O uso da enzima hialuronidase como adjuvante do anestésico local está consagrado em oftalmologia, por melhorar a eficácia anestésica devido ao seu efeito difusor de fármacos, ocasionado pela quebra temporária do hialuronan (ácido hialurônico) que é o principal constituinte de tecidos conectivos. Em odontologia, a utilização da enzima como adjuvante no bloqueio do nervo alveolar inferior não apresentou vantagens quando injetada concomitante ao anestésico local, resultando em dor e trismo. Entretanto, com a utilização de um novo protocolo onde a aplicação da hialuronidase ocorria aos 30 min do início da anestesia, prolongou o efeito anestésico e sem ocorrência de efeitos adversos. Este protocolo oferecia a vantagem de evitar complementação anestésica reduzindo os riscos de toxicidade local e sistêmica, porém ainda havia a desvantagem da necessidade de uma nova puntura para aplicação da enzima. Surgiu a hipótese de se manter os benefícios desse protocolo com o uso da hialuronidase, de prolongar a duração da ação anestésica, injetando-a concomitantemente ao anestésico local, porém estando a enzima em um sistema de liberação lenta. Deste modo, a hialuronidase (75 UTR/ml) foi incorporada a uma nanopartícula, a hidroxipropil- ß-ciclodextrina, que atrasaria sua biodisponibilidade e simularia o protocolo da injeção antes do término da ação anestésica. Assim, este trabalho teve como objetivo verificar a eficácia do complexo de inclusão hialuronidase: hidroxipropil- ß-ciclodextrina injetado concomitantemente ao anestésico local, em prolongar a duração de ação do bloqueio nervoso funcional, a fim de oferecer uma alternativa futura de solução anestésica em procedimentos clínicos demorados ou para o alívio de dor, principalmente, em pacientes com comprometimento sistêmico cuja utilização de vasoconstritor adrenérgico ou anestésico de ação prolongada esteja contraindicada. Também foi avaliada a citotoxicidade do novo sistema carreador, o complexo de inclusão hialuronidase: hidroxipropil- ß-ciclodextrina. O bloqueio funcional sensitivo, motor e proprioceptivo do nervo ciático de ratos foi avaliado através de reflexo de retirada da pata e pinçamento, reflexo extensor tibiotarsal e claudicação, e resposta de salto. A citotoxicidade foi avaliada através do teste contagem por Azul de Tripan em fibroblastos e de hemólise em eritrócitos, ambos de rato. Os grupos onde o complexo de inclusão hialuronidase: hidroxipropil- ß-ciclodextrina foi injetado concomitantemente ao anestésico local apresentaram aumento significativo em comparação a todos os demais. O complexo de inclusão não se apresentou citotóxico, mas quando associado à lidocaína, manteve a citotoxicidade desta. Nenhum efeito hemolítico foi observado nas concentrações utilizadas para enzima, o complexo de inclusão e para a lidocaína. / The use of hyaluronidase as an adjuvant to local anesthetic is established in ophthalmology anesthesia to improve the effect of the drugs due to its spreading effect caused by a temporary break of hyaluronan (hyaluronic acid), which is the main component of connective tissue. In dentistry, the use of the enzyme as adjuvant in inferior alveolar nerve blockade was not advantageous when injected concomitantly with local anesthetic, resulting in pain and trismus. However, when the enzyme was injected before the end of nervous block, the anesthetic effect was extended and had no adverse effects. This protocol offered the advantage of avoiding anesthetic supplementation and reduces the risk of local and systemic toxicity, but there was still the disadvantage of receiving a new puncture to inject the enzyme. It has been hypothesized to maintain the benefits of this protocol with the use of hyaluronidase, to extend the duration of anesthetic action, injecting the hyaluronidase concomitantly with the local anesthetic, but the enzyme should be in a slow release system. Thus, hyaluronidase (75 TRU/ml) was incorporated into a nanoparticle, hydroxypropyl- ß-cyclodextrin, which would delay its bioavailability and simulate the protocol of the injection before the end of anesthetic action. This study aimed to determine the efficacy of inclusion complex hyaluronidase: hydroxypropyl- ß- cyclodextrin injected concomitantly with the local anesthetic to extend the duration of action of functional nervous block, to offer a future alternative of anesthetics to the clinical prolonged procedures or to relieve the pain, mainly in patients with systemic compromising whose the use of adrenergic vasoconstrictor or long-acting anesthetic are contraindicated. The cytotoxicity of the inclusion complex hyaluronidase: hydroxypropyl- -cyclodextrin was also evaluated. The nociceptive, motor and proprioceptive functional blockade of the sciatic nerve in rats was assessed by paw withdrawal reflex and clamping (pinprick), tibiotarsal extensor reflex response and claudication, and jumping response, respectively. The cytotoxicity was assessed through cell viability test by Trypan blue counts of fibroblasts and hemolysis test, both in rat cells. Groups where the inclusion complex hyaluronidase : hydroxypropyl- ß-cyclodextrin was injected concomitantly to the local anesthetic showed a significant increase of duration of anesthetic action compared to the others. The plain inclusion complex showed no cytotoxicity, but when associated with lidocaine, the cytotoxicity of this was maintained. None haemolytic effect was observed for the concentration used to the groups hyaluronidase, inclusion complex and lidocaine.

Made available in DSpace on 2015-04-11T13:56:33Z (GMT). No. of bitstreams: 1 franmir.pdf: 3650652 bytes, checksum: 39d6972da143ac70177c337f822781c1 (MD5) Previous issue date: 2009-07-10 / Fundação de Amparo à Pesquisa do Estado do Amazonas / Brycon amazonicus, commonly known as matrinxa, is one of the most potential species for commercial fish farming in the Western Amazon. Nevertheless this is a very aggressive fish, and excessive movements in handling may lead animals to undesired consequences as body wounds, diseases or even mortality. The objective of this work was to evaluate zeolite in the transport in order to reduce excreted ammonia on water transport that may represent absence of one acute transport stressor. Additionally we evaluated the use an alternative anesthetic, eugenol, also in the transport water to tranquilize fish and together with zeolite increase the chances of the transport success. Three experiments were held: 1) matrinxã excreted ammonia in the transport water; 2) capacity of zeolite to absorb water ammonia; 3) Effects of zeolite and eugenol addition on the transport water on the metabolic stress responses of matrinxã. Water samples were taken during transport to measure temperature, oxygen, pH, ammonia and nitrite. Blood samples were also taken to measure hematrocrit, lactate, glucose, ammonia, protein, chlorides and sodium. Glycogen tissues contents were still measured. Transportation of fish during 4 h accumulated ammonia in the water in concentration of 1,39 mg/L, and pH 6,45±0,43, oxygen 13,5±0,24 mg/L and temperature 27,1±0,13°C. In the second experiment, zeolite in concentration of 7,5 mg/L absorbed properly ammonia transport water. In the third study zeolite and eugenol decreased metabolic stress responses of matrinxã to transport. Plasma glucose was around 65,62 mg/dL and cortisol 4,1 ng/dL. / O Brycon amazonicus, genericamente conhecido como matrinxã, é um dos peixes com maior potencial para a piscicultura na Amazônia. Porém por ser um peixe naturalmente agitado, movimenta-se de forma intensa durante o manejo sendo mais suscetível aos efeitos indesejáveis das diversas práticas como biometria, classificação e transporte, podendo ocorrer ferimentos na superfície do corpo, manifestação de doenças e até altas mortalidades. Os objetivos do proposto trabalho foram avaliar as possibilidades de uso da zeolita durante o transporte de matrinxã, associado ao uso de um anestésico alternativo, o eugenol, também na água de transporte, para reduzir a movimentação dos animais, a fim de aumentar com esses dois produtos as chances de sucesso do transporte. Foram realizados três estudos: 1) análise de amônia liberada pelo matrinxã na água durante o transporte; 2) análise do poder de absorção da amônia pela zeolita; 3) Efeito da adição de zeolita e eugenol à água de transporte nas respostas metabólicas ao estresse do matrinxã submetido ao transporte. Foram retiradas amostras de água das embalagens de transporte para análises de temperatura, oxigênio, pH, amônia e nitrito. Amostras de sangue e tecido muscular e hepático foram coletadas para realização das análises de hematócrito, lactato, glicose plasmática, lactato, amônia plasmática, proteína total, cloretos, sódio, glicogênio hepático e glicogênio muscular. No primeiro experimento determinou-se que a liberação de amônia na água de transporte de 4 horas apresentou um aumento exponencial. No segundo experimento de absorção da amônia pela zeolita, todas as concentrações mostraram-se eficientes para o fim proposto. No terceiro experimento a influência da zeolita conjuntamente com o eugenol nas respostas metabólicas ao estresse foram satisfatórias para amenizá-las. A concentração de zeolita determinada como adequada foi de 7,5 mg/L levandose em consideração o custo-benefício ao produtor. O tratamento zeolita + eugenol foi o mais eficiente mostrando bons resultados para melhorar a qualidade do transporte com respostas fisiológicas e tissulares ao estresse menores.

O consumo de medicamentos de qualidade é pré-requisito básico para o reestabelecimento da saúde dos indivíduos. No trabalho de pesquisa desenvolvido na faculdade de ciências farmacêuticas da Universidade de São Paulo(USP), destacou-se o controle físico-químico da qualidade dos medicamentos, as principais metodologias adotadas nos laboratórios de controle de qualidade enfatizando-se a identificação e quantificação das impurezas, e de que forma as mesmas são geradas nos processos de fabricação e armazenamento dos medicamentos. Evidencia-se a importância da atuação de órgãos de vigilância sanitária como a Agência Nacional de Vigilância Sanitária (ANVISA) através da consulta da legislação específica das Boas Práticas de Fabricação. Neste contexto, explorou-se o estudo de um medicamento anestésico injetável utilizadoem ambiente hospitalar que está apresentando diversas notificações de desvios de qualidade, através de queixas técnicas e eventos adversos recebidos no sistema de notificações(Notivisa) da Agência Nacional de Vigilância Sanitária. Para a pesquisa, o mestrando utilizou diferentes métodos de identificação, citando-se a cromatografia de camada delgada, espectroscopia no infravermelho, ponto de fusão, espectroscopia UV-Vis e termoanálise. Para a identificação e quantificação, destacou-se a cromatografia líquida de alta eficiência(CLAE) e eletroforese capilar(EC). As pesquisas foram relizadas no laboratório de controle físico químico de qualidade e central analítica da faculdade de ciências farmacêuticas da Universidade de São Paulo. / The use of medicines of good qualityis a basicprerequisite forthe re-establishmentof the health ofdisabledpatients. Thisresearch, developed in the Laboratory of Physical and Chemical Quality Control of Pharmaceutical Preparations and Cosmetics and Central Analytical Center at theFaculty of PharmaceuticalSciences-University of São Paulo, aims the studyand application ofthe main and newmethodologies usedin qualitycontrol laboratories. It was emphasizedthe identification andquantification ofimpuritiesand howthey can begeneratedin the manufacturing processesand storage of pharmaceutical preparations. It was evidenced the importanceof theroleof health surveillanceagenciessuch as the NationalHealth Surveillance Agency(ANVISA) through theconsultationof the specific legislationof GoodManufacturing Practices (GMP). In this context, the local anesthetic drug, bupivacaine in injectables, was selected for the study. This formulation is very much used in hospitals, and recently, several complaints of quality deviations related to technical complaints and adverse events were made through the ANVISA notification system. Several analytical methods were used for identification, such as, thin layer chromatography, infrared spectroscopy, determination of the melting point, UV-VIS spectrophotometry, and termoanalysis. For identification and quantification of the degradation products, high performance liquid chromatography (HPLC) and capillary electrophoresis (CE) were used in the research.

Orientador: Jose Ranali / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-01T00:20:44Z (GMT). No. of bitstreams: 1 Soares_PatriciaCristinedeOliveira_M.pdf: 3581523 bytes, checksum: 0acfec963e5a1be1e2748b5f7426b0e7 (MD5) Previous issue date: 2002 / Resumo: Este estudo avaliou a variação de parâmetros cardiovasculares após injeção anestésica, através do monitoramento contínuo por 48 horas. Foram selecionados 20 voluntários com idade entre 20 e 39 anos, normotensos, saudáveis e com canino superior direito hígido. Realizaram-se registros da pressão arterial sistólica (PAS), diastólica (PAD), média (PAM) e freqüência cardíaca (FC) em 3 fases: A - monitoramento por 24 horas sem procedimento odontológico; B pnmeIro procedimento anestésico, 48 horas, registros 15-15 minutos, e 2-2 minutos durante o procedimento anestésico; o segundo procedimento anestésico, semelhante a fase B, variando a solução anestésica. As injeções infiltrativas, vestibular e palatina, foram realizadas com duas soluções anestésicas: articaína 4% com adrenalina 1: 100.000 (Septanest® - DFL) e lidocaína 2% com adrenalina 1:100.000 (Alphacaine® - DFL), nas sessões B e C, de forma cruzada, duplo-cega e ao acaso. A eficiência da anestesia foi analisada pela aplicação de estímulo elétrico, e a sensibilidade dolorosa pela escala analógica visual. A análise de variância em esquema de parcelas subdivididas ('alfa¿= 0,05) foi utilizada para avaliar as variações nos parâmetros cardiovasculares e mostrou não haver diferença estatística significante entre as 3 fases. Ao analisar os valores obtidos nas 48 horas, observaram-se que houve diferenças estatísticas nos sub-períodos para PAS, PAD, PAM e FC (p< 0,0001). Durante o procedimento anestésico observou-se diferenças estatísticas significantes em relação aos subperíodos, porém com diminuição frente aos outros intervalos de avaliação. Os valores comparativos entre as soluções anestésicas foram analisados pelo teste de Wilcoxon pareado ('alfa¿= 0,05), não havendo diferença estatística significante entre as soluções de articaína e lidocaína quanto a latência (p=0,80), anestesia completa (p= 0,08), parcial (p= 0,55) e em tecidos moles (p= 0,18). Os valores da Escala Analógica Visual foram submetidos ao teste de Wilcoxon pareado ('alfa¿= 0,05), não foram verificadas diferenças entre as duas soluções (p=0,45). Pode-se concluir que em pacientes jovens, normotensos e saudáveis, o procedimento anestésico e a sensibilidade dolorosa não provocaram aumento dos parâmetros cardiovasculares avaliados e que as soluções anestésicas apresentaram desempenho clínico similares / Abstract: The purpose of this study was to evaluate the changes ofcardiovascular parameters by anesthetic injection, throughout a 48-hour continuous nonlnvaslve registration. Twenty normotensive healthy volunteers, aged between 20-39 years, were selected. The heart rate (HR) and systolic (SBP), diastolic (DBP) and media (MBP) blood pressures were evaluated in 3 phases: A - registration for 24 hours without anesthetic injection; B - first anesthetic solution injection, registration for 48 hours, the records were taken every 15 minutes, and every 2 minutes during the anesthetic procedure; C ¿ second anesthetic solution, similar to phase B. The infiltration anesthesias with the solutions in the vestibular and palatine regions of upper right canine were accomplished using two anesthetic solutions: articaine 4% with adrenaline 1:100.000 (Septanest-DFL) and lidocaine 2% with adrenaline 1:100.000 (Alphacaine-DFL), in a double blind cross-over manner. The efficiency of the anesthesia was verified by application of electric stimulus and the painful sensibility was verified by the visual analogue scale. The cardiovasculars parameters were analyzed trought ANOVA in sub-parcels scheme following Tukey's test ('alfa¿=0,05). No statistical significant difference was observed among the 3 phases. When the values obtained in 48 hours were analyzed, statistical differences were observed in the sub-periods of 48 hours period in SBP, DBP, MBP and HR (p< 0,0001) and in sub-periods during the anesthetic procedure with decrease in cardiovascular parameters during this procedure. The comparative values between two anesthetic solutions were analyzed by Wilcoxon's test ('alfa¿=0,05). There were no significant statistical differences between articaine and lidocaine solutions by latency (p= 0,80) and pulp (p= 0,08), partial (p= 0,55) and soft tissue (p= 0,18) anesthesias. For visual analogue scale the two solutions did not present differences (p=0,45). It can be concluded that in normotensive healthy patients, the anesthetic injection and painful sensibility were not enough to increase the cardiovasculars parameters, and the both anesthetic solutions, lidocaine 2% with adrenaline 1:100.000 and articaine 4% with adrenaline 1: 100.000, presented similar clinical behavior / Mestrado / Farmacologia, Anestesiologia e Terapeutica / Mestre em Odontologia

No description available.

Introduction The neuropsychological deterioration after cardiac surgery involving cardiopulmonary bypass (CPB), is ascribed to brain ischaemia caused by, amongst others, hypotension, cerebral hyperthermia, cerebral embolism, interaction between pharmacological methods and hypothermia during ischaemia, and the directly neurotoxic of anaesthetic drugs. AimTo investigate the effect of the anaesthetic techniques midazolam plus ketamine (MK) or sufentanil (S) on the quantitative EEG (QEEG), reaction time (RT), serum neuron specific enolase (NSE), and serum S-100<font face="symbol">b</font> protein after cardiac surgery involving CPB in humans. Patients and methodsThe sample consisted of a total of 42 patients scheduled for elective coronary artery bypass (CABG) or valve replacement (VR). All patients were not available for all the postoperative tests. Patients were allocated randomly to group MK or S. Anaesthetic technique: S or MK. Isoflurane was administered when necessary. CPB technique: 30°C, membrane oxygenation, a 40 <font face="symbol">m</font>m filter in the arterial cannula and <font face="symbol">a</font>-stat-blood gas management, blood pressure of 50 to 70 mm Hg and a haematocrit <font face="symbol">></font> 22%. Patients were weaned from CPB when nasopharyngeal temperature reached a maximum of 37,5°C. QEEG and RT was performed 1 to 2 days preoperatively and 5 to 6 days postoperatively.Serum-NSE and -S-100<font face="symbol">b</font> protein were measured preoperatively, 2 minutes after going on CPB, after rewarming to 37°C, just before the end of CPB and 2, 4, 10, 20, 30, and 48 hours after CPB. ResultsQEEG: The most noticable finding was an increase in slow wave activity (relative <font face="symbol">q</font> and <font face="symbol">s</font>). The QEEG outcome was better after CABG than after VR (p < 0,001), but not different between MK and S (p = 0,5000). <font face="symbol">Dq</font>% was better with MK than S (p = 0,0120). <font face="symbol">Dq</font>% (p = 0,0010), <font face="symbol">Da/q</font>% (p = 0,0090) and <font face="symbol">D</font>PS% (p = 0,0025) was better after CABG than VR. Reaction time: There was a significant deterioration in 5/18 (27,78%) of MK and 12/18 (66,67%) of S (p = 0,0220). The change in accuracy in sequential reation time 1 (p = 0,0100), and sequential reation time 2 (p = 0,0970) and the cumulative accuracy was better with MK than S(p = 0,0020). Chemical markers: Over groups 14,8% of patients had a poor NSE and 61,9% a poor S-100<font face="symbol">b</font> outcome. Within groups a poor NSE outcome was found in 14,8% of MK and 14,8% of S (p = 1,0000), and 4,8% of CABG but 23,8% of VR (p = 0,1840). Within groups as adverse S-100<font face="symbol">b</font> outcome was found in 42,9% of MK but 81,0% van S (p = 0,0250; Fisher's exact test), and 66,7% of CABG and 57,1% of KV (p = 0,7510. According to area under the curve of corrected NSE, CABG had a better outcome than VR (p = 0,0040). According to both maximum S-100<font face="symbol">b</font> level and the area under the curve of S-100<font face="symbol">b</font>, an interaction occurred between the anaesthetic technique and the procedure, with VR doing better with MK while CABG did significantly better with S (p = 0,0180 en 0,0040 respectively). Conclusion, shortcomings, significance and contribution This study has shown that, in as far as brain damage is concerned, the outcome was probably better with MK than with S, and CABG better than VR. An interaction was found between the anaesthetic technique and the type of operation. / Thesis (MD)--University of Pretoria, 2003. / Anaesthesiology / unrestricted

Bakgrund: Anestesi- och operationssjuksköterskan träffar många olika patienter, allt ifrån barn och äldre till friska som svårt sjuka. I den perioperativa vården sker dödsfall sällan och personalen är ofta oerfarna av detta. Tidigare forskning visar att perioperativa dödsfall påverkar personalen. Det finns olika sätt att hantera känslomässiga eller stressande situationer. Syfte: att undersöka anestesi- och operationssjuksköterskans upplevelse av perioperativa dödsfall. Metod: Kvalitativ innehållsanalys med induktiv ansats. Anestesi- och operationssjuksköterskor som varit med om ett perioperativt dödsfall intervjuades. Resultat: Temat som framkom är ”En sällanhändelse som berör” från kategorierna ”Omständigheterna kring dödsfallet påverkar”, ”Yrkeserfarenheten spelar roll”, ”Betydelsen av teamet”, ”Emotionella reaktioner” och ”Betydelsen av bearbetning” med tillhörande subkategorier.  Konklusion: Perioperativa dödsfall är något som händer sällan men som berör anestesi- och operationssjuksköterskan. Dödsfall är alltid speciellt när det sker på operationsavdelningen och några viktiga aspekter i upplevelsen är att personalen känner att de har gjort allt de kan, haft god samverkan i teamet och fått bearbeta händelsen. / Background: The anesthetic- and surgical nurse meets many different patients, everything from children and the elderly, to the healthy and the seriously ill. In perioperative care, deaths rarely occur and the staff are often inexperienced of this. Previous research shows that perioperative deaths affect staff. There are different ways to deal with emotional or stressful situations. Aim: to investigate the anesthetic- and surgical nurse's experience of perioperative death. Method: Qualitative content analysis with an inductive approach. Anesthetic- and surgical nurses' who had experienced a perioperative death were interviewed. Results: The theme that emerged is "A rare event that affects" from the categories "The circumstances surrounding the death affect", "Professional experience matters", "The importance of the team", "Emotional reactions" and "The importance of processing" with their subcategories. Conclusion: Perioperative death is something that happens rarely but affects the anesthetic- and surgical nurse. Death is always special when it happens in the operating room and some important aspects of the experience are that the staff feel they have done everything they can, have good teamwork and been able to process the event.

The primary focus of this thesis is to establish the clinical utility of corticosteroid injections mixed with local anesthetics, when compared to only local anesthetics, for relief of pain in patients with chronic non-cancer pain. Chronic non-cancer pain is common and causes significant pain and suffering to patients, and economic burden to health care system. Injection of steroids is an option, either by targeting the painful structure or the associated neural elements. Steroids are commonly mixed with local anesthetics in the hope of prolonging the pain relief. Since there is no evident inflammation in most chronic pain conditions, and because existing clinical studies do not consistently support its effectiveness in various clinical conditions, the potential value of adding steroids is questionable. This clinical question has been addressed through a comprehensive systematic review and meta-analysis of randomized control trials comparing injections of steroid with local anesthetics against only local anesthetics for chronic non-cancer pain conditions. Our review found that there is paucity of good quality randomized controlled studies specifically addressing this comparison. Although a large numbers of studies were identified, there was a small effect favoring steroids in studies measuring pain relief by dichotomous outcomes. Overall confidence in the effect estimates were limited due to serious concerns of bias, significant heterogeneity and variability in studies, leading to low quality. A majority of the included studies did not aim to capture the full spectrum of adverse effects. Future studies addressing this clinical question should aim to be of optimum size, must aim to limit the threat of bias, and capture all patient important outcomes including pain relief. / Thesis / Master of Science (MSc)

Bakgrund: Trauma är den vanligaste primära dödsorsaken bland individer upp till 44 års ålder i Sverige, vilket påvisar betydelsen av en utvecklad traumavård. Inom kontexten av traumalarm på sjukhus är anestesisjuksköterskans roll avgörande. När traumapatienter anländer till sjukhus, larmas dedikerade traumateam enligt förutbestämda protokoll för att möta patienten och dennes behov. Specifikt för traumalarm nivå 1, vilket indikerar en högre grad allvar, är att anestesisjuksköterskan tillsammans med en anestesiläkare mobiliseras. I dessa situationer lämnar anestesisjuksköterskan den vanliga arbetsmiljön på operationsavdelningen för att arbeta under akuta och oförutsedda förhållanden på akutmottagningen. Syfte: Att undersöka anestesisjuksköterskors upplevelse av traumalarm nivå 1. Metod: Datamaterialet samlades in genom kvalitativa semistrukturerade intervjuer med tio deltagare från samma sjukhus. Datamaterialet analyserades genom en kvalitativ innehållsanalys. Resultat: Utifrån datamaterialet utformades nio underkategorier med tre tillhörande kategorier; förutsättningar för säkert traumaomhändertagande, stress vid traumalarm och känslomässiga aspekter vid traumalarm. Utifrån dessa kategorier framkom ett tema; kan det oförberedda förberedas. Konklusion: Anestesisjuksköterskor upplever att god och tydlig kommunikation under traumalarm är centralt och att framgång i arbetet underlättas mycket av en stark traumaledare. Anestesisjuksköterskorna upplever känslomässiga reaktioner både före, under och efter traumalarm. Mest framträdande i de emotionella aspekterna är den eftervarande responsen då larmet och situationen är hanterad. / Background: Trauma is the leading primary cause of death for individuals up to 44 years old in Sweden, underscoring the need for advanced trauma care. Nurse anaesthetists play a crucial role in hospital trauma alerts. When trauma patients arrive, specialized teams are mobilized following specific protocols. For level 1 trauma alerts, indicating severe cases, nurse anaesthetists work with anaesthesiologists, leaving their regular operating room duties for emergency department conditions. Purpose: This study investigates nurse anaesthetists’ experiences with level 1 trauma alerts. Method: Data were gathered from qualitative semi-structured interviews with ten hospital staff members working at the same hospital. A qualitative content analysis was conducted. Results: The analysis yielded nine subcategories and three main categories: prerequisites for safe trauma care, stress during trauma alerts, and emotional aspects of trauma alerts. From these categories a theme emerged: can the unprepared be prepared? Conclusion: Effective communication is vital during trauma alerts, and successful outcomes are often aided by strong leadership. Nurse anaesthetists experience emotional responses before, during, and after trauma alerts, with notable emotional impacts following the resolution of the situation.

No description available.