Atribuições do enfermeiro no manejo do marcapasso transcutâneo em pacientes idosos: Uma revisão integrativa / Asignaciones del enfermero em el manejo del marcapasos transcutáneo en anciano: Una revisión integrativa / Nurse attributions in the handling of transcutaneous pacemaker in elderly patients: Integrative review

Objetivo: investigar a produção científica nacional e internacional sobre as ações e cuidados do enfermeiro no manejo do marca-passo transcutâneo em idosos. Método: revisão integrativa, realizada nas bases de dados "Scopus", "Web of Science", "EMBASE", "PUBMED", "MEDLINE", no período de 2012 a 2022. Resultados: foram selecionados oito artigos, todos internacionais, somente um conduzido por enfermeiros. Categorizados por: (1) Possibilidades e limitações no uso do marca-passo trânscutâneo na prática clínica; (2) Cuidados de enfermagem na utilização do marca-passo transcutâneo em idosos e (3) Sistematização da Assistência de Enfermagem e a abordagem ao paciente em uso de marca-passo transcutâneo. Conclusão: os principais cuidados de enfermagem ao idoso que utiliza o marca-passo transcutâneo são: prevenção de queimaduras cutâneas; administração de medicamentos; manejo da dor; monitoramento dos dados vitais; avaliação da captura mecânica; investigação do histórico familiar; medicações em uso; realização do exame físico e acesso venoso periférico.(AU)

Objective: : to investigate the national and international scientific production regarding the actions and handling of the transcutaneous pacemaker in elderly. Method: integrative review, made in the databases Scopus", "Web of Science", "EMBASE", "PUBMED", and "MEDLINE", for the period 2012 to 2022. Findings: there were selected eight articles, all international, and only one conducted by nurses. Categorized into: (1) Possibilities and limitations of the use from the transcutaneous pacemaker in clinical practice; (2) Nursing care when utilizing transcutaneous pacemaker in elderly and (3) Systematization of Nursing Care and approach to patients using transcutaneous pacemaker. Conclusion: the main Nursing Care approaches to elderly who use transcutaneous pacemaker are prevent skin burn; drug administration; pain management; monitoring vital signs; evaluation of heart activity; investigating family history and drugs in use; performing physical examination and peripheral venous access.(AU)

Objetivo: investigar cual és lá produccion científica nacional e internacional sobre Las acciones y cuidados del enfermero en el manejo del marca-pado intracutaneo en ancianos. Método: Revision Integrativa realizada en Las bases de datos "Scopus" web of Science", EMBASE", "PUBMED", "MEDLINE", durante el período 2012 a 2022. Resultados: fueron Seleccionados ocho articulos todos internacionales, solanemente uno fue llevado a cabo por enfermeros. Categorizado por (1) posibilidades y limitaciones en El uso del marca-paso intracutaneo en lá práctica clínica; (2) cuidados de enfermeria en lá utilização del marca-paso intracutaneo y (3) sistematizacion de la assistencia de enfermeria y el abordaje del paciente que usa marca-paso intracutaneo. Conclusion: Los principales cuidados de enfermeria Al anciano que utiliza marca-paso intracutaneo son: prevencion de quemaduras cutaneas; administracion de medicamentos, manejo del dolor, monitorizacion de datos vitales, evaluacion de lá captura mecanica, investigação del histórico famíliar, medicaciones en uso, realizacion de examen fisico y acceso venoso periférico.(AU)

Influencing factors associated with delayed time in pre-hospital emergency medical care for hypertensive emergency in the main urban area of Chongqing / 上海预防医学

ObjectiveTo investigate the influencing factors associated with delayed time in pre-hospital emergency medical care in patients with hypertensive emergency in the main urban area of Chongqing. MethodsA total of 1 246 patients with hypertension in the main urban area of Chongqing from March 2018 to August 2021 were included in this study. The delayed time in the pre-hospital emergency medical care was determined. A multivariate linear regression model was used to analyze the influencing factors. ResultsThe delayed time in the pre-hospital emergency medical care for the patients with hypertensive emergency was concentrated in 0‒12 h， with the average of （5.89±1.96） h. The delayed time differed significantly by gender， age， history of atrial fibrillation， diabetes， educational level， time of onset， mode of transportation， awareness of hypertensive emergency， blood pressure at the onset， and presence of persons at the onset of emergency （P<0.05）. Multivariate linear regression analysis showed that educational level， time of onset， blood pressure at the onset， awareness of hypertensive emergency， presence of persons at the onset were linearly correlated with delayed time in the pre-hospital medical care for hypertensive emergencies （P<0.05）. ConclusionDelay in pre-hospital medical care is prevalent for patients with hypertensive emergency in the main urban area of Chongqing. The delayed time is associated with multiple factors， such as educational level， time of onset， blood pressure at onset， awareness of hypertensive emergency， and presence of persons at onset. It warrants further improvement in the interventions to reduce the delay in the pre-hospital medical care.

Clinical risk profile associated with SARS-CoV-2 infection and complications in the emergency area of a pediatric COVID-19 center / Perfil clínico de riesgo asociado a infección y complicaciones por SARS-CoV-2 en el área de urgencias de un centro pediátrico COVID-19

Abstract Background: In February 2020, the disease caused by the novel coronavirus (SARS-CoV-2), was classified as a pandemic. In the pediatric population, coronavirus disease (COVID)-19 has a reported mortality of less than 6% in complicated cases; however, the clinical characteristics and severity are not the same as those presented in the adult population. This study aimed to describe the clinical manifestations of patients younger than 18 years old and their association with the confirmation of the test and outcomes. Methods: We conducted an analytical cross-sectional study of symptoms suggestive for SARS-CoV-2 infection. All subjects with a confirmatory test for SARS-CoV-2 were included. Initial symptoms, history of influenza vaccination, and previous contact were documented, and mortality and the requirement for assisted mechanical ventilation were identified. The proportions of the variables were compared with the χ2 test. The odds ratio for a positive test and the requirement of intubation was calculated. Results: Of a total of 510 subjects, 76 (15%) were positive for SARS-CoV-2. The associated symptoms were chest pain, sudden onset of symptoms, and general malaise. The variable most associated with contagion was the exposure to a relative with a confirmed diagnosis of COVID-19. Infants and subjects without the influenza vaccine showed an increased risk for respiratory complications. Conclusions: The frequency of positivity in the test was 15% (infants and adolescents represented 64% of the confirmed cases), and the associated factors identified were contact with a confirmed case, sudden onset of symptoms, and chest pain.

Resumen Introducción: En 2019 se reportaron los primeros casos de SARS-CoV-2 (coronavirus tipo 2 del síndrome respiratorio agudo grave), causante de la COVID-19, que alcanzó el grado de pandemia en febrero de 2020. La presentación en la etapa pediátrica reporta una mortalidad menor del 6% en los casos complicados; sin embargo, las características clínicas y su gravedad no son iguales que en la población adulta. El objetivo de este estudio fue describir las manifestaciones clínicas de los pacientes menores de 18 años y su asociación con la confirmación de la prueba, la intubación endotraqueal y la muerte. Métodos: Estudio transversal analítico por cuadro sugestivo de infección por SARS-CoV-2. Se incluyeron sujetos positivos para SARS-CoV-2. Se documentaron los síntomas iniciales, los antecedentes de vacunación contra la influenza y los contactos previos, y se identificaron los desenlaces de mortalidad y requerimiento de ventilación mecánica asistida. Se compararon las proporciones de las variables con la prueba χ2 y se calculó la razón de momios para la presencia de una prueba positiva y requerir intubación. Resultados: De un total de 510 sujetos, 76 (15%) fueron positivos para SARS-CoV-2. Los síntomas asociados fueron dolor precordial, inicio súbito y malestar general. La variable asociada con mayor frecuencia el contagio fue la exposición a un familiar con COVID-19 confirmada. Los sujetos sin vacuna de la influenza presentaron un riesgo mayor de complicaciones respiratorias. Conclusiones: La frecuencia de positividad en la prueba fue del 15%. Se identificaron como factores asociados a prueba positiva el contacto con un caso confirmado de COVID-19, el inicio súbito de los síntomas y el dolor precordial.

Prevalence and prediction of pre-hospital medical trauma in Urumqi / 中华急诊医学杂志

Objective@#To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years, so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system.@*Methods@#A total of 427 754 pre-hospital emergency patients were collected from January 1, 2011 to December 31, 2008 in Urumqi. Epidemiological methods were performed for statistical description and analysis. The single-factor gray model [GM (1,1)], multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year. The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction.@*Results@#The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (χ2=7 659.707, P<0.01), and the incidence rate of male patients was 1.95 times higher than that of female patients. The trauma patients aged 35-59 years accounted for the largest proportion (42%), and the incidence of the disease was the highest among those aged≥ 60 years old (644.23/100 000). The incidence of pre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017), with a high incidence in summer (27 123, 31.03%), especially in August (9 535, 10.91%), most of which occurred in the new urban area (high-tech zone) (23 157, 26.50%). The single-factor gray model [GM (1,1)] , multi-factor gray model, and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118, 11 715 and 13 305, respectively, and the MAE were 451.125 0, 607.428 6, and 205.125 0, respectively. The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999, respectively, and the MAE were 47.129 0 and 110.370 4, respectively.@*Conclusions@#The pre-hospital trauma in Urumqi is mainly male and young work-age adults, the incidence of the elderly is the highest, summer is the season of high incidence, and the new urban area (high-tech zone) is the primary district. The moving average model (MA1) model has a more accurate annual prediction, and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction. The pre-hospital trauma emergency medical care demand will continue to increase in the next five years. The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies.

Prevalence and prediction of pre-hospital medical trauma in Urumqi / 中华急诊医学杂志

Objective To investigate the current situation of pre-hospital trauma emergency medical care of Urumqi in 2011-2018 and predict the situation in the next five years,so as to provide a basis for rational allocation of pre-hospital emergency resources and improvement of health service system.Methods A total of 427 754 pre-hospital emergency patients were collected from January 1,2011 to December 31,2008 in Urumqi.Epidemiological methods were performed for statistical description and analysis.The single-factor gray model [GM (1,1)],multi-factor grey model and moving average model (MA1) was established for predicting the number of pre-hospital trauma patients each year.The single-factor gray model [GM (1,1)] and SARIMA model were used for the seasonal prediction.Results The male-female ratio of pre-hospital trauma patients was 1.98:1 and the incidence rate of male patients (534.91/100 000) was significantly higher than that of female patients (274.88/100 000) (x2=7 659.707,P＜0.01),and the incidence rate of male patients was 1.95 times higher than that of female patients.The trauma patients aged 35-59 years accounted for the largest proportion (42％),and the incidence of the disease was the highest among those aged ≥ 60 years old (644.23/100 000).The incidence ofpre-hospital trauma increased year by year (from 408.86/100 000 in 2011 to 550.02/100 000 in 2017),with a high incidence in summer (27 123,31.03％),especially in August (9 535,10.91％),most of which occurred in the new urban area (high-tech zone) (23 157,26.50％).The single-factor gray model [GM (1,1)],multi-factor gray model,and moving average model (MA1) predicted that the total number of pre-hospital trauma patients in 2023 was 13 118,11 715 and 13 305,respectively,and the MAE were 451.125 0,607.428 6,and 205.125 0,respectively.The single-factor gray model [GM (1,1)] and SARIMA model predicted the value in the summer of 2023 would be 3 638 and 4 999,respectively,and the MAE were 47.129 0 and 110.370 4,respectively.Conclusions The pre-hospital trauma in Urumqi is mainly male and young work-age adults,the incidence of the elderly is the highest,summer is the season of high incidence,and the new urban area (high-tech zone) is the primary district.The moving average model (MA1) model has a more accurate annual prediction,and the single-factor gray model [GM (1,1)] is the best model for seasonal prediction.The pre-hospital trauma emergency medical care demand will continue to increase in the next five years.The health administrative department should enlarge the allocation of pre-hospital emergency resources and improve the emergency service capabilities and efficiencies.

Motivos de consulta de pacientes con enfermedades autoinmunes sistémicas en el servicio de urgencias de un hospital terciario / Causes for consultation in the emergency room among patients with systemic autoimmune diseases

Background: The causes of acute decompensations of patients with systemic autoimmune diseases are not well known. Aim: To describe the causes for consultation in an emergency room of patients with systemic autoimmune diseases. Material and Methods: Review of medical records of patients with systemic autoimmune diseases, aged over 14 years, consulting in an emergency room of a general hospital during three months. Results: In the study period, 166 patients with systemic autoimmune diseases consulted in the emergency room, of a total of 18,153 consultations (0.9%). Patients with rheumatoid arthritis were those that consulted with higher frequency (37%) followed by patients with systemic lupus erythematosus (21%). The most common causes for consultation were cardiovascular diseases in 25%, followed by digestive disorders in 15%. The most common diagnosis was chest pain with suspected ischemic heart disease in 36%. No differences in cardiovascular risk factors were observed between those patients consulting for cardiovascular diseases and those consulting for other causes. Conclusions: The most common cause of consultation in the emergency room of patients with systemic autoimmune diseases is cardiovascular.

Organizing the health sector for response to disasters / Organizando o setor saúde para responder a desastres

Each year millions of people around the world are affected by natural and manmade disasters. The consequences of natural disasters in terms of health are complex. Disasters directly impact the health of the population resulting in physical trauma, acute disease, and emotional trauma. Furthermore, disasters may increase the morbidity and mortality associated with chronic and infectious diseases due to the impact on the health system. The health sector must be organized for adequate preparedness, mitigation, response and recuperation from a plethora of potential disasters. This paper examines the various potential impacts of disasters on health, the components of the health sector and their roles in emergency medical care and disaster situations, as well as the coordination and organization necessary within the system to best meet the health needs of a population in the aftermath of a disaster.

A cada ano, milhões de pessoas são afetadas por desastres em todo o mundo, sejam eles naturais ou promovidos pelo homem. As consequências dos desastres naturais para a saúde são complexas. Os desastres impactam diretamente na saúde da população, resultando em danos físicos, doenças agudas e traumas emocionais. Além disso, podem aumentar a morbidade e a mortalidade associada às doenças crônicas e infecciosas, dado o impacto resultante no sistema de saúde. O setor saúde deve estar organizado para a preparação, a mitigação, a resposta e a recuperação para uma miríade de potenciais desastres. O presente artigo explora os vários possíveis impactos dos desastres para a saúde, os componentes do setor saúde e os seus papéis na medicina de emergência e de desastres, da mesma forma, aborda a coordenação e a organização necessária dentro do sistema de saúde para melhor alcançar as necessidades de uma população em um desastre.

Acidentes e violências entre mulheres atendidas em Serviços de Emergência Sentinela - Brasil, 2009 / Accidents and violence among women attended in Sentinel Emergency Services - Brazil, 2009

As causas externas afetam de maneira desigual as populações humanas. O presente artigo tem como objetivo analisar os atendimentos de emergência em mulheres vítimas de acidentes e violências. Foram analisados dados do inquérito de Vigilância de Violências e Acidentes em 74 Unidades de Emergência de 23 capitais e no Distrito Federal em 2009. Analisaram-se 6.965 atendimentos de mulheres adultas comparando-se as faixas de 20-39 e 40-59 anos, em relação a ocorrência de acidentes e violências. Os acidentes foram mais frequentes em mulheres jovens (20 a 39 anos), de cor negra e com escolaridade maior que 9 anos de estudo. A ocorrência de violência também foi predominante em mulheres jovens e negras, porém com menor escolaridade. Entre os acidentes predominaram as quedas (38,6%), seguidas de acidentes de transporte. As violências foram mais frequentes no domicílio (p < 0,000) e a referencia ao uso de álcool predominou entre as vítimas de violência. O tipo de violência mais frequente foi a agressão (84,6%), sendo o agressor do sexo masculino (79,1%) e identificado como parceiro íntimo em 44,1%. É cada vez mais relevante que os serviços estejam capacitados para a atenção integral e humanizada às vítimas desse importante problema de saúde pública.

Accidents from external causes affect the human population in different ways. This article seeks to analyze emergency care for women who are victims of accidents and violence. Data from the Surveillance System for Violence and Accidents were analyzed. This study was carried out in 74 emergency units of 23 state capitals and the Federal District in 2009 and included 6,965 women aged from 20-59 years. The age groups of 20-39 and 40-59 years were compared for the occurrence of accidents and violence. Accidents were more frequent among young black women (20-39 years) with more than nine years of schooling. The occurrence of violence was also prevalent in young black women but with less schooling. Falls were the most frequent accidents (38.6%), followed by traffic accidents. The occurrence of violence was more frequent in the home (p <0.000) and the mention of alcohol abuse among victims of violence was predominant. The most frequent type of violence was aggression (84.6%), in which the aggressor was male (79.1%) and identified as an intimate partner (44.1%). It is increasingly important that services are able to provide comprehensive and humanized care to the victims of this important public health problem.

Current situation and standardization of pediatric emergency system / 中国小儿急救医学

The current situation of pediatric emergency medicine and the pediatric emergency medical service systems were analyzed.The equipment configuration,personnel allocation and the requirement of professional knowledge and technology in pediatric emergency setting,the triage system,the process of medical services for patients with acute illness or trauma,and the optimizing process of diagnosis and treatment for emergency cases and critical cases were discussed.The nationwide development model of pediatric emergency service systems were reviewed.

Caracterización de accidentes de tránsito y valoración tarifaria de la atención médica en el servicio de urgencias, Caldas-Antioquia 2007-2008 / Caracterização de acidentes de trânsito e valorização tarifária do atendimento médico no pronto-socorro, Caldas-Antioquia 2007-2008 / Characterization of traffic accidents and tariff rating of the medical attention in the emergency services, Caldas-Antioquia, 2007-2008

El objetivo del estudio fue describir las características de persona, tiempo y lugar de los eventos y los lesionados en accidentes de tránsito, así como la tarifa de atención en el servicio de urgencias del Hospital San Vicente de Paúl del municipio de Caldas-Antioquia. Se analizaron 139 registros de personas ingresadas por lesiones producidas por accidentes de tránsito al servicio de urgencias entre 2007-2008. Las variables analizadas fueron tipo de usuario en la vía, sexo, edad, tipo de lesión producida y tarifa de atención. Resultados: la mayoría de las víctimas fueron hombres entre veinte y cuarenta años de edad. Los usuarios más vulnerables fueron peatones (33,1%), seguidos de pasajeros (30,9%) y motociclistas (20,9%). El trauma decabeza y el politrauma fueron los más comunes. Conclusión: generar medidas que ayuden a proteger a los usuarios más vulnerables de las vías debe considerarse como prioridad para losentes gubernamentales.

The objective of this study was to analyze the characteristics of person, time, place of events and injured people in traffic accidents and the rate of attention in the emergency departmentof San Vicente de Paul, Hospital in the municipality of Caldas. A total of 139 visits to hospital san Vicente de Paul of Caldas (Antioquia) emergency departments (ED) were analyzed in theperiod 2007-2008. The variables analyzed are presented as follows: type of road user (vehicle occupant, pedestrian, motorcyclist, and cyclist), sex, age group, and type of injury suffered. Results: The majority of victims were male people (64%) in the 20-to-29-year age group (35.0%).Vulnerable road users totaled 84.9% of all cases (20.9% were motorcyclists, 33.1% pedestrians, and 30.9% vehicle occupant). Victims - aged between 1 and 89 years- who had suffered injurieswere mostly pedestrians and vehicle occupants. Head and polytrauma were the most affected body parts. Conclusions: Measures aimed to protect vulnerable road users must be considered a top priority to reduce traffic-related injuries.

O objetivo deste estudo foi descrever as características de pessoa, tempo e lugar dos eventos e os feridos em acidentes de trânsito, bem como a tarifa de atenção no pronto-socorro do HospitalSan Vicente de Paúl do município de Caldas departamento de Antioquia. Foram analisados 139 registros de pessoas atendidas no pronto-socorro devido a lesões produzidas por acidentes de trânsito entre 2007-2008. As variáveis analisadas foram tipo de usuário, sexo, idade, tipo de lesãoproduzida e tarifa de atendimento. Resultados: a maioria das vítimas foram homens entre vinte e quarenta anos de idade. Os usuários mais vulneráveis foram os pedestres (33,1%), seguidospelos passageiros (30,9%) e motociclistas (20,9%). O traumatismo de cabeça e o politraumatismo foram os mais comuns. Conclusão: gerar medidas que ajudem a proteger os usuários maisvulneráveis deve ser considerado como prioridade pelos entes governamentais.

Protocolo de enfermagem em atendimento emergencial: subsídios para o acolhimento às vítimas / Emergency nursing care guidelines: subsidies for victims admission / Protocolo de enfermería en atendimiento de emergencia: subsídios para el acogimiento a las víctimas

Este estudo é de natureza descritiva exploratória e teve o objetivo de propor protocolos de atendimento de enfermagem a partir da identificação dos motivos de demanda e da caracterização do perfil das vítimas acolhidas no setor de triagem de um Pronto Socorro. A amostra constituiu-se de 203 fichas de atendimento do mês de março de 2008 que, analisadas descritivamente, serviram de base para o estabelecimento de protocolos. O resultado demonstra média de idade de 39 anos, e os mecanismos de trauma foram quedas e acidentes de trânsito. Os atendimentos triados foram avaliação da dor e retorno, primeiro atendimento, gesso e infecção. A distribuição das vítimas e classificação de risco permaneceu na cor verde, ou seja, paciente não crítico, em observação ou aguardando vaga, perfazendo 65 por cento da atenção ao trauma. Sugere-se a realização de outros estudos baseados na atual política institucional, em processo de adequação à proposta ministerial.

This is a descriptive and exploratory research which aimed to propose emergency nursing care guidelines from the demand identification and the characterization of the victim?s profile admitted to the triage sector at an Emergency Unit. The sample consisted of 203 patient records of treatments performed on March 2008. Through descriptive analysis, the records served as a basis for the guidelines development. Results show that the age of the victims was of 39 years on average, trauma mechanisms were falls and traffic accidents. The demand of treatment was for pain assessment, return of the first consultation, plaster and infection. Victims distribution and risk classification remained on the green color (non critical patient, need of monitoring or waiting for inpatient care vacancy), accounting to 65 percent of the demand for trauma treatment. The development of other studies based on the current institutional policy, which is in process of the federal policy compliance is suggested.

Este estudio es de naturaleza descriptiva exploratoria y tuvo el objetivo de proponer protocolos de atendimiento de enfermería a partir de la identificación de los motivos de demanda y de la caracterización del perfil de las víctimas acogidas en el sector triage de un Pronto Socorro. La muestra se constituyó de 203 fichas de atendimiento del mes de marzo de 2008 que, analizadas descriptivamente, sirvieron de base para el establecimiento de protocolos. El resultado demuestra media de edad de 39 años, y los mecanismos de trauma fueron caídas y accidentes de tránsito. Los atendimientos triados fueron evaluación del dolor y retorno, primer atendimiento, yeso e infección. La distribución de las víctimas y clasificación de riesgo permaneció en el color verde, o sea, paciente crítico, en observación o aguardando vaga, concluyendo 65 por ciento de la atención al trauma. Se sugiere la realización de otros estudios basados en la actual política institucional, en proceso de adecuación a la propuesta ministerial.

Perfil dos atendimentos a acidentes de transporte terrestre por serviços de emergência em São Paulo, 2005 / Perfil de las atenciones a accidentes de transporte terrestre por servicios de emergencia en São Paulo, 2005 / Land transport injuries among emergency department visits in the state of São Paulo, in 2005

OBJETIVO: Analisar as características dos atendimentos decorrentes de lesões relacionadas com transporte terrestre. MÉTODOS: Foram analisados 5.934 atendimentos em quatro unidades de emergências hospitalares do estado de São Paulo, em 2005. O instrumento utilizado foi um questionário baseado em modelos disponibilizados pela Organização Mundial de Saúde. As variáveis analisadas foram: tipo de usuário (ocupante de veículo, pedestre, motociclista e ciclista), sexo e faixa etária e tipo de lesão sofrida. Foi utilizada análise de regressão logística para testar associações entre variáveis. Foram calculadas as odds ratios com os respectivos intervalos de confiança de 95 por cento. RESULTADOS: A maior parte dos atendimentos foram para o sexo masculino (74,2 por cento) e para a faixa de 20 a 29 anos (35,0 por cento). Os usuários vulneráveis do sistema responderam por 72,4 por cento do total de casos (motociclistas 29,8 por cento, pedestres 24,1 por cento e ciclistas 18,5 por cento). As vítimas com idades entre zero e 14 anos que sofreram lesões eram principalmente pedestres e ciclistas; entre 15 e 39 anos predominaram os motociclistas e na faixa acima de 50 anos, pedestres...

OBJECTIVE: To analyze the characteristics of visits resulting from land transport injuries. METHODS: A total of 5,934 visits in four hospital emergency departments (ED) were analyzed, in the state of São Paulo, in 2005. A questionnaire based on the following three models was used to collect data: World Health Organization (WHO), Center for Disease Control and Prevention (CDC), and Pan American Health Organization (PAHO). Variables analyzed were as follows: type of road user (vehicle occupant, pedestrian, motorcyclist, and cyclist), sex, age group, and type of injury suffered. Logistic regression analysis was employed to test associations between variables. Odds ratios with their respective 95 percent confidence intervals were calculated. RESULTS: The majority of victims were males (74.2 percent) in the 20-to-29-year age group (35.0 percent). Vulnerable road users totaled 72.4 percent of all cases (29.8 percent were motorcyclists, 24.1 percent pedestrians, and 18.5 percent cyclists). Victims aged between zero and 14 years who had suffered injuries were mostly pedestrians and cyclists; motorcyclists predominated among those aged between 15 and 39 years; and pedestrians among those aged over 50 years...

OBJETIVO: Analizar las características de las atenciones derivadas de lesiones relacionadas con transporte terrestre. MÉTODOS: Fueron analizadas 5.934 atenciones en cuatro unidades de emergencias hospitalarias del estado de Sao Paulo (Sureste de Brasil), en 2005. El instrumento utilizado fue un cuestionario basado en modelos disponibilizados por la Organización Mundial de la Salud. Las variables analizadas fueron: tipo de usuario (ocupante del vehículo, peatón, motociclista y ciclista), sexo y grupo de edad y tipo de lesión sufrida. Fue utilizado análisis de regresión logística para evaluar asociaciones entre variables. Fueron calculados los odds ratios con los respectivos intervalos de confianza de 95 por ciento. RESULTADOS: La mayor parte de las atenciones fueron para el sexo masculino (74,2 por ciento) y para el grupo de 20 a 29 años (35,0 por ciento). Los usuarios vulnerables del sistema respondieron por 72,4 por ciento del total de casos (motociclistas 29,8 por ciento, peatones 24,1 por ciento y ciclistas 18,5 por ciento). Las víctimas con edades entre cero y 14 años que sufrieron lesiones eran principalmente peatones y ciclistas; entre 15 y 39 años predominaron los motociclistas y en edades por encima de 50 años, peatones...

An analysis on the framework of investigation plans and indicators for pre-hospital emergency medical care / 中华医院管理杂志

Pre-bospital Emergency Medical Care (EMC) is special medical care based on emergency medical facilities, mainly providing emergency care for patients who need immediate and intensive care out of the hospital Over many years of practice, both patients and medical staff have realized that immediate access to emergency treatment is essential; quality of care is fundamental and effect is ultimate. Therefore, there is an urgent need to establish an overall, objective, and feasible evaluation system for the purpose of improving quality of care. In the present article, the author has designed a framework of quality evaluation system for pre-hospital EMC by means of formulating investigation plans and analyzing the indicators that reflect the quality of care being evaluated so as to promote the implementation of the evaluation system.

Analysis of epidemiology in 2 055 trauma patients / 中华急诊医学杂志

Objective To investigate the causes and time distribution of trauma in prehospital patients. Methods The data of 2 055 trauma patients of our department admitted from January 2003 to March 2005 were analyzed. Results ① The mortality was 1.9%. ②723 patients (35.2%) were common trauma,and 32 had falling injuries (4.4%) with 18 dead including 12 at scene and 6 in emergency room. ③1 332 were Traffic accidents (64.8%) including 13 dead associated with bike , electric bicycle and motorbike. At the same time, there were 566 patients from 18:00 to 24:00 including 298 patients(52.7%) for the drivers after drinking. Conclusion Falling injuries and traffic accidents were the most important cause for death, especially in building spot . So we should enhance the security education for workers in these companies and limit the speed of electric bicycle for the increasing injury and mortality in traffic accidents . Driving after drinking at night should be prohibited too.

National System of Medical Assistance for Radiation Emergencies and Relevant Researches

Korea has advanced nuclear and radioisotope industry, and it is urgent to establish a national system to countermeasure the radiation accidents and preparedness for radiation emergency medical management. The Government opened the National Radiation Emergency Medical Center (NREMC) in the Korea Institute of Radiological and Medical Sciences (KIRAMS) in 2002, and the NREMC is setting up a radiation emergency medical preparedness and assistance network in nationwide. On April 30, 2003 the special law was proposed for the physical protection of nuclear facilities and emergency response against radiological accidents, which includes medical preparedness and management. Detailed guidelines for this law is being prepared by the Ministry of Science and Technology (MOST), and will be take effect in February 2004. Per this guideline, regional emergency medical centers will be appointed by the MOST, and the NREMC will operate this national system including education of the medical personnel.