Biosafety Issues in Patient Transport during COVID-19: A Case Study on the Portuguese Emergency Services.

During the COVID-19 pandemic, first responders faced significant biosafety challenges, especially while handling patient transport, potentially exposing them to infection. The PANDEM-2 (European project on pandemic preparedness and response) project, funded by the Horizon 2020 program, sought to investigate the challenges confronting Emergency Medical Systems throughout the EU. First responders from Portugal's National Institute of Medical Emergency (INEM) were considered as a representative operational model of the national first responder agencies of European member states because they played a critical role during the COVID-19 pandemic. As a result, they were asked to complete an online survey about their COVID-19 pandemic-related professional activities. The survey focused on their perspectives on current biosafety guidelines and their operational practices. It covered opinions on existing protocols, technical concerns during patient transport, and issues after the patients arrived at the hospital. The key findings revealed concerns about risk assessment, the inadequacy of guidelines, and disparities in equipment access. This survey emphasizes the importance of developing streamlined, adaptable biosafety protocols, better coordination between prehospital and in-hospital services, and the development of scalable, cost-effective biosafety solutions. Based on our findings, we propose improvements to national and European biosafety directives and advocate for streamlined adaptation during pandemics.

A gestão do cuidado de enfermagem à pessoa em situação crítica em contexto de hospital de campanha / Nursing care management for critical patients in the context of a field hospital

A ocorrência de catástrofes e a gravidade dos danos resultantes têm vindo a aumentar gradualmente no mundo contemporâneo. Do aumento dramático na procura por cuidados de emergência, pelo elevado número de vítimas, emerge a necessidade da implementação de hospitais de campanha, cuja principal finalidade é a prestação de cuidados de saúde às vítimas de catástrofe. As competências essenciais do enfermeiro de catástrofe incluem o pensamento crítico, adaptabilidade, trabalho em equipa e liderança. A abordagem em massa, requer a mobilização de conhecimentos epidemiológicos, fisiológicos, farmacológicos, psicológicos e culturais. A dimensão do cuidar em enfermagem engloba também a gestão do cuidado, que ocorre por via do exercício contínuo de analisar, elaborar planos, fazer escolhas e avaliar as ações. Refletir sobre a gestão do cuidado é refletir sobre o processo de enfermagem, o qual norteia a tomada de decisão do enfermeiro, cujo modelo teórico encontra alicerces no quadro conceptual de Ida Orlando e na sua Teoria do Processo de Enfermagem. A realização do presente relatório de estágio, permitiu-me estruturar, de forma reflexiva, o conhecimento e as experiências vividas ao longo de três campos de estágio (Unidade de Cuidados Intensivos, Unidade de Queimados e Hospital de Campanha) e espelhar todo um percurso de aprendizagem e enriquecimento profissional e pessoal, o qual possibilitou a mobilização de conhecimentos, aquisição e desenvolvimento de competências de enfermagem à pessoa em situação crítica, dando resposta aos objetivos propostos conducentes ao grau de mestre em enfermagem e, assim, aumentar a consciencialização acerca do meu desempenho.

The occurrence of disasters and the severity of the resulting damage have been gradually increasing in the contemporary world. From the dramatic increase in the demand for emergency care, due to the high number of victims, emerges the need for the implementation of field hospitals, whose main purpose is the provision of health care to victims of catastrophe. The essential skills of the disaster nurse include critical thinking, adaptability, teamwork and leadership. The mass approach requires the mobilization of epidemiological, physiological, pharmacological, psychological and cultural knowledge. The dimension of nursing care also encompasses care management, which occurs through the continuous exercise of analyzing, drawing up plans, making choices and evaluating actions. To reflect on care management is to reflect on the nursing process, which guides the nurse's decision-making, whose theoretical model finds foundations in the conceptual framework of Ida Orlando and in her Nursing Process Theory. The realization of this internship report, allowed me to reflectively structure the knowledge and experiences lived through three internship fields (intensive care unit, burns unit and governmental field hospital) and mirror a whole path of learning and professional and personal enrichment, which enabled the mobilization of knowledge , acquisition and development of nursing skills to people in critical situation, responding to the proposed objectives leading to the master's degree in nursing and, thus, raising awareness about my performance.