Experience of ambulance drivers on transfer of suspected or confirmed patients for COVID-19.

OBJECTIVE: To unveil the experience of ambulance drivers regarding the transfer of suspected or confirmed patients for COVID-19. METHOD: Exploratory study with a qualitative approach conducted in October 2021 with 18 drivers from the Northwestern Mesoregion of the State of Ceará-Brazil. The individual interviews occurred virtually, via Google Meet®, and for data processing the IRAMUTEQ® software was used. RESULTS: Six classes were obtained: Feelings experienced during transfers; Concern about contamination of the work team and family members; Therapeutic itinerary, patients' clinical status and increase in the number of transfers; Disinfection of ambulances between transfers of patients with suspected and/or diagnosed COVID-19; Gowning for patient transfers and Psychospiritual aspects of drivers during the pandemic. CONCLUSION: The experience was marked by challenges in adapting to the new routine and procedures during transfers. It was evidenced feelings of fear, insecurity, tension and anguish in the worker's reports.

Use of the prone position in pregnant women with COVID-19 or other health conditions.

OBJECTIVE: to analyze, in the scientific literature, the knowledge available on the use of the prone position in pregnant women diagnosed with COVID-19 or other health conditions. METHOD: an integrative literature review developed through the following guiding question: What is the scientific knowledge available on the use of the prone position in pregnant women with COVID-19 or other health conditions? The search for studies was carried out in eight databases. RESULTS: using the prone position in pregnant women with Acute Respiratory Distress syndrome allowed for improvements in lung compliance and oxygenation. It also allowed reducing uterine compression on the maternal large vessels, and a reduction in blood pressure was observed in pregnant women with pre-eclampsia. The prone position was also safe in the surgical management of pregnant patients. In addition, the following conditions stood out as disadvantages related to the prone position in pregnant women: possibility of aortocaval compression, causing severe hypotension, and inability to easily monitor fetal status or to perform emergency Cesarean sections. CONCLUSION: the prone position was considered safe, reliable and comfortable for its use in the clinical management of pregnant women, where specific care measures must be taken to avoid compression of gravid abdomen, as well as fetal monitoring is important to detect placental circulation impairment.

Use of the prone position in pregnant women with COVID-19 or other health conditions Uso de la posición prona en gestantes con COVID-19 u otras condiciones de salud Utilização da posição prona em gestantes com COVID-19 ou outras condições de saúde

Objective: to analyze, in the scientific literature, the knowledge available on the use of the prone position in pregnant women diagnosed with COVID-19 or other health conditions. Method: an integrative literature review developed through the following guiding question: What is the scientific knowledge available on the use of the prone position in pregnant women with COVID-19 or other health conditions? The search for studies was carried out in eight databases. Results: using the prone position in pregnant women with Acute Respiratory Distress syndrome allowed for improvements in lung compliance and oxygenation. It also allowed reducing uterine compression on the maternal large vessels, and a reduction in blood pressure was observed in pregnant women with pre-eclampsia. The prone position was also safe in the surgical management of pregnant patients. In addition, the following conditions stood out as disadvantages related to the prone position in pregnant women: possibility of aortocaval compression, causing severe hypotension, and inability to easily monitor fetal status or to perform emergency Cesarean sections. Conclusion: the prone position was considered safe, reliable and comfortable for its use in the clinical management of pregnant women, where specific care measures must be taken to avoid compression of gravid abdomen, as well as fetal monitoring is important to detect placental circulation impairment.

Práticas seguras no manejo de vias aéreas de pacientes com Covid-19: revisão integrativa

Introduçao: A pandemia causada pelo vírus SARS-CoV-2 no inicio de 2020 alterou práticas dos profissionais de saúde com a finalidade em atenuar os riscos de contaminaçâo dos trabalhadores da linha de frente de assistencia a saúde, principalmente, atividades relacionadas ao manejo de vias aéreas de pacientes com Covid-19. Objetivo: identificar as práticas necessárias para garantir a segurança dos profissionais de saúde no manejo de vias aéreas de pacientes suspeitos ou diagnosticados com Covid-19. Materiais e métodos: revisâo integrativa realizada em dez bases de dados relevantes na área da saúde, sendo a amostra composta por 17 pesquisas. As práticas identificadas foram elencadas conforme os quatro procedimentos pontuados pela literatura: intubaçâo endotraqueal, extubaçâo, broncoscopia e traqueostomia. Resultados: as principais recomendaçöes mencionadas foram: intubaçâo endotraqueal: realizada por equipe experiente, treinada, mínima e profissionais de grupos de risco para Covid-19 nâo devem fazer parte desta equipe;extubaçâo: nâo utilizar cateter nasal de alto fluxo após o procedimento;broncoscopia: realizar em sala isolada e com pressâo negativa;traqueostomia: poderá ser considerada precocemente, mas o risco-beneficio deve ser avaliado. Conclusäo: as práticas identificadas poderâo direcionar o gerenciamento de vias aéreas e nortear a construçâo de tecnologías assistenciais, educacionais ou gerenciais.Alternate :Introduction:The pandemic caused by the SARS-CoV-2 virus in early 2020 changed the practices of health professionals in order to mitigate the risks of contamination of health care frontline workers, mainly activities related to the management of the airways of patients with Covid-19. Objective: to identify the practices necessary to ensure the safety of health professionals in managing the airway of patients suspected or diagnosed with Covid-19. Materials and methods: an integrative review carried out in ten relevant databases in the health area, with the sample consisting of 17 surveys. The practices identified were listed according to the four procedures punctuated by the literature: endotracheal intubation, extubation, bronchoscopy and tracheostomy. Results: the main recommendations mentioned were: endotracheal intubation: performed by an experienced, trained, minimal team and professionals from risk groups for covid-19 should not be part of this team;extubation: do not use a high flow nasal catheter after the procedure;bronchoscopy: perform in an isolated room with negative pressure;tracheostomy: may be considered early, but the risk-benefit must be assessed. Conclusion: the practices identified may direct the management of airways and guide the construction of assistive, educational or managerial technologies.Alternate :Introducción: La pandemia causada por el virus SARS-CoV-2 a principios de 2020 cambió las prácticas de los profesionales de la salud con el fin de mitigar los riesgos de contaminación de los trabajadores de primera línea de atención médica, principalmente actividades relacionadas con el manejo de las vías respiratorias de pacientes con Covid-19. Objetivo: identificar las prácticas necesarias para garantizar la seguridad de los profesionales de la salud en el manejo de la vía aérea de pacientes sospechosos o diagnosticados con Covid-19. Materiales y métodos: una revisión integradora realizada en diez bases de datos relevantes en el área de la salud, la muestra consiste en 17 encuestas. Las prácticas identificadas se enumeraron de acuerdo con los cuatro procedimientos puntuados por la literatura: intubación endotraqueal, extubación, broncoscopia y traqueotomía. Resultados: las principales recomendaciones mencionadas fueron: intubación endotraqueal: realizada por un equipo experimentado, capacitado, mínimo y profesionales de grupos de riesgo para Covid-19 no deberían formar parte de este equipo;extubación: no use un catéter nasal de alto flujo después del procedimiento;broncoscopia: realizar en una habi ación aislada con presión negativa;traqueotomía: puede considerarse temprano, pero se debe evaluar el riesgo-beneficio. Conclusión: las prácticas identificadas pueden dirigir la gestión de las vías aéreas y guiar la construcción de tecnologías de asistencia, educación o gestión.