ABSTRACT
Introdução: A ressuscitação cardiopulmonar (RCP) precoce depende da disponibilidade e da funcionalidade do equipamento de reanimação, que deve estar pronto para uso imediato, além do treinamento da equipe, o que pode ser feito através dos cursos em Suporte Básico de Vida (SBV) e Suporte Avançado de Vida (SAV). Objetivo: Capacitar profissionais e acadêmicos da área de saúde em SBV. Metodologia: Curso teórico-prático com simulação em manequins. Realização de pré e pós-teste, comparando-se os resultados. Resultados: Foram treinadas 348 pessoas do Hospital Escola (HE) da UFPel. O número de acertos no pré-teste variou entre 55 e 65% (média de 63%) e no pós-teste variou entre 75 e 93% (média de 84%), portanto um acréscimo de 21% nos acertos. Conclusão: O treinamento qualificou os profissionais e acadêmicos que atuam no HE no atendimento em vítimas de parada cardiorrespiratória (AU)
Introduction: The precocious cardiopulmonary resuscitation (CPR) depends on avaliability and functionality of the reanimation equipment, which must be ready for immediate use, and on the training of the team, which can be made through the Basic Life Support (BLS) and Advanced Life Support (ALS) courses. Objective: enable the health professionals and medical students in BLS. Methodology: Theoretical-practical course with simulations in mannequins. Pre and post-test were done and the results before and after the course were compared. Results: 348 people from Medical School Hospital (MSH) were trained. The correct answers percentage in the pre-test was from 55 to 65% (avarage was 63%) and in the post-test was from 75 to 93% (avarage was 84%), there was a 21% increase in the percentage of correct answers. Conclusion: The training qualified health professionals and medical studentes, who work in MSH, in charge of CPR (AU)
Subject(s)
Advanced Cardiac Life Support/education , Heart Arrest/therapy , Inpatients , Brazil/epidemiology , Cardiopulmonary Resuscitation/methods , Advanced Cardiac Life Support/methods , Heart Arrest/mortalityABSTRACT
BACKGROUND: Although redefinition for acute myocardial infarction (AMI) has been proposed few years ago, to date it has not been universally adopted by many institutions. The purpose of this study is to evaluate the diagnostic, prognostic and economical impact of the new diagnostic criteria for AMI. METHODS: Patients consecutively admitted to the emergency department with suspected acute coronary syndromes were enrolled in this study. Troponin T (cTnT) was measured in samples collected for routine CK-MB analyses and results were not available to physicians. Patients without AMI by traditional criteria and cTnT > or = 0.035 ng/mL were coded as redefined AMI. Clinical outcomes were hospital death, major cardiac events and revascularization procedures. In-hospital management and reimbursement rates were also analyzed. RESULTS: Among 363 patients, 59 (16%) patients had AMI by conventional criteria, whereas additional 75 (21%) had redefined AMI, an increase of 127% in the incidence. Patients with redefined AMI were significantly older, more frequently male, with atypical chest pain and more risk factors. In multivariate analysis, redefined AMI was associated with 3.1 fold higher hospital death (95% CI: 0.6-14) and a 5.6 fold more cardiac events (95% CI: 2.1-15) compared to those without AMI. From hospital perspective, based on DRGs payment system, adoption of AMI redefinition would increase 12% the reimbursement rate [3552 Int dollars per 100 patients evaluated]. CONCLUSIONS: The redefined criteria result in a substantial increase in AMI cases, and allow identification of high-risk patients. Efforts should be made to reinforce the adoption of AMI redefinition, which may result in more qualified and efficient management of ACS.
Subject(s)
Coronary Disease , Fee-for-Service Plans , Myocardial Infarction , Acute Disease , Adult , Aged , Biomarkers/blood , Coronary Disease/diagnosis , Coronary Disease/economics , Coronary Disease/epidemiology , Coronary Disease/therapy , Creatine Kinase, MB Form/blood , Diagnosis, Differential , Female , Health Care Costs , Humans , Incidence , Male , Middle Aged , Multivariate Analysis , Myocardial Infarction/diagnosis , Myocardial Infarction/economics , Myocardial Infarction/epidemiology , Myocardial Infarction/therapy , Prognosis , Risk Factors , Sensitivity and Specificity , Syndrome , Troponin T/bloodABSTRACT
Pretende avaliar o impacto diagnóstico, prognóstico e econômico da nova definição de Infarto do Miocárdio (IAM) proposta pela AHA/ESC usando troponina T(TnT)como marcador de lesão cardíaca. Foram incluídos no estudo 740 pacientes com dor torácica admitidos na Emergência do Hospital de Clínicas de Porto Alegre, no período de julho/1999 a janeiro/2002. Creatinina quinase total ( CK), CK-MB atividade e TnT foram dosados em uma amostra de 363 pacientes, representativa de todo o coorte. O novo diagnóstico de IAM acrescenta um número expressivo de indivíduos com infarto aos serviços de emergência. A incorporação deste critério é importante na medida que estes pacientes têm um prognóstico semelhante aos demais casos tradicionalmente diagnosticados. Como a identificação destes casos poderia resultar em um manejo mais qualificado e eficiente destes pacientes, esforços deveriam ser adotados para reforçar a adoção da redefinição de IAM.
