scholarly journals O enfermeiro na admissão de pacientes em pronto-socorro: acolhimento, avaliação, sinais e sintomas

2019 ◽  
Vol 87 (25) ◽  
Author(s):  
Sérgio Luis Alves de Morais Junior ◽  
Elisangela Teixeira Alves Sotelo ◽  
Leticia da Silva Seltenreich ◽  
Patrícia Cristina de Oliveira Garcia ◽  
Luciane Aparecida Simão Lima ◽  
...  

Objetivou-se selecionar e analisar os sinais e sintomas, apresentados por pacientes do pronto-socorro do hospital privado degrande porte do município de São Paulo. Trata-se de um estudo retrospectivo, transversal, observacional não intervencionista,com a avaliação e extração de dados dos prontuários de pacientes atendidos nos serviços de Pronto Atendimento, internadosapós caracterização de urgência ou emergência, em um hospital particular de grande porte localizado em São Paulo. Os pacientes classificados em classe vermelha devem ser atendidos imediatamente, por: obstrução de vias aéreas, Respiração de Kussmaul,dor torácica com dispneia e dispneia acentuada, n. 43. Na categoria laranja os pacientes devem ser atendidos com tempo máximode 10 minutos, com: dor abdominal grave, temperatura abaixo de 36°C ou acima de 37.8°C, pressão arterial abaixo de 100X60ou acima de 140X90 mmHg, agitação, n. 13. A classificação amarela destina-se a pacientes críticos e semicríticos que já foram estabilizados no atendimento inicial. Devem ser atendidos em tempo inferior a 60 minutos, com: edemas nos membros superioresou inferiores e fraturas de ossos curtos, n. 30, se incluíram nessa categoria. As categorias verde e azul são destinadas a pacientesde menor complexidade podendo esperar por tempo de atendimento de 120 a 240 minutos. O enfermeiro é o profissionalque realiza a classificação de risco, porém, mesmo embasado em protocolos específicos, sua avaliação é intuitiva. Enfatiza-se arelevância da tecnologia no meio hospitalar, prinicpalmente o registro do paciente sendo aberto em seu primeiro contato como profissional de enfermagem no acolhimento/avaliação de risco, tal qual possibilita a melhoria da comunicação entre todos osintegrantes da equipe multidisciplinar em saúde a partir do fácil e rápido acesso.Palavras-chave: Sinais e Sintomas; Pronto-Socorro; Emergência; Medição de Risco.ABSTRACTThe aim of this study was to select and analyze the signs and symptoms presented by patients in the emergency room of thelarge private hospital in the city of São Paulo. This is a retrospective, cross-sectional, non-interventional observational study,with the evaluation and extraction of data from the medical records of patients attending emergency services, hospitalized after an emergency or emergency characterization, in a large private hospital located in São Paulo. Red class patients should betreated immediately for: airway obstruction, Kussmaul respiration, thoracic pain with dyspnea, and severe dyspnea, n. 43. In theorange category, patients should be treated within a maximum time of 10 minutes, with: severe abdominal pain, temperaturebelow 36 ° C or above 37.8° C, blood pressure below 100X60 or above 140X90 mmHg, shaking, n. 13. The yellow classification is intended for critical and semi-critical patients who have already been stabilized in initial care. They should be treatedin less than 60 minutes, with: upper or lower limb edema and short-bone fractures, n. 30, were included in this category. Thegreen and blue categories are intended for patients of lesser complexity and can wait for a service time of 120 to 240 minutes. The nurse is the professional who carries out the risk classification, but even based on specific protocols, its evaluation isintuitive. Emphasis is given to the relevance of technology in the hospital environment, mainly the registration of the patientbeing opened in his first contact with the nursing professional in the host/risk assessment, as this enables the improvement ofcommunication among all the members of the multidisciplinary health team from easy and quick access.Keywords: Signals and Symptoms; Emergency Room; Emergency; Risk Measurement

2020 ◽  
Vol 11 (1.ESP) ◽  
Author(s):  
Vagner Ferreira do Nascimento ◽  
Mariano Martínez Espinosa ◽  
Manoel Carlos Neri da Silva ◽  
Neyson Pinheiro Freire ◽  
Ana Cláudia Pereira Terças-Trettel

Objetivo: Analisar aspectos epidemiológicos da infecção por COVID-19 nos profissionais de Enfermagem durante a emergência da pandemia no território brasileiro em 2020. Método: Estudo transversal, descritivo, quantitativo e retrospectivo, de profissionais de Enfermagem brasileiros com suspeita e/ou confirmação de infecção por COVID-19 nos meses de março e abril de 2020. Estatística descritiva foi conduzida para os dados sociodemográficos e inferenciais dos dados temporais por meio da modelagem de séries pelo modelo exponencial duplo. Resultados: Houve 8.399 suspeitos, sendo 1.750 confirmados laboratorialmente. A maioria dos profissionais são jovens, do sexo feminino, residentes em todos os Estados, com maior concentração em São Paulo, Rio de Janeiro, Santa Catarina, Ceará, Rio Grande do Sul, Minas Gerais, Pernambuco e Bahia. A atuação profissional predominou em ambiente hospitalar e a distribuição temporal dos casos e óbitos confirmados por COVID-19 apresentou comportamento exponencial. Conclusões: A sensibilização das equipes de Enfermagem quanto a notificação de irregularidades e de casos é um importante recurso para que haja a intensificação de medidas fiscalizatórias e adesão efetiva das medidas preventivas preconizadas, e consequentemente haverá preservação de vidas dos profissionais de Enfermagem e comunidades sob seus cuidados.Descritores: Epidemiologia; Pandemias; Infecções por Coronavírus; Enfermagem; Profissionais de Enfermagem.IMPACT OF COVID-19 ON BRAZILIAN NURSING WORK: EPIDEMIOLOGICAL ASPECTSObjective: To analyze the epidemiological aspects of COVID-19 infection in nursing professionals during the emergence of the pandemic in Brazil in 2020. Method: Cross-sectional, descriptive, quantitative and retrospective study of Brazilian nursing professionals with suspected and/or confirmed infection by COVID-19 in the months of March and April 2020. Descriptive statistics was conducted for the sociodemographic and inferential data of the temporal data through the modeling of series by the double exponential model. Results: There were 8,399 suspects, 1,750 of which were laboratory confirmed. Most professionals are young, female, residing in all states, with a greater concentration in São Paulo, Rio de Janeiro, Santa Catarina, Ceará, Rio Grande do Sul, Minas Gerais, Pernambuco and Bahia. Professional performance predominated in the hospital environment and the temporal distribution of cases and deaths confirmed by COVID-19 showed exponential behavior. Conclusions: The awareness of nursing teams regarding the notification of irregularities and cases is an important resource for the intensification of inspection measures and effective adherence to the recommended preventive measures, and consequently there will be preservation of the lives of nursing professionals and communities under their care.Descriptors: Epidemiology; Pandemics; Coronavirus Infections; Nursing; Nursing professionals. IMPACTO DA COVID-19 EN EL TRABAJO DE ENFERMERÍA BRASILEÑO: ASPECTOS EPIDEMIOLÓGICOSObjetivo: analizar los aspectos epidemiológicos de la infección por COVID-19 en profesionales de enfermería durante el surgimiento de la pandemia en Brasil en 2020. Metodo: estudio transversal, descriptivo, cuantitativo y retrospectivo de profesionales de enfermería brasileños con infección sospechada y/o confirmada por COVID-19 en los meses de marzo y abril de 2020. Se realizó estadística descriptiva para los datos sociodemográficos e inferenciales de los datos temporales a través del modelado de series por el modelo exponencial doble. Resultados: Hubo 8.399 sospechosos, 1.750 de los cuales fueron confirmados por laboratorio. La mayoría de los profesionales son jóvenes, mujeres, residentes en todos los estados, con una mayor concentración en São Paulo, Río de Janeiro, Santa Catarina, Ceará, Río Grande del Sur, Minas Gerais, Pernambuco y Bahía. El desempeño profesional predominó en el ambiente hospitalario y la distribución temporal de casos y muertes confirmados por COVID-19 mostró un comportamiento exponencial. Conclusiones: La conciencia de los equipos de enfermería sobre la notificación de irregularidades y casos es un recurso importante para la intensificación de las medidas de inspección y el cumplimiento efectivo de las medidas preventivas recomendadas, y en consecuencia se preservará la vida de los profesionales de enfermería y las comunidades bajo su cuidado. Descriptores: Epidemiología; Pandemias; Infecciones por Coronavirus; Enfermería; Profesionales de enfermería.


2020 ◽  
Vol 11 (3) ◽  
Author(s):  
Lívia De Souza Gonçalves ◽  
Luciano Garcia Lourenção ◽  
Margaret Ártico Baptista ◽  
Jacqueline Flores de Oliveira ◽  
Francisco Rosemiro Guimarães Ximenes Neto ◽  
...  

Objetivo: Analisar ocorrências de efeitos adversos relacionados a medicamentos no tratamento de tuberculose e sua associação com variáveis clínicas e desfecho. Método: Estudo transversal com 63 casos de tuberculose tratados no Ambulatório de Tuberculose e Hanseníase de São José do Rio Preto, São Paulo, no período de 2010 a 2015. Utilizou-se análise de frequência e teste qui-quadrado com correção de Monte Carlo. Resultados: Os efeitos adversos iniciaram-se antes do terceiro mês de tratamento; efeitos menores foram mais frequentes, com predomínio de irritação gástrica. Houve associação entre conduta médica e efeitos adversos (p = 0,009). Conclusão: Efeitos adversos causados pelos medicamentos podem prejudicar o desfecho clínico devido ao risco de abandono do tratamento. Profissionais de saúde devem estar atentos aos sinais e sintomas relacionados aos efeitos adversos, implementando condutas necessárias para neutralizar ou diminuir as queixas, visando adesão ao tratamento e cura da doença.Descritores: Tuberculose; Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos; Terapia Combinada; Tuberculose Resistente a Múltiplos Medicamentos; Tuberculose Pulmonar. ADVERSE EFFECTS IN THE TREATMENT OF TUBERCULOSIS Objective: To analyze occurrences of drug-related adverse effects in treatment of tuberculosis and its association with clinical variables and outcome. Method: Cross-sectional study with 63 cases of tuberculosis treated at Tuberculosis and Leprosy Outpatient Clinic of São José do Rio Preto, São Paulo, from 2010 to 2015. We used frequency analysis and chi-square test with Monte Carlo correction. Results: Adverse effects started before the third month of treatment; effects were more frequent, with predominance of gastric irritation. There was association between medical conduct and adverse effects (p=0.009). Conclusion: Adverse effects caused by medications may impair the clinical outcome due to risk of treatment withdrawal. Health professionals should be alert to signs and symptoms related to adverse effects, implementing the necessary behaviors to neutralize or reduce complaints, aiming adherence to treatment and cure of the disease.Descriptors: Tuberculosis; Drug-Related Side Effects and Adverse Reactions; Combined Modality Therapy; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary.EFECTOS ADVERSOS EN EL TRATAMIENTO DE TUBERCULOSISObjetivo: Analizar los efectos adversos relacionados con medicamentos en tratamiento de la tuberculosis y su asociación con variables clínicas y desenlace. Método: Estudio transversal con 63 casos de tuberculosis tratados en Ambulatorio de Tuberculosis y Hanseniasis de São José Rio Preto, São Paulo, en período de 2010 a 2015. Se utilizó análisis de frecuencia y prueba chi-cuadrado con corrección de Monte Carlo. Los efectos adversos se iniciaron antes del tercer mes de tratamiento; los efectos menores fueron más frecuentes, con predominio de irritación gástrica. Se observó asociación entre conducta médica y efectos adversos (p=0,009). Resultados: Los efectos adversos causados por medicamentos pueden perjudicar el resultado clínico debido al riesgo de abandono del tratamiento. Conclusiones: Los profesionales de salud deben estar atentos a los signos y síntomas relacionados con efectos adversos, implementando conductas necesarias para neutralizar o disminuir las quejas, visando adhesión al tratamiento y cura de la enfermedad.Descriptores: Tuberculosis; Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos; Terapia Combinada; Tuberculosis Resistente a Múltiples Medicamentos; Tuberculosis Pulmonar.


2013 ◽  
Vol 11 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Alessandra Maria Julião ◽  
Ana Luiza Lourenço Simões Camargo ◽  
Vanessa de Albuquerque Cítero ◽  
Mara Fernandes Maranhão ◽  
Alfredo Maluf Neto ◽  
...  

OBJECTIVE: To investigate how often physicians identify and treat tobacco dependence and whether characteristics as gender, age, marital status, medical specialty and smoking status can influence their attitude towards this question. METHODS: A cross-sectional study was performed on 515 physicians working in a private hospital in São Paulo, Brazil, using a confidential voluntary questionnaire sent and answered electronically. RESULTS: We found that 89% of physicians who answered the research questionnaire often or always asked their patients about smoking habits, but only 39% often or always treated patients' tobacco dependence. In our sample, 5.8% of individuals were current smokers. Tobacco dependent physicians provided less treatment for smoking dependence compared with those who had never smoked, or were former smokers. Being a clinician was associated with higher probability to treat tobacco dependence. CONCLUSION: Physicians should not only address patients' smoking habits but also provide treatment whenever tobacco dependence is diagnosed. To understand physicians' attitude towards smoking may help to develop strategies to stimulate patients' treatment. The development of smoking cessation programs meant specifically for physicians may also be a strategy to enhance patients' treatment.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alex Antonio Florindo ◽  
Gavin Turrell ◽  
Leandro Martin Totaro Garcia ◽  
João Paulo dos Anjos Souza Barbosa ◽  
Michele Santos Cruz ◽  
...  

Abstract Background Sedentary behavior is influenced by contextual, social, and individual factors, including the built environment. However, associations between the built environment and sitting time have not been extensively investigated in countries with economies in transition such as Brazil. The objective of this study is to examine the relationship between sitting-time and access to a mix of destinations for adults from Sao Paulo city, Brazil. Methods This study uses data from the Health Survey of Sao Paulo. Sedentary behavior was assessed by a questionnaire using two questions: total sitting time in minutes on a usual weekday; and on a usual weekend day. The mix of destinations was measured by summing the number of facilities (comprising bus stops, train/subway stations, parks, squares, public recreation centres, bike paths, primary health care units, supermarkets, food stores, bakeries, and coffee-shops) within 500 m of each participant’s residence. Minutes of sitting time in a typical weekday and weekend day were the outcomes and the mix of destinations score in 500 m buffers was the exposure variable. Associations between the mix of destinations and sitting time were examined using multilevel linear regression: these models accounted for clustering within census tracts and households and adjusted for environmental, sociodemographic, and health-related factors. Results After adjustment for covariates, the mix of destinations was inversely associated with minutes of sitting time on a weekday (β=− 8.8, p=0.001) and weekend day (β=− 6.1, p=0.022). People who lived in areas with a greater mix of destinations had shorter average sitting times. Conclusion Greater mix of destinations within 500 m of peoples’ residences was inversely associated with sitting time on a typical weekday and weekend day. In Latin American cities like Sao Paulo built environments more favorable for walking may contribute to reducing sedentary behavior and prevent associated chronic disease.


2011 ◽  
Vol 24 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Itamar S. Santos ◽  
Márcia Scazufca ◽  
Paulo A. Lotufo ◽  
Paulo R. Menezes ◽  
Isabela M. Benseñor

ABSTRACTBackground: Anemia and dementia are common diseases among the elderly, but conflicting data are available regarding an association between these two conditions. We analyzed data from the São Paulo Ageing & Health Study to address the relationship between anemia and dementia.Methods: This cross-sectional observational study included participants aged 65 years and older from a deprived area of the borough of Butantan, São Paulo, Brazil. Data about demographics, education, income, and cognitive and daily life function were collected, as well as blood samples. Anemia and dementia were defined according to WHO and DSM-IV criteria, respectively.Results: Of the 2267 subjects meeting the inclusion criteria, 2072 agreed to participate in the study; of whom 1948 had a valid total blood count and were included in the analysis. Anemia was diagnosed in 203 (10.2%) participants and dementia in 99 (5.1%). The frequency of anemia was higher in patients with dementia according to univariate analysis (odds ratio (OR) = 2.00, 95% confidence interval (CI) = 1.17–3.41, p = 0.01), but this association was not present after adjusting for age (OR = 1.33, 95% CI = 0.76–2.33, p = 0.32). Further multivariate adjustment did not change the results.Conclusion: Although anemia and dementia are frequent disorders in older people, we found their relationship to be mediated exclusively by aging in this low-income population from São Paulo.


2018 ◽  
Vol 26 (5) ◽  
pp. 338-341 ◽  
Author(s):  
Eduardo Ramalho de Moraes ◽  
Gustavo Gonçalves Arliani ◽  
Paulo Henrique Schmidt Lara ◽  
Eli Henrique Rodrigues da Silva ◽  
Jorge Roberto Pagura ◽  
...  

ABSTRACT Purpose: The purpose is to compare the incidence and characteristics of injuries sustained in two consecutive seasons of the São Paulo State Football Championship. Methods: Prospective study performed using an electronic form previously developed by the Medical Committee of the São Paulo State Football Federation, sent to the physicians responsible for the tournament's series A1 and A2 teams, after each round. Results: 17.63 injuries sustained per 1000 hours of matches in the A1 series and 14.91 injuries sustained per 1000 hours of matches in the A2 series. Incidence of injuries per 1000 hours of matches decreased from 24.16 to 17.63 in the A1 series (p<0.037) and from 19.10 to 14.01 in the A2 series (p<0.064). External defenders suffered most injuries, while muscular injuries were most common and lower limbs, the most affected areas. Most injuries occurred between 30 and 45 minutes of the match and only 11.9% of the injuries required surgery. Conclusions: Prevalence and frequency of injuries decreased between seasons. Most injuries were sustained in the lower limbs; strains were the most common injuries, followed by strains and contusions; MRIs were the most frequently requested exams and most injuries were classified as moderate (8-28 days). Level of evidence III, Cross-Sectional Study.


2007 ◽  
Vol 125 (3) ◽  
pp. 180-185
Author(s):  
Ana Paula de Carvalho Panzeri Carlotti ◽  
Maria Lúcia Silveira Ferlin ◽  
Francisco Eulógio Martinez

CONTEXT AND OBJECTIVE: Neonatal resuscitation should be part of medical school curriculums. We aimed to evaluate medical school graduates' knowledge of neonatal resuscitation. DESIGN AND SETTING: Cross-sectional study on the performance of candidates sitting a medical residency exam at Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, in 2004. METHODS: There were two questions on neonatal resuscitation. One question in the theory test aimed at evaluating basic knowledge on the initial approach towards newly born infants. The question in the practical exam was designed to evaluate the candidate's ability to perform the initial steps of resuscitation and to establish bag-mask ventilation. RESULTS: Out of 642 candidates from 74 medical schools, 151 (23.5%) answered the theory question correctly. Significantly more physicians from public medical schools in the State of São Paulo answered correctly than did those from other schools in Brazil (52.5% versus 9.2%; p < 0.05). A total of 436 candidates did the practical exam. The grades among graduates from medical schools belonging to the State of São Paulo were significantly higher than among those from other schools (5.9 ± 2.6 versus 4.1 ± 2.1; p < 0.001). The grades for the practical question among candidates who had answered the theory question correctly were significantly higher than those obtained by candidates who had given wrong answers (p < 0.05). CONCLUSION: Medical school graduates' knowledge of neonate resuscitation in the delivery room is quite precarious. Emphasis on neonatal resuscitation training is urgently needed in medical schools.


2018 ◽  
Vol 46 (6) ◽  
pp. S55
Author(s):  
Raisa Beatrice Mourão Novo ◽  
Diana Teixeira Franca ◽  
Marcelle Rocha ◽  
Glaucia Fernanda Varkulja ◽  
Marcelle Rocha

2014 ◽  
Vol 12 (1) ◽  
pp. 1-5
Author(s):  
Renata Dejtiar Waksman ◽  
Renato Melli Carrera ◽  
Erica Santos ◽  
Sulim Abramovici ◽  
Cláudio Schvartsman

Objective : To identify the factors that determine unintentional injuries in children living in the community of Paraisopolis, in the city of São Paulo, Brazil. Methods : A cross-sectional and non-controlled study. Data collected during 4 consecutive months through questionnaires filled out for the Einstein Program in Paraisopolis Community included identification of the patient and his/her family, scholarity level, housing conditions, storage of hazardous products, access to the streets and concrete slab ceilings, supervision, and trauma mechanism involved. The observed data were treated as absolute and relative frequencies; χ2, Fisher’s exact test, Student’s t test, and Mann-Whitney’s tests were implemented, with a significance level of 5% (p<0.05). Results : A total of 1,490 questionnaires were analyzed. There was a predominance of trauma within boys (59.6%) and the medium age was 5.2 years. The predominant educational level of the parents was incomplete junior school education. The main caregiver identified was the mother (69.4%). Among the children that suffered trauma, 56.4% belonged to large families (≥6 people), lived in houses up to three rooms, and a family income up to R$ 1,000.00 (76.6%). Easy access to hazardous materials was considerable and free access to concrete slab ceilings was reported in 92.8% of the cases. The main trauma mechanisms were falls and burns. In this study, the child victim of a fall was aged under 5 years. Conclusion : Small children that live in a hazardous environment have a significant tendency to suffering trauma


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