselow tape group (<20% of doses were correct). The accuracy was significantly higher with the PAWPER XL tape group and the mobile app group (47% and 31% respectively). The times taken to obtain the required information did not differ in a clinically meaningful magnitude. Conclusions: Both an accurate weight estimation and a dosing guide with comprehensive information were necessary to produce an accurate prescription. The information on the Broselow tape was not sufficient for this purpose. The current guidelines recommending the use of tapes with limited information should be revised. The results from the comprehensive dosing guides were substantially better, but still had a lower proportion of accurate prescriptions than desirable. The role of training in every aspect of the emergency paediatric weight estimation and drug dosing procedure cannot be underestimated and should be routine in any environment where emergency care may be needed


Subject(s)
Dose-Response Relationship, Drug , Emergency Medicine , Pediatric Emergency Medicine , Resuscitation , South Africa
17.
Article in English | WPRIM | ID: wpr-811106

ABSTRACT

PURPOSE: Unstable pelvic fracture with bleeding can be fatal, with a mortality rate of up to 40%. Therefore, early detection and treatment are important in unstable pelvic trauma. We investigated the early predictive factors for possible embolization in patients with hemodynamically unstable pelvic trauma.METHODS: From January 2011 to December 2013, 46 patients with shock arrived at a single hospital within 24 hours after injury. Of them, 44 patients underwent CT scan after initial resuscitation, except for 2 who were dead on arrival. Nine patients with other organ injuries were excluded. Seventeen patients underwent embolization. A single radiologist measured the width (longest length in axial view) and length (longest length in coronal view) of pelvic hematoma on CT scans. Demographic, clinical, and radiological data were reviewed retrospectively.RESULTS: Among 35 patients with hemodynamically unstable pelvic fracture, 22 (62.9%) were men. Width (P = 0.002) and length (P = 0.006) of hematoma on CT scans were significantly different between the embolization and nonembolization groups. The predictors of embolization were width of pelvic hematoma (odds ratio [OR], 1.07; P = 0.028) and female sex (OR, 10.83; P = 0.031). The cutoff value was 3.35 cm. More embolization was performed (OR, 12.00; P = 0.003) and higher mortality was observed in patients with hematoma width >3.35 cm (OR, 4.96; P = 0.048).CONCLUSION: Patients with hemodynamically unstable pelvic trauma have a high mortality rate. CT is useful for the initial identification of the need for embolization among these patients. The width of pelvic hematoma can predict possible embolization in patients with unstable pelvic trauma.


Subject(s)
Embolization, Therapeutic , Female , Fractures, Bone , Hematoma , Hemorrhage , Humans , Male , Mortality , Resuscitation , Retrospective Studies , Shock , Tomography, X-Ray Computed
18.
Article in Chinese | WPRIM | ID: wpr-828707

ABSTRACT

In the current revision of neonatal resuscitation training course material and its in-depth learning, referring to the American original textbook on neonatal resuscitation, the authors have some recognition and discussion about its several technical details or translated words. These include the location and time period of postnatal rapid assessment, the expression of respiratory questions, the pressing position in the tracheal intubation, and the expression of respiratory questions in the flow chart of resuscitation, etc. The accurate understanding and interpretation of the above will help grass-roots training to be carried out more accurately and effectively.


Subject(s)
Humans , Infant, Newborn , Intubation, Intratracheal , Resuscitation
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