RESUMO
Objetivos: Describir las percepciones del personal de enfermería de unidades neonatales sobre el manejo del dolor, conocer el perfil formativo y describir el uso de herramientas de valoración del dolor y de medidas no farmacológicas. Método: Estudio multicéntrico observacional descriptivo transversal desarrollado durante febrero-septiembre de 2015 en los Servicios de Neonatología de tres hospitales de la Comunidad de Madrid, España. La recogida de datos se realizó a través de cuestionario de elaboración propia enviado en formato papel o electrónico utilizando la plataforma Survey Monkey®. Resultados: La muestra consta de 142 profesionales (tasa de respuesta: 55%). El 47,9% (68) afirman que han recibido formación específica sobre el manejo del dolor. El 39,5% (56) refieren que el dolor se evalúa de forma habitual en su unidad. Tan solo el 43,6% refieren utilizar escalas validadas, siendo la PIPP la más usada. La contención y la succión no nutritiva son las medidas no farmacológicas más usadas, seguidas de la sacarosa. Se identifica la canalización intravenosa como el procedimiento más doloroso. Conclusiones: El manejo del dolor está en vías de mejora, ya sea por la formación como por la escasa evaluación a través de escalas validadas. Destaca la mejora en el uso de medidas no farmacológicas (AU)
Objectives: To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. Methods: Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. Results: The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure.Conclusions: Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy (AU)
Assuntos
Humanos , Feminino , Adulto , Manejo da Dor/enfermagem , Enfermagem Neonatal/organização & administração , Percepção , Terapia Intensiva Neonatal , Inquéritos e Questionários , Estudos Transversais/métodosRESUMO
OBJECTIVES: To describe the perceptions of nurses in neonatal units on pain management, meet the educational profile and describe the use of pain assessment tools and non-pharmacological management for treatment. METHODS: Cross-sectional descriptive multicentre study, developed during the months of February to September 2015, in the neonatology services of three hospitals at the Community of Madrid, Spain. Data collection was performed through an ad hoc questionnaire on paper or electronically using Survey Monkey platform. RESULTS: The sample consisted of 142 professionals, with a response rate of 55%: 47.9% (68) confirmed they had received specific training in pain management; 39.5% (56) stated that pain is regularly assessed in the unit; only 43.6% reported using validated scales, the most used being the Premature Infant Pain Profile (PIPP). As for the non-pharmacological management, swaddling and non-nutritive sucking it is the most used, followed by sucrose. Intravenous cannulation was identified as the most painful procedure. CONCLUSIONS: Pain management is in the process of improvement, because of training and because there is little pain assessment using validated scales. The improvement in the use of non-pharmacological management for the relief of pain in minor procedures is noteworthy.
Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Enfermagem Neonatal , Manejo da Dor , Medição da Dor , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-IdadeRESUMO
Introducción: Las concentraciones altas de colesterol y ácido úrico, el sedentarismo y la dieta hipercalórica cuando produce un aumento de peso, son factores de riesgo relacionados entre sí y que pueden predecir enfermedades cardiovasculares. Material y Métodos: En este trabajo se han estudiado y comparado las concentraciones plasmáticas de colesterol y ácido úrico obtenidas en el reconocimiento médico antes y después de la misión en un grupo de 270 militares, hombres y mujeres desplazados a Kosovo desde Abril a Octubre 2004. Se correlacionaron estos datos con la dieta y el ejercicio físico realizados durante el tiempo desplazados fuera de territorio nacional. Resultados: Los datos muestran un aumento de la colesterolemia y uricemia en relación con la dieta, el sedentarismo y el índice de masa corporal (IMC) que presentaba la población del estudio. Conclusiones: La suma de otros factores generales de riesgo cardiovascular, como el estrés que estas misiones generan, o individuales como tabaquismo e hipertensión, podrían hacer que esta población tuviera una mayor predisposición al desarrollo de enfermedades cardiovasculares (AU)
Introduction: the high levels of cholesterol and uric acid, sedentary lifestyle, and the hypercaloric diet when it causes a weight gain, are interrelated risk factors which can predict cardiovascular disease. Material and Methods: we have studied and compared the blood levels of cholesterol and uric acid in the medical exams of a group of 270 service members, male and female, before and after the deployment in Kosovo from April to October 2004. These data were correlated with diet and physical activity during the deployment abroad. Results: the data show an increase of cholesterol and uric acid levels in relationship with the diet, sedentary lifestyle and body mass index (BMI) of the studied population. Conclusions: the addition of other general factors of cardiovascular risk, such as the stress of these deployments, or individual factors as smoking and hypertension, could increase the predisposition of this population to developing cardiovascular disease (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Hipercolesterolemia/epidemiologia , Hiperuricemia/epidemiologia , Estresse Psicológico/complicações , Colesterol na Dieta/efeitos adversos , Atividade Motora , Fatores de Risco , Doenças Cardiovasculares/prevenção & controle , Militares , GuerraRESUMO
Varón de 22 años ingresa para ser operado de urgencia con un diagnóstico de apendicitis aguda. Para la intubación y posterior mantenimiento de la anestesia se usó anectine y sevoflurano respectivamente. A los pocos minutos se observa un aumento del CO2 exhalado, taquicardia e hipotensión. En el postoperatorio inmediato como parátmetros relevantes destacaron valores mayores de 50.000 de CPK y una actividad de protombina de 50%. La hipertermia maligna sigue siendo uno de los mayores temores para el anestesiólogo y a veces es difícil de diagnosticar por presentar cuadros parciales, en pacientes con anestesias previas sin complicaciones. Un diagnóstico rápido y la instauración precoz del tratamiento siguen siendo la manera más eficaz de yugular el cuadro y evitar su progresión fatal (AU)
A 22-years old man underwent surgery due to an acute apendicitis. Anectine and sevoflurane were used to intubate him and to keep the anesthesia at a correct level. However, after a few minutes of anesthesia, there was a surprising exhaled cargon dioxide increase, tachycardia and hypotension. However, in the following hours in the observation room, CPK levels increased over 50,000 and prothrombine activity turned around 50%. Nowadays, malignant hyperthermia is one of the main worries and it is sometimes hard to be diagnosed due to incomplete medical profiles in previous anaesthesias without troubles. In summary, the best way to avoid a tragic evolution is to diagnose a malignant hyperthermia case as soon as possible and to implement immediate treatment (AU)