High-fidelity simulation versus case-based discussion for training undergraduate medical students in pediatric emergencies: a quasi-experimental study

Abstract Objective: To evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in undergraduate medical students. Methods: 33 medical students were allocated to two teaching methods: high-fidelity simulation (HFS, n = 18) or case-based discussion (CBD, n = 15). Self-confidence and knowledge tests were applied before and after the interventions and the effect of HFS on both outcomes was estimated with mixed-effect models. An Objective Structured Clinical Examination activity was conducted after the interventions, while two independent raters used specific simulation checklists to assess clinical reasoning, communication, attitude, and leadership. The effect of HFS on these outcomes was estimated with linear and logistic regressions. The effect size was estimated with the Hedge'sg. Results: Both groups had an increase in self-confidence (HFS 59.1 × 93.6, p < 0.001; CDB 50.5 × 88.2, p < 0.001) and knowledge scores over time (HFS 45.1 × 63.2, p = 0.001; CDB 43.5 × 56.7, p-value < 0.01), but no difference was observed between groups (group*time effect in the mixed effect models adjusted for the student ranking) for both tests (p = 0.6565 and p = 0.3331, respectively). The simulation checklist scores of the HFS group were higher than those of the CBD group, with large effect sizes in all domains (Hedges g 1.15 to 2.20). Conclusion: HFS performed better than CBD in developing clinical reasoning, communication, attitude, and leadership in undergraduate medical students in pediatric emergency care, but no significant difference was observed in self-confidence and theoretical knowledge.

Angioedema hereditário com deficiência do Inibidor de C1 ­ Armadilhas no diagnóstico, tratamento e compreensão / Hereditary angioedema with C1 inhibitor deficiency: traps in the diagnosis, treatment, and understanding

Angioedema hereditário (AEH) é uma condição rara, subdiagnosticada e de elevada morbimortalidade, devido ao caráter de suas manifestações clínicas. O AEH se diferencia do angioedema histaminérgico por não responder aos anti-histamínicos, corticosteroides ou epinefrina. Por esse motivo, é extremamente importante o diagnóstico dessa situação, a fim de instituir a terapia adequada. Tal afecção deve ser suspeitada a partir da história clínica de episódios imprevisíveis e recorrentes de edema que quando se manifesta sob a forma de edema laríngeo, pode levar a óbito por asfixia, se não for adequadamente tratado. Relatamos o caso de uma paciente de 18 anos que, apesar de previamente diagnosticada com AEH tipo 1, ao procurar um serviço de emergência devido a crise de angioedema, não dispunha de medicação específica nem apresentou plano de ação com as opções possíveis para crises. Este caso reforça a necessidade de maior divulgação da doença, além da conscientização de pacientes e familiares sobre a doença e eventuais crises, assim como o acesso as medicações.

Hereditary angioedema (HAE) is a rare, underdiagnosed condition with high morbidity and mortality due to the characteristics of its clinical presentation. HAE differs from histaminergic angioedema by not responding to antihistamines, corticosteroids, or epinephrine. Therefore, early diagnose is crucial to initiate adequate therapy. HAE is suspected in patients with a clinical history of unpredictable and recurrent episodes of edema. When laryngeal edema occurs, it can lead to death from asphyxiation if not treated properly. We report the case of an 18-year-old patient previously diagnosed with HAE type 1 who sought emergency care during an angioedema attack. However, the patient was not taking any specific medication and did not have an action plan to manage attacks. This case highlights the importance of increasing awareness about the disease, educating patients and their families about the disease and potential attacks, and ensuring access to medications.

Investigation of the job satisfaction and its influencing factors of the pre-hospital emergency staff in Beijing / 中国现代医生

@#Objective To provide reference for improving job satisfaction,ensuring service quality and promoting sustainable development of pre-hospital emergency care field,this paper investigated the current situation of job satisfaction of pre-hospital emergency staff in Beijing and analyzed it's differences and influencing factors.Methods SPSS 23.0 was used to input the data,and T-test,variance analysis,multiple linear regression and other processing were performed.Result Basic information of 714 pre-hospital emergency staff in Beijing in terms of subordinate unit,gender,age,education level,job post,title classification,title grade and working years;the proportion of job satisfaction of average and unsatisfactory reached 39.91%;the difference in job satisfaction among the seven categories was statistically significant;seven factors had statistically significant effects on job satisfaction;90.20%of pre-hospital emergency staff suggested improving their salary.Conclusion Prehospital emergency staff in Beijing are mainly young and middle-aged men,with a high proportion of college or university degree;job satisfaction is not good;pre-hospital emergency staff with different levels of education,jobs and working years have significant influence on job satisfaction;reinforcing the construction of talent team from the aspects of salary improvement and pre-hospital emergency technical training is important to improve the job satisfaction of pre-hospital emergency personnel.

Satisfacción de los pacientes con los servicios de urgencias desde la perspectiva de Hildegard E. Peplau / Patient Satisfaction with Emergency Services from the Perspective of Hildegard E. Peplau

Introducción: Los servicios de urgencias son contextos multiprofesionales, donde la satisfacción, fenómeno multifactorial, va unida a la calidad. Entonces, es necesaria la contextualización del fenómeno desde la Enfermería, pues cada profesional hace su análisis desde su objeto de estudio. Objetivo: Sistematizar la satisfacción de pacientes con los servicios de urgencia desde una perspectiva de Hildegard E. Peplau. Métodos: Se realizó una revisión integrativa de artículos originales y de revisión publicados en las bases de datos SciELO, Medigraphic, Index, Sciencedirect, PubMed y Cuiden. Se elaboró la pregunta guía a través del acrónimo PICo. La estrategia de búsqueda se realizó mediante los descriptores en Ciencias de la Salud (DeCS) "satisfacción" AND "servicios de atención de urgencia" AND "enfermería" AND "Teoría de Enfermería" OR "atención de enfermería". Se utilizó el diagrama de flujo (PRISMA), se identificaron y revisaron 93 artículos, de los que 8 fueron útiles de la evolución de la categoría, se realizó análisis de contenido de documentos. Conclusiones: La sistematización favoreció la identificación de regularidades y elementos relevantes enfocados en la concepción de Enfermería, tales como: indicador para evaluar la calidad de la atención en salud, mediada por la relación interpersonal, reconocimiento de necesidades, reconocer expectativas y objetivos concretos, análisis y percepción final de resultados y grado de satisfacción(AU)

Introduction: Emergency departments are multiprofessional scenarios, in which satisfaction, a multifactorial phenomenon, goes hand in hand with quality. Therefore, it is necessary to contextualize the phenomenon from the nursing perspective, since each professional makes their analysis from their object of study. Objective: To systematize patient satisfaction with emergency services from the perspective of Hildegard E. Peplau. Methods: An integrative review was conducted of original and review articles published in the SciELO, Medigraphic, Index, Sciencedirect, PubMed and Cuiden databases. The guiding question was elaborated using the acronym PICo. The search strategy was performed using the descriptors in Health Sciences (DeCS) satisfacción [satisfaction] AND servicios de atención de urgencia [emergency care services] AND enfermería [nursing] AND teoría de enfermería [nursing theory] OR atención de enfermería [nursing care]. The flowchart (PRISMA) was used; as well as 93 articles were identified and reviewed, of which 8 were useful. In addition, content analysis of documents was performed. Conclusions: The systematization favored the identification of regularities and relevant elements focused on the nursing conception, such as an indicator to evaluate the quality of health care, mediated by interpersonal relationship, recognition of needs, recognition of expectations and concrete objectives, analysis and final perception of results, and degree of satisfaction(AU)

Valoración inicial de enfermería en emergencias psiquiátricas: revisión sistemática / Initial nursing assessment in psychiatric emergencies: a systematic review / Avaliação inicial de enfermagem em emergências psiquiátricas: uma revisão sistemática

Un porcentaje significativo de las emergencias hospitalarias son psiquiátricas; por lo que, durante la práctica clínica diaria, el personal de enfermería debe atender a pacientes con síntomas mentales y signos conductuales. Para tomar decisiones que permitan afrontar dichas urgencias, el profesional de enfermería requiere realizar una adecuada valoración para establecer las necesidades reales del paciente. Objetivo. Identificar los instrumentos utilizados por el servicio de enfermería para una valoración inicial efectiva en emergencias psiquiátricas. Metodología. Se realizó una revisión sistemática cuya búsqueda se realizó en las bases de datos Scopus y PubMed. La ecuación empleada fue la base de datos Scopus se utilizaron (mental AND health AND diagnosis AND psychiatric AND emergency) OR (instruments AND diagnosis AND psychiatric AND emergencies); en PubMed se usaron (initial AND assessment AND psychiatric AND patients AND emergency AND diagnosis), a partir de metodo de busqyeda empleado se obtuvo un total de 802 fuentes que pasaron por un proceso de selección quedando para el análisis de 22 publicaciones. Conclusión. Las entrevistas y cuestionarios se erigen como una herramienta indispensable. Permiten establecer un vínculo directo con el paciente, identificar sus preocupaciones, síntomas y necesidades específicas, garantizando así su bienestar físico y emocional desde el inicio de la atención. El uso de las escalas de medición varía de acuerdo a la enfermedad del paciente, el sistema de clasificación más utilizada es la CIE-10 y que los registros clínicos sobre antecedentes familiares y de sustancias, además de los aspectos sociodemográficos, son los más usados y permiten visualizar el perfil general del paciente de emergencias psiquiátricas.

A significant percentage of hospital emergencies are psychiatric; therefore, during daily clinical practice, the nursing staff must attend patients with mental symptoms and behavioral signs. In order to make decisions to deal with such emergencies, the nursing professional requires an adequate assessment to establish the real needs of the patient. Objective. To identify the instruments used by the nursing service for an effective initial assessment in psychiatric emergencies. Methodology. A systematic review was carried out using the Scopus and PubMed databases. The equation used was the Scopus database (mental AND health AND diagnosis AND psychiatric AND emergency) OR (instruments AND diagnosis AND psychiatric AND emergencies); in PubMed (initial AND assessment AND psychiatric AND patients AND emergency AND diagnosis); from the search method used, a total of 802 sources were obtained which went through a selection process leaving 22 publications for analysis. Conclusion. Interviews and questionnaires are an indispensable tool. They allow establishing a direct link with the patient, identifying their concerns, symptoms and specific needs, thus guaranteeing their physical and emotional well-being from the beginning of care. The use of measurement scales varies according to the patient's disease; the most commonly used classification system is the ICD-10 and clinical records on family and substance history, in addition to sociodemographic aspects, are the most used and allow visualizing the general profile of the psychiatric emergency patient.

Uma porcentagem significativa das emergências hospitalares é psiquiátrica; portanto, durante a prática clínica diária, os enfermeiros devem atender a pacientes com sintomas mentais e sinais comportamentais. Para tomar decisões sobre como lidar com essas emergências, o profissional de enfermagem precisa fazer uma avaliação adequada para estabelecer as reais necessidades do paciente. Objetivo. Identificar os instrumentos utilizados pelo serviço de enfermagem para uma avaliação inicial eficaz em emergências psiquiátricas. Metodologia. Foi realizada uma revisão sistemática utilizando as bases de dados Scopus e PubMed. A equação utilizada foi a da base de dados Scopus (mental AND health AND diagnosis AND psychiatric AND emergency) OR (instruments AND diagnosis AND psychiatric AND emergencies); na PubMed (initial AND assessment AND psychiatric AND patients AND emergency AND diagnosis); a partir do método de busca utilizado, obteve-se um total de 802 fontes que passaram por um processo de seleção, restando 22 publicações para análise. Conclusões. As entrevistas e os questionários são uma ferramenta indispensável. Eles permitem estabelecer um vínculo direto com o paciente, identificar suas preocupações, sintomas e necessidades específicas, garantindo assim seu bem-estar físico e emocional desde o início do atendimento. O uso de escalas de medição varia de acordo com a doença do paciente. O sistema de classificação mais usado é o CID-10 e os registros clínicos sobre histórico familiar e de substâncias, além de aspectos sociodemográficos, são os mais usados e permitem visualizar o perfil geral do paciente de emergência psiquiátrica.

Validity of the Brazilian pediatric triage system CLARIPED at a secondary level of emergency care

Abstract Objective To evaluate the validity of the triage system CLARIPED in a pediatric population in the city of São Paulo, Brazil. Methods Prospective, observational study in a secondary-level pediatric emergency service from Sep-2018 to Ago-2019. A convenience sample of all patients aged 0-18 years triaged by the computerized CLARIPED system was selected. Associations between urgency levels and patient outcomes were analyzed to assess construct validity. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) to identify the most urgent patients were estimated, as well as under-triage and over-triage rates. Results The distribution of 24,338 visits was: RED 0.02%, ORANGE 0.9%, YELLOW 23.5%, GREEN 47.9%, and BLUE 27.7% (highest to the lowest level of urgency). The frequency of the following outcomes increased with increasing urgency: hospital admission (0.0%, 0.02%, 0.1%, 7.1% and 20%); stay in ED observation room (1.9%, 2,4%, 4.8%, 24.1%, 60%); use of ≥ 2 diagnostic/therapeutic resources (2.3%, 3.0%, 5.9%, 28.8%, 40%); ED length of stay (12, 12, 15, 99.5, 362 min). The most urgent patients (RED, ORANGE, and YELLOW) exhibited higher chances of using ≥ 2 resources (OR 2.55; 95%CI: 2.23-2.92) or of being hospitalized (OR 23.9; 95%CI: 7.17-79.62), compared to the least urgent (GREEN and BLUE). The sensitivity to identify urgency was 0.88 (95%CI: 0.70-0.98); specificity, 0.76 (95%CI: 0.75-0.76); NPV, 0.99 (95%CI: 0.99-1.00); overtriage rate, 23.0%, and undertriage, 11.5%. Conclusion This study corroborates the validity and safety of CLARIPED, demonstrating significant correlations with clinical outcomes, good sensitivity, and low undertriage rate in a secondary-level Brazilian pediatric emergency service.

Caracterización de los registros de atención en una institución prestadora de servicios de salud mental en Bogotá, 2001-2017 / Characteristics of care delivery records in a mental health service providerinstitution in Bogota, 2001-2017 / Caracterização dos registros de atendimento em uma instituição prestadora deserviços de saúde mental em Bogotá, 2001-2017

Introducción:el abordaje integral de la salud mental es uno de los retos del país en salud pública, dado que la población colombiana ha presentado un deterioro en ese aspectoen los últimos veinte años de acuerdo con el documentoCONPES 3992del2020.Objetivo:Caracterizar los registros individuales de prestación de servicios en atención desalud mental en unainstitución prestadora de servicios enBogotá,Colombia, entre el 2001 y el2017. Métodos:estudio descriptivo trasversal. Se usaron los registros individuales de prestación de servicios como fuente de informacióny se tuvo en cuentaclasificación internacional de enfermedades (CIE-10) Entotal de registros RIPS en salud mental, por equipo interdisciplinario: médico general, médico psiquiatra, enfermería, psicología, trabajo social y terapia ocupacional. Resultados:se analizaron 2.360.295 registros individuales de prestación de servicios en salud mental de la institución seleccionada. Según los registros,el promedio de edad de las personas atendidas era de 47 añosypredominó el sexo femenino con el 52,5%. Los servicios utilizados fueronhospitalización (49,82%), consulta externa (43,42%), urgencias (4,54%)y hospital de día (0,39%). Elmayor número de registros (64,47%) se presentó en el grupo entre los 18 y 59 años de edad; seguido del grupo de 60 años o más (28,50%)y de menores de 18 años (7,03%). Los grupos de diagnóstico principales fueron trastorno psicótico con el 33,38%,depresióncon el 15,39%y ansiedad con el 13,71%. Conclusiones:Son las mujeres quienes más utilizan el servicio (52.5%). Es la hospitalización el servicio más utilizado (49.82%). Son los adultos entre 18 y 59 años quienes más utilizan los servicios (64.47%). Se observa un progresivo incremento en el número de atenciones. Los trastornos mentales severos esquizofrenia y bipolar son los másatendidos (33.38%) seguidos de trastornos de depresión y ansiedad (29%). Las enfermedades medicas generales se presentaron en el (10.95%)de las atenciones.

Introduction: The comprehensive approach to mental health is one of the country's public health challenges, as the Colombian population has deteriorated in this area over the past twenty years, according to the CONPES Document 3992, 2020. Objective:To characterize the individual mental health service delivery records at a service provider institution in Bogota, Colombia, between 2001 and 2017. Methods:Descriptive cross-sectional study. Individual service delivery records were used as a source of information, and the International Classification of Diseases (ICD-10) was considered. Total mental health RIPS by interdisciplinary team: general practitioner, psychiatrist, nurse, psychologist, social worker, and occupational therapist. Results:A total of 2,360,295 individualmental health service delivery records from the selected institution were analyzed. According to the records, the average age of the patients was 47 years, and females predominated with 52.5% of the patients. Inpatient (49.82%), outpatient (43.42%), emergency room (4.54%), and day hospital (0.39%) services were used. The highest number of records (64.47 %) were found among the 18-59 years age group, followed by the 60+ year age group (28.50 %) and those under 18 years of age (7.03 %). The main diagnostic groups were psychotic disorder (33.38%), depression (15.39%), and anxiety (13.71%). Conclusions:Women are the main users of the service (52.5%). Hospitalization is the service most frequently used (49.82%). Adults between the ages of 18 and 59 use the services the most (64.47%). There has been a progressive increase in the number of attendances. Severe schizophrenia and bipolar mental disorders are the most treated (33.38%), followed by depression and anxiety (29%). General medical conditions were present in 10.95% of attendances

Introdução:a abordagem integral da saúde mental é um dos desafios do país em saúde pública, visto que a população colombiana tem apresentadouma deterioração neste aspecto nos últimos vinte anos de acordo com o documento Conpes 3992de 2020. Objetivo:Caracterizar os registros individuais de prestação de serviços em saúde mental em uma instituição prestadora de serviços em Bogotá, Colômbia, entre 2001 e 2017. Métodos:estudo descritivo transversal. Usaram-se os registros individuais de prestação de serviços como fonte de informação e considerou-sea classificação internacional de doenças (CID-10). No total de registros RIPS em saúde mental, por equipe interdisciplinar: clínico geral, psiquiatra, enfermagem, psicologia, serviço social e terapia ocupacional. Resultados:Foram analisados 2.360.295 prontuários individuais de prestação de serviço de saúde mental da instituição selecionada. De acordo com os registros, a média de idade das pessoas atendidas foi de 47 anos e o sexo feminino predominou com 52,5%. Os serviços utilizados foram internação (49,82%), ambulatorial (43,42%), emergência (4,54%) e hospital-dia (0,39%). O maior número de registros (64,47%) foi apresentado no grupo entre 18 e 59 anos; seguido pelo grupo de 60 anos ou mais (28,50%) e os menores de 18 anos(7,03%). Os principais grupos diagnósticos foram transtorno psicótico com 33,38%, depressão com 15,39% e ansiedade com 13,71%. Conclusões:As mulheres são as que mais utilizam o serviço (52,5%). A internação é o serviço mais utilizado (49,82%). Os adultosentre 18 e 59 anos são os que mais utilizam os serviços (64,47%). Observa-se um aumento progressivo no número de atenções. Os transtornos mentais graves esquizofrenia e bipolaridadesão os mais atendidos (33,38%) seguidos de depressão e transtornos de ansiedade (29%). Doenças médicas gerais estiveram presentes em (10,95%) dos atendimentos

Telemedicine in healthcare access during the covid-19 pandemic: a scoping review / Telemedicina no acesso à saúde durante a pandemia de covid-19: uma revisão de escopo

ABSTRACT OBJECTIVE Mapping the role of telemedicine in the health access of patients with chronic diseases in continuous care actions (except for covid-19) during the pandemic. METHODS This is a scoping review, with an adapted version of the Prisma-Scr methodology and using the Population (patients with chronic diseases), Concept (telemedicine as a health access tool) and Context (covid-19 pandemic) strategy. We searched through the following databases: PubMed, Scopus, Embase, Web of Science, Lilacs and SciELO, resulting in 18 articles at the end of the review. We used the technological, sociocultural and assistance analysis dimensions. RESULTS Eighty-eight percent of the analyzed papers posited that telemedicine use to provide care increased during the pandemic. We identified that this use was positively related to the reduction of complications and the absence of physical displacement for care, expanding it to rural areas. Important barriers were presented, most importantly the digital exclusion, language sociocultural barriers, and inaccessibility to technological instruments for disabled people. CONCLUSIONS Innovation in care arrangements calls attention to how living labor is important to produce healthcare, using various technologies, and reveals tensions caused by the forces acting on healthcare micro politics. We conclude that, despite important barriers, telemedicine contributed to the care of chronic patients during the covid-19 pandemic.

RESUMO OBJETIVO Mapear a contribuição da telemedicina para o acesso à saúde dos pacientes portadores de doenças crônicas em ações de cuidados continuados (exceto para covid-19) no contexto da pandemia. MÉTODOS Trata de revisão de escopo, com adaptação da metodologia Prisma-Scr e utilizou a estratégia População (Pacientes portadores de doenças crônicas), Conceito (Telemedicina como ferramenta de acesso à saúde) e Contexto (Pandemia de covid-19). Foram realizadas buscas nas bases de dados PubMed, Scopus, Embase, Web of Science, Lilacs e SciELO, que resultou em um total de 18 artigos ao final da revisão. As dimensões de análise utilizadas foram tecnológica, sociocultural e assistencial. RESULTADOS Entre os artigos analisados, 88% demonstraram o aumento do uso da telemedicina para realização do cuidado durante a pandemia. Identificamos que a utilização da telemedicina esteve relacionada positivamente com a diminuição de complicações e a falta de necessidade de deslocamento físico para o atendimento com ampliação da assistência para áreas rurais. Barreiras importantes foram apresentadas, sendo a exclusão digital e barreiras socioculturais de idioma e falta de acessibilidade dos instrumentos tecnológicos para portadores de deficiência as principais. CONCLUSÕES A inovação nos arranjos assistenciais ressalta a importância do trabalho vivo no processo de produção do cuidado, com o emprego de tipos de tecnologias diversos, e expressa tensionamentos em decorrência das forças atuantes na micropolítica do cuidado. Concluímos que, apesar de barreiras importantes, a telemedicina contribuiu para o cuidado dos pacientes crônicos durante a pandemia de covid-19.

Concepción del servicio de urgencia desde la mirada de la Enfermería / Conception on Emergency Service from the Nursing Perspective

Introducción: Los servicios de urgencia constituyen entornos donde confluyen múltiples profesiones. En este contexto, los profesionales de Enfermería se muestran como coordinadores en medio de las situaciones complejas que se generan. Por tanto, se necesita concebirlo desde la visión de cada profesional en particular, pues las visiones profesionales se convierten en un elemento a tener en cuenta. Objetivo: Sistematizar la concepción de servicio de urgencia desde una perspectiva de Enfermería. Métodos: Revisión integrativa para un análisis crítico reflexivo de contenidos de documentos publicados durante 5 años, desde 2015 al 2019, con clara metodología y referencial teórico seleccionado durante los meses de octubre-diciembre del 2020. Se utilizaron las palabras clave identificadas en DeCS y operadores booleanos: "satisfacción" AND "servicios de atención de urgencia" AND "enfermería" OR "atención de enfermería". La búsqueda fue realizada en las bases de datos Dialnet, Index, Medigraphic, Redalyc, PubMed. Se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses para contribuir a la formulación de la estrategia de búsqueda. Conclusiones: La sistematización sobre las concepciones de servicio de urgencias revelan que la Enfermería es protagonista en los procesos que se gestan en este espacio físico y de relaciones humanas; espacio en el que convergen los servicios de salud y de cuyos resultados depende el flujo de acciones posteriores para el cuidado de la salud humana en condiciones complejas, en el que se desarrollan procesos terapéuticos a partir de las relaciones multiprofesionales volcadas a la solución de los problemas de salud del ser humano(AU)

Introduction: Emergency services are settings where multiple professions converge. In this context, nursing professionals are coordinators amidst the complex situations that occur. Therefore, emergency services need to be conceived from the point of view of each professional individually, since particular professional visions become an element to be taken into account. Objective: To systematize the conception on emergency services from a nursing perspective. Methods: An integrative review was carried out aimed at a reflexive critical analysis of contents from documents published during 5 years, from 2015 to 2019, with a clear methodology and theoretical referents, selected during the months of October-December 2020. Keywords identified in DeCS, together with Boolean operators, were used: satisfacción [satisfaction] AND servicios de atención de urgencia [emergency care services] AND enfermeria [nursing] OR atención de enfermería [nursing care]. The search was performed in the databases Dialnet, Index, Medigraphic, Redalyc, PubMed. The flowchart Preferred Reporting Items for Systematic Review and Meta-Analyses was used for contributing to the formulation of the search strategy. Conclusions: The systematized conceptions about emergency service reveal that nursing is a protagonist in the processes taking place in this physical setting of human relations. Health services converge in such setting, decisive for the flow of subsequent actions aimed at caring for human health in complex conditions, and where therapeutic processes are developed based on multiprofessional relationships aimed at solving the health problems of the human being(AU)

Emergency department use and Artificial Intelligence in Pelotas: design and baseline results / Uso serviços de serviços de urgência e emergência e Inteligência Artificial em Pelotas: protocolo e resultados iniciais

RESUMO Objetivo: To describe the initial baseline results of a population-based study, as well as a protocol in order to evaluate the performance of different machine learning algorithms with the objective of predicting the demand for urgent and emergency services in a representative sample of adults from the urban area of Pelotas, Southern Brazil. Methods: The study is entitled "Emergency department use and Artificial Intelligence in PELOTAS (RS) (EAI PELOTAS)" (https://wp.ufpel.edu.br/eaipelotas/). Between September and December 2021, a baseline was carried out with participants. A follow-up was planned to be conducted after 12 months in order to assess the use of urgent and emergency services in the last year. Afterwards, machine learning algorithms will be tested to predict the use of urgent and emergency services over one year. Results: In total, 5,722 participants answered the survey, mostly females (66.8%), with an average age of 50.3 years. The mean number of household people was 2.6. Most of the sample has white skin color and incomplete elementary school or less. Around 30% of the sample has obesity, 14% diabetes, and 39% hypertension. Conclusion: The present paper presented a protocol describing the steps that were and will be taken to produce a model capable of predicting the demand for urgent and emergency services in one year among residents of Pelotas, in Rio Grande do Sul state.

RESUMO Objetivo: Descrever os resultados iniciais da linha de base de um estudo de base populacional, bem como um protocolo para avaliar o desempenho de diferentes algoritmos de aprendizado de máquina, com o objetivo de predizer a demanda de serviços de urgência e emergência em uma amostra representativa de adultos da zona urbana de Pelotas, no Sul do Brasil. Métodos: O estudo intitula-se "Emergency department use and Artificial Intelligence in PELOTAS (RS) (EAI PELOTAS)" (https://wp.ufpel.edu.br/eaipelotas/). Entre setembro e dezembro de 2021, foi realizada uma linha de base com os participantes. Está previsto um acompanhamento após 12 meses para avaliar a utilização de serviços de urgência e emergência no último ano. Em seguida, serão testados algoritmos de machine learning para predizer a utilização de serviços de urgência e emergência no período de um ano. Resultados: No total, 5.722 participantes responderam à pesquisa, a maioria do sexo feminino (66,8%), com idade média de 50,3 anos. O número médio de pessoas no domicílio foi de 2,6. A maioria da amostra tem cor da pele branca e ensino fundamental incompleto ou menos. Cerca de 30% da amostra estava com obesidade, 14% com diabetes e 39% eram hipertensos. Conclusão: O presente trabalho apresentou um protocolo descrevendo as etapas que foram e serão tomadas para a produção de um modelo capaz de prever a demanda por serviços de urgência e emergência em um ano entre moradores de Pelotas, no estado do Rio Grande do Sul.