Bakgrund: Hjärtstopp är något som allt fler individer överlever och varje år ökar chansen att överleva procentuellt sett. En stor anledning till det ökade antalet överlevare är följsamheten till HLR riktlinjer. En person som överlever ett hjärtstoppkan ofta förvänta sig flera konsekvenser så som fatigue och problem med exekutiva funktioner. Då personer som överlever hjärtstopp står inför en stor livsförändring är det av vikt att undersöka deras upplevelser, och med det bidra till en ökad kunskap inom området. Syfte: Att beskriva patienters upplevelser av att överleva hjärtstopp. Metod: En litteraturöversikt gjordes med stöd av Fribergs analysmetod. Artiklarna hittades genom en sökning i databaserna Cinahl och PubMed. Sökningen resulterade i 14 kvalitativa peer-reviewed originalartiklar, skrivna på engelska och publicerade efter2014.  Resultat: Hjärtstoppet var svårt att förstå och skapade många funderingar. Fysiska symptom var förekommande vilket tvingade till förändringar i vardagen. Vissapatienter såg hjärtstoppet som ett uppvaknade genererade positiva livsstilsförändringar. Slutsatser. Deltagarna upplevde oro och ångest inför framtiden efter att ha överlevt ett hjärtstopp. Oron kan minskas genom att besvara individuella frågor och funderingar. Med ett gott omhändertagande med varje enskild individ i fokus kan sjuksköterskan skapa förutsättningen för att möta de individuella behoven. / Background: More people survive cardiac arrest, and the percentage of survival increases each year. One of the reasons is the compliance with HLR guidelines. A person that survives cardiac arrest usually suffers from multiple complications with the most common one being fatigue and problems with executive functions. Since people who survive cardiac arrest have gone through a life-changing event, it is important to study the experiences of patients to generate a deeper understanding of the subject. Aim: Describe patients' experiences of surviving cardiac arrest.  Method: A literature review was chosen as the method with inspiration taken from Friberg’s analysis method. The searches were conducted in the databases Cinahl and PubMed. The searches resulted in 14 peer-reviewed articles, written in English, and published after 2014.  Result: The cardiac arrest was hard for the patients to understand. Bodily symptoms were frequent in patients which led to changes in daily life. Some participants saw the cardiac arrest as a wake-up call which prompted positive lifestyle changes. Summary: The participants experienced anxiety about the future after surviving cardiac arrest. The anxiety can be reduced if individual thoughts and questions are properly addressed. With good care the nurse can answer to the individuals needs

Abstrakt: Beslut gällande patienters HLR-status fattas av läkare, men den process som föranleder beslutet bör involvera flera parter. I enlighet med autonomiprincipen ska patienter vara delaktiga i de beslut som berör deras egen vård. Syftet: med denna litteraturstudie var att undersöka några frågor kring HLR/ej-HLR vid vård i livets slutskede. Metoden var en systematisk litteraturstudie, baserad på tio vetenskapliga artiklar. Litteratursökningen utfördes i databaserna PubMed och CINAHL, samt manuella sökningar. Både kvalitativa och kvantitativa artiklar inkluderades i litteraturstudien. I resultatet framkom det tre olika huvudteman samt två underteman. Det tema som framkom tydligast i resultatet var; information i livets slutskede. Informationsbehovet rörande HLR, bland patienter som vårdas i livets slutskede, skiljer sig åt och bör därför individanpassas. Eftersom sjuksköterskor oftast är de som har mest kontakt med obotligt sjuka patienter, är det av stor vikt att de involveras i beslutsfattandet. Det framkom även att patientens livskvalitet är en faktor som inverkar på beslut gällande HLR. Upplevelsen av livskvalitet är individuell och kan därför vara svår för andra att bedöma. Att värna om patienters rätt till autonomi är essentiellt och speciellt gällande livsavgörande beslut. Allmänsjuksköterskans roll vid vård i livets slutskede bör därför vara, att på bästa möjliga vis tillmötesgå patienterna och därmed även underlätta de anhörigas sorgarbete. / Abstract: Decisions regarding patient’s CPR status are made by doctors, but the process that causes the decision should involve several parties. In accordance with the autonomy principle, patients should be involved in the decisions that affect their own care. The aim of this study was to examine some questions regarding CPR / DNR in the final stages of life. The method was a systematic literature review, based on ten articles. The literature search was performed in the databases PubMed and CINAHL, as well as manual searches. Both qualitative and quantitative articles were included in the literature review. The results revealed three main themes and two sub-themes. The theme that emerged most clearly in the results was: information in final stages of life. The need for information regarding CPR, among patient’s cared for at the end of life, differs and should be individualized. Because nurses often are the ones who have most contact with terminally ill patients, it is essential that they get involved in decision making. It also revealed that the patient’s quality of life is a factor influencing the decision regarding CPR. The perception of quality of life is individual and can therefore be difficult for others to judge. Protecting patients’ rights to autonomy is essential, especially regarding vital decisions. General Nurses role, when caring for patients in their final stages of life, should therefore be, in the best possible way, to accommodate the patients and by doing so also help to ease the relative’s grief.

Background: It has been proved that bystander cardiopulmonary resuscitation (CPR) saves lives; however, which training method in CPR is most instructive and whether survival is affected by the training level of the bystander have not yet been fully described. Aim: To identify the factors that may affect 7th grade students’ acquisition of CPR skills during CPR training and their willingness to act, and to describe 30-day survival from outof- hospital cardiac arrest (OHCA) after bystander CPR and the actions performed by laymen versus off-duty medically educated personnel. Methods: Studies I–III investigate a CPR training intervention given to students in 7th grade during 2013–2014. The classes were randomized to the main intervention: the mobile phone application (app) or DVD-based training. Some of the classes were randomized to one or several additional interventions: a practical test with feedback, reflection, a web course, a visit from elite athletes and automated external defibrillator (AED) training. The students’ practical skills, willingness to act and knowledge of stroke symptoms, symptoms of acute myocardial infarction (AMI) and lifestyle factors were assessed directly after training and at 6 months using the Laerdal PC SkillReporting system (and entered into a modified version of the Cardiff test scoring sheet) and a questionnaire. The Cardiff test resulted in a total score of 12–48 points, and the questionnaire resulted in a total score of 0–7 points for stroke symptoms, 0–9 points for symptoms of AMI and 0– 6 points on lifestyle factors. Study IV is based on retrospective data from the national quality register, the Swedish registry of cardiopulmonary resuscitation, 2010-2014. Results: A total of 1339 students were included in the CPR training intervention. The DVD-based group was superior to the app-based group in CPR skills, with a total score of 35 (SD 4.o) vs 33 (SD 4.2) points directly after training (p<0.001) and 33 (SD 4.0) vs 31 (SD 4.2) points at six months (p<0.001). Of the additional interventions, the practical test with feedback had the greatest influence regarding practical skills: at six months the intervention group scored 32 (SD 3.9) points and the control group (CPR only) scored 30 (SD 4.0) points (p<0.001). Reflection, the web course, visits from elite athletes and AED training did not further increase the students’ acquisition of practical CPR skills. The students who completed the web course Help-Brain-Heart received a higher total score for theoretical knowledge in comparison with the control group, directly after training: stroke 3.8 (SD 1.8) vs 2.7 (SD 2.0) points (p<0.001); AMI 4.0 (SD 2.0) vs 2.5 (SD 2.0) points (p<0.001); lifestyle factors 5.4 (SD 1.2) vs 4.5 (SD 2.0) points p<0.001. Most of the students (77% at 6 months), regardless of the intervention applied, expressed that they would perform both chest compressions and ventilations in a cardiac arrest (CA) situation involving a relative. If a stranger had CA, a significantly lower proportion of students (32%; p<0.001) would perform both compressions and ventilations. In this case, however, many would perform compressions only. In most cases of bystander-witnessed OHCA, CPR was performed by laymen. Off-duty health care personnel bystanders initiated CPR within 1 minute vs 2 minutes for laymen (p<0.0001). Thirty-day survival was 14.7% among patients who received CPR from laymen and 17.2% (p=0.02) among patients who received bystander CPR from off-duty health care personnel. Conclusions: The DVD-based method was superior to the app-based method in terms of teaching practical CPR skills to 7th grade students. Of the additional interventions, a practical test with feedback was the most efficient intervention to increase learning outcome. The additional interventions, reflection, web course, visit from elite athletes and AED did not increase CPR skills further. However, the web course Help-Brain-Heart improved the students’ acquisition of theoretical knowledge regarding stroke, AMI and lifestyle factors. For OHCA, off-duty health care personnel bystanders initiated CPR earlier and 30-day survival was higher compared with laymen bystanders.

Made available in DSpace on 2016-04-26T20:26:27Z (GMT). No. of bitstreams: 1 Penhor Rural.pdf: 792737 bytes, checksum: 299cc134c170a40efab877bf142c7da7 (MD5) Previous issue date: 2005-05-20 / Cuida a respeito do penhor rural a partir de alguns dos seus aspectos mais relevantes e suas vicissitudes. Como tema inserido no direito civil, o trabalho se inicia tratando das fontes do direito civil e cláusulas gerais do sistema moderno, tais como a dignidade da pessoa humana, autonomia privada, boa-fé objetiva, função social da propriedade e dos contratos. Diante da natureza jurídica do penhor rural trata em seguida dos direitos reais e peculiaridades desses direitos como garantia de outras obrigações, suas espécies e objeto. Propriamente no penhor rural, que engloba o penhor rural e o pecuário, tratou-se de seus requisitos (subjetivos, objetivos, formais e de conteúdo), formas de constituição, modificação e extinção, bem como ocorrências nas obrigações e seus reflexos no penhor. Foram abordadas as obrigações garantidas por penhor rural a partir de seus títulos de constituição, tratando do contrato e dos títulos de crédito garantidos pela espécie, dando-se especial ênfase à Cédula de Produto Rural, em razão da sua larga ocorrência e do parco tratamento doutrinário. Após, foram abordados alguns temas processuais, como forma de proteção, a medida cautelar para proteção da garantia e, para satisfação do crédito, a medida executiva. Por fim, cuidou-se de verificar alguns aspectos penais do desvio de bens objeto de penhor, tanto na esfera civil, a questão do depositário infiel, e, no âmbito penal procurou-se esclarecer a respeito do tipo penal de defraudação do penhor.

O prognóstico após a parada cárdio-respiratória (PCR) e reanimação cardio-pulmonar (RCP) depende de intervenções críticas, particularmente, do tempo de resposta entre a chamada de socorro ou resgate, até a chegada ao local onde se encontra a vítima, além das compressões torácicas eficazes, da desfibrilação precoce e do suporte avançado de vida. Para avaliar a eficácia e a adequação dos procedimentos de RCP durante a PCR, entidades e associações científicas se reuniram e elaboraram o Utstein Style out-of-hospital, cujas definições e instrumento, usados para registro do evento, têm sido amplamente utilizadas em todo o mundo, bem como para estudos publicados sobre atendimento à parada cardíaca. A adoção de um instrumento de consenso internacional levou a uma grande evolução guidelines de reanimação e a progressos científicos, possibilitando a troca de informações mais efetivas para promover comparações internacionais em relação aos procedimentos de ressuscitação tendo como propósito codificar variáveis, mensurar aspectos do processo e avaliar resultados dos atendimentos na PCR fora do hospital. Apesar do grande numero de PCR que ocorre no Brasil, não há, até então, um instrumento em nosso idioma adaptado à nossa realidade. Este trabalho teve pro objetivos realizar a tradução e adaptação cultural do Utstein Style out-of-hospital, com base nos pressupostos metodológicos de Guillemin (2002). O instrumento foi, também, testado em dois centros de atendimento pré-hospitalar para verificar a viabilidade de sua utilização. Como resultado deste estudo metodológico obtivemos um instrumento traduzido para o idioma português, com algumas modificações necessárias para sua adaptação à cultura nacional, sugeridas por um comitê de juizes e cuja aplicação, ainda que em pré-teste, permitiu verificar que os resultados obtidos assemelham-se aos dados internacionais. O maior número de causas de PCR ocorreu em adultos do sexo feminino (58,8%), com idade acima de 29 anos. Grande parte das paradas cardíacas foi identificada por espectador (47,0%), pelo Serviço Médico de Emergência (35,5) e pelo médico (17,5%). Quanto à ocorrência da PCR, 82,4% foi por causa desconhecida e 17,6% por trauma / The prognostic after the cardiac arrest and cardio-pulmonary resuscitation (CPR) is dependent of critical interventions, particularly, time reply called until place, efficient chest compressions early defibrillation and the advanced life support. The definitions of the Utstein style and the instrument of register have been widely used in published studies of cardiopulmonary arrest (CPA), what it took to a great evolution and the progress for international consensuses on science and guidelines of resuscitation, making possible the exchange of information more effective to promote international auditorship in relation to the resuscitation procedures having as intention to codify variable, to measure aspects of the process and to evaluate resulted of the take care of in the CPA of the hospital. Currently several countries already use with this purpose. The Utstein was approved by the international committees. Although the great one number of CPA in Brazil, we did not possess an instrument in our language and adapted. This instrument underwent a process of translation into Portuguese, back-translation into its original language and finally analysis by a committee of judges to evaluate semantics, idiomatic, cultural and conceptual equivalences, with the authorization of the AHA, following the recommendations of Guillemin, revised in 2002. The instrument was tested in two centers the out-of-hospital attendance to verify the use of in the Brazilian country and making possible comparisons with international data, enriching adding the evolution of the CPR in the world. As result of this study we got an instrument translated into the Portuguese language, with some necessary modifications for its adaptation to the national culture, suggested for a committee of judges and whose application allowed verifying that the gotten results resemble it the international data. The biggest number of CPA causes occurred in adults, females (58.8%), with age above of 29 years. Great part of the CPA was identified by witness (47.0%), the Emergency Medical Service (35.5%) and by the physician (17.5%). Several occurrences of CPA, 82.4% it was for unknown cause and 17.6% for trauma

A parada cardiorrespiratória é um evento potencialmente letal, e a qualidade do atendimento prestado depende da agilidade, conhecimento e habilidade de toda a equipe envolvida. O desenvolvimento de um guia com os pontos relevantes a serem observados durante o atendimento à PCR intra-hospitalar surgiu em 1997, com a criação do In-Hospital Utstein Style por uma força tarefa de especialistas em atendimento e pesquisa em PCR. Trata-se de um guia que agrega informações acerca do atendimento à PCR, contendo um relatório padrão para coleta de dados, divido em variáveis: do paciente, do evento e de resultados, além de algumas informações adicionais. A criação de um relatório padrão de coleta de dados, permitiu uniformizar a linguagem, bem como o desenvolvimento de novas pesquisas, baseadas no mesmo modelo. Com a finalidade de disponibilizar o In-hospital Utstein Style para a realidade brasileira, este instrumento foi submetido ao processo de tradução e adaptação cultural, nas seguintes etapas: tradução para o português, retro-tradução para a língua de origem, análise por comitê de juízes para avaliação das equivalências semântica, idiomática, cultural e conceitual. O resultado deste processo gerou um instrumento para pré-teste, aplicado em 20 pacientes que sofreram PCR, com a finalidade de verificar o comportamento do instrumento em nossa realidade. As variáveis de resultado não foram coletadas, pois pressupõe o acompanhamento destes pacientes ao longo do tempo. A amostra foi constituída por 60,0% de homens, com idade média de 63 anos ±16,17. O ritmo de PCR mais comum foi atividade elétrica sem pulso (65,0%), o tempo médio para desfibrilar foi de 1,25 minutos. Assim como observado por pesquisadores internacionais, existem informações perdidas durante o atendimento, não registradas, prejudicando a coleta dos dados referentes a este momento. A análise dos dados, permite concluir que o instrumento é aplicável à realidade brasileira, tornando possíveis comparações com estudos internacionais, buscando melhor atendimento ao evento da PCR. A falta de preenchimento de alguns itens , principalmente aqueles referentes às variáveis do evento (coletados no momento da PCR), podem ser perdidos, por falta de preenchimento adequado do instrumento, por profissionais médicos e de enfermagem. O treinamento e incentivo para melhorar a quantidade e qualidade de registros, tornam possíveis, através da aplicação do Utstein Style conhecer cada atendimento feito e toda a assistência prestada, identificando prováveis falhas e principalmente investindo em qualidade de vida após o evento / Cardiopulmonary Arrest is a potentially lethal event in which the quality of the service rendered depends on agility, knowledge and the skills of all of the involved team. The development of the first guide identifying the significant points to be taken during the procedure of an in-hospital CPA appeared in 1997, with the creation of the In-Hospital Utstein Style by a task force of personnel specialized in attendance and research of CPA. This guide brings together information concerning CPA attendance and contains a standardized report for collecting data which is divided into the following variables: patient, event, and the outcome, as well as some other additional information. The creation of this standardized report for collecting data made it possible to standardize the language as well as to develop new research based on the same model. With the intended goal of making available, the In-hospital Utstein Style for Brazilian professionals, this instrument underwent a process of translation and cultural adaptation in the following steps: translation into Portuguese, back-translation into its original language and finally analysis by a committee of judges to evaluate semantics, idiomatic, cultural and conceptual equivalences. The outcome of this process resulted in a pre-test instrument applied to 20 patients who had had CPA in order to verify the behavior of this instrument according to our reality. The outcome variables were not collected, because it involved accompanying these patients over a lengthy period of time. The sample consisted of 60% men, with an average age of 63 years ±16, 17. The most common CPA rhythm was pulseless electrical activity (65%); the defibrillation average time was 1.25 minutes. Therefore, as verified by international researchers, there is a loss of information during the attendance, which is not-recorded, thus hindering the collection of data concerning the moment of the CPA. With the data analysis, we can conclude that the instrument is adaptable to the Brazilian reality, enabling further comparisons with international studies, therefore improving the care administered during the CPA event. The failure to complete some of the items principally those referencing the variables of the CPA event (that should have been collected at the CPA moment) could result in critical data being lost if not properly answered in the report done by attending medical and nursing personnel. Personnel trained and encouraged to improve the quantity and quality of date collection can make it possible, through the utilization of the Utstein Style, to better understand each attendance and assistance rendered, identifying possible failures and, above all, enabling further investments in quality of life after the arrest

<p>Decentralized development approaches have in recent years gained wide acceptance in policy circles. In India the national and the state</p><p>governments have for a long time undertaken the primary responsibility for water management. In recent years however, there has been a clear shift of policy towards increased reliance on the local communities. This thesis deals with the capacity of rural communities in India to manage their water resources in a sustainable way.</p><p>Through a case study of water management in a South Indian village opportunities and barriers for rural communities in India to manage their water resources in a sustainable way is analysed. The thesis deals with both formal and informal institutions involved in the water management.Factors that can promote and obstruct locals’ contribution in water management are discussed. Also the role of external actors such as NGOs, the Panchayats and the government is dealt with, and how they may facilitate a development towards sustainability and increased locals’ contribution in order to achieve a sustainable community bases water management.</p><p>Theories on collective action and the commons have been used in the analysis. These theories deal with how to get people to cooperate regarding the management of common resources such as water in order to achieve higher collective benefits. The study is primarily based on 66 semistructured qualitative interviews with local water users in a village in Andhra Pradesh.</p> / <p>Decentralized development approaches have in recent years gained wide acceptance in policy circles. In India the national and the state</p><p>governments have for a long time undertaken the primary responsibility for water management. In recent years however, there has been a clear shift of policy towards increased reliance on the local communities. This thesis deals with the capacity of rural communities in India to manage their water resources in a sustainable way.</p><p>Through a case study of water management in a South Indian village opportunities and barriers for rural communities in India to manage their water resources in a sustainable way is analysed. The thesis deals with both formal and informal institutions involved in the water management.Factors that can promote and obstruct locals’ contribution in water management are discussed. Also the role of external actors such as NGOs, the Panchayats and the government is dealt with, and how they may facilitate a development towards sustainability and increased locals’ contribution in order to achieve a sustainable community bases water management.</p><p>Theories on collective action and the commons have been used in the analysis. These theories deal with how to get people to cooperate regarding the management of common resources such as water in order to achieve higher collective benefits. The study is primarily based on 66 semistructured qualitative interviews with local water users in a village in Andhra Pradesh.</p> / The ISRN in the pdf-file is incorrect. The correct ISRN is shown below.

För att patienten ska ha optimal chans till överlevnad är det av största vikt att rekommendationer i samtliga delar av kedjan som räddar liv följs. Sjuksköterskan är oftast bland de första på plats vid ett hjärtstopp på en vårdenhet, vilket gör det intressant att belysa vilka faktorer som påverkar överlevnaden efter hjärtstopp på sjukhus. Syftet med litteraturstudien var att belysa faktorer i behandlingen av hjärtstopp på sjukhus som påverkar överlevnaden. Genom en sammanställning och analys av vetenskapligt värderad litteratur utfördes en systematisk litteraturstudie i ämnet. Resultatet visade att en väl fungerande organisation, utbildning, monitorering och följsamhet till riktlinjer var framgångsfaktorer i behandling av hjärtstopp. En hjärt-lungräddningsorganisation behövs, vilken organiserar och kvalitetssäkrar utbildning, rutiner, riktlinjer, utrustning och uppföljning. Utbildning av all personal är en förutsättning för framgångsrik behandling. Sjuksköterskan har möjlighet att identifiera och initiera åtgärder, såsom monitorering, vid ett hjärtstopp på sjukhus för att ge patienten största chans till överlevnad. Följsamheten till rekommendationer är låg med risk för att patientens chans att överleva efter ett hjärtstopp minskas. Hjärtstopp på sjukhus har hittills inte varit föremål för forskning i samma mängd som hjärtstopp utanför sjukhus. Speciellt omvårdnadsforskning om åtgärder där sjuksköterskan kan påverka överlevnaden saknas. / In order to achieve the highest survival among patients suffering from in-hospital cardiac arrest, adherence to treatment guidelines are of utmost importance. A nurse is often among the first person on scene when in-hospital cardiac arrest occurs in a regular ward. For this reason, this study explores the factors that may affect survival. The aim of this literature study was to explore factors that affect survival among patients suffering from in-hospital cardiac arrest. Analysis was made on publications found by a systematic search in peer-reviewed publications in the field. The result emphasis the large impact of structure and organization in order to achieve high quality cardiac arrest treatment. There is a need for a centralized cardiopulmonary resuscitation (CPR) management structure in every hospital. This CPR managing group is vital in organizing guidelines, equipment, training and follow-up on treatment results. Training in CPR of all hospital staff is importance for treatment quality. The nurse has the possibility to identify and modify nursing factors such as monitoring level in order to increase chance of detection and thereby the chance of survival in case of cardiac arrest. Current adherence to treatment guidelines is low leading to lower chance of survival. CPR research has so far focused on out-of-hospital cardiac arrest, less focus has been spent on in-hospital cardiac arrest. In particular nursing science concerning areas were nurses are able to affect outcome is lacking.

O prognóstico após a parada cárdio-respiratória (PCR) e reanimação cardio-pulmonar (RCP) depende de intervenções críticas, particularmente, do tempo de resposta entre a chamada de socorro ou resgate, até a chegada ao local onde se encontra a vítima, além das compressões torácicas eficazes, da desfibrilação precoce e do suporte avançado de vida. Para avaliar a eficácia e a adequação dos procedimentos de RCP durante a PCR, entidades e associações científicas se reuniram e elaboraram o Utstein Style out-of-hospital, cujas definições e instrumento, usados para registro do evento, têm sido amplamente utilizadas em todo o mundo, bem como para estudos publicados sobre atendimento à parada cardíaca. A adoção de um instrumento de consenso internacional levou a uma grande evolução guidelines de reanimação e a progressos científicos, possibilitando a troca de informações mais efetivas para promover comparações internacionais em relação aos procedimentos de ressuscitação tendo como propósito codificar variáveis, mensurar aspectos do processo e avaliar resultados dos atendimentos na PCR fora do hospital. Apesar do grande numero de PCR que ocorre no Brasil, não há, até então, um instrumento em nosso idioma adaptado à nossa realidade. Este trabalho teve pro objetivos realizar a tradução e adaptação cultural do Utstein Style out-of-hospital, com base nos pressupostos metodológicos de Guillemin (2002). O instrumento foi, também, testado em dois centros de atendimento pré-hospitalar para verificar a viabilidade de sua utilização. Como resultado deste estudo metodológico obtivemos um instrumento traduzido para o idioma português, com algumas modificações necessárias para sua adaptação à cultura nacional, sugeridas por um comitê de juizes e cuja aplicação, ainda que em pré-teste, permitiu verificar que os resultados obtidos assemelham-se aos dados internacionais. O maior número de causas de PCR ocorreu em adultos do sexo feminino (58,8%), com idade acima de 29 anos. Grande parte das paradas cardíacas foi identificada por espectador (47,0%), pelo Serviço Médico de Emergência (35,5) e pelo médico (17,5%). Quanto à ocorrência da PCR, 82,4% foi por causa desconhecida e 17,6% por trauma / The prognostic after the cardiac arrest and cardio-pulmonary resuscitation (CPR) is dependent of critical interventions, particularly, time reply called until place, efficient chest compressions early defibrillation and the advanced life support. The definitions of the Utstein style and the instrument of register have been widely used in published studies of cardiopulmonary arrest (CPA), what it took to a great evolution and the progress for international consensuses on science and guidelines of resuscitation, making possible the exchange of information more effective to promote international auditorship in relation to the resuscitation procedures having as intention to codify variable, to measure aspects of the process and to evaluate resulted of the take care of in the CPA of the hospital. Currently several countries already use with this purpose. The Utstein was approved by the international committees. Although the great one number of CPA in Brazil, we did not possess an instrument in our language and adapted. This instrument underwent a process of translation into Portuguese, back-translation into its original language and finally analysis by a committee of judges to evaluate semantics, idiomatic, cultural and conceptual equivalences, with the authorization of the AHA, following the recommendations of Guillemin, revised in 2002. The instrument was tested in two centers the out-of-hospital attendance to verify the use of in the Brazilian country and making possible comparisons with international data, enriching adding the evolution of the CPR in the world. As result of this study we got an instrument translated into the Portuguese language, with some necessary modifications for its adaptation to the national culture, suggested for a committee of judges and whose application allowed verifying that the gotten results resemble it the international data. The biggest number of CPA causes occurred in adults, females (58.8%), with age above of 29 years. Great part of the CPA was identified by witness (47.0%), the Emergency Medical Service (35.5%) and by the physician (17.5%). Several occurrences of CPA, 82.4% it was for unknown cause and 17.6% for trauma

A parada cardiorrespiratória é um evento potencialmente letal, e a qualidade do atendimento prestado depende da agilidade, conhecimento e habilidade de toda a equipe envolvida. O desenvolvimento de um guia com os pontos relevantes a serem observados durante o atendimento à PCR intra-hospitalar surgiu em 1997, com a criação do In-Hospital Utstein Style por uma força tarefa de especialistas em atendimento e pesquisa em PCR. Trata-se de um guia que agrega informações acerca do atendimento à PCR, contendo um relatório padrão para coleta de dados, divido em variáveis: do paciente, do evento e de resultados, além de algumas informações adicionais. A criação de um relatório padrão de coleta de dados, permitiu uniformizar a linguagem, bem como o desenvolvimento de novas pesquisas, baseadas no mesmo modelo. Com a finalidade de disponibilizar o In-hospital Utstein Style para a realidade brasileira, este instrumento foi submetido ao processo de tradução e adaptação cultural, nas seguintes etapas: tradução para o português, retro-tradução para a língua de origem, análise por comitê de juízes para avaliação das equivalências semântica, idiomática, cultural e conceitual. O resultado deste processo gerou um instrumento para pré-teste, aplicado em 20 pacientes que sofreram PCR, com a finalidade de verificar o comportamento do instrumento em nossa realidade. As variáveis de resultado não foram coletadas, pois pressupõe o acompanhamento destes pacientes ao longo do tempo. A amostra foi constituída por 60,0% de homens, com idade média de 63 anos ±16,17. O ritmo de PCR mais comum foi atividade elétrica sem pulso (65,0%), o tempo médio para desfibrilar foi de 1,25 minutos. Assim como observado por pesquisadores internacionais, existem informações perdidas durante o atendimento, não registradas, prejudicando a coleta dos dados referentes a este momento. A análise dos dados, permite concluir que o instrumento é aplicável à realidade brasileira, tornando possíveis comparações com estudos internacionais, buscando melhor atendimento ao evento da PCR. A falta de preenchimento de alguns itens , principalmente aqueles referentes às variáveis do evento (coletados no momento da PCR), podem ser perdidos, por falta de preenchimento adequado do instrumento, por profissionais médicos e de enfermagem. O treinamento e incentivo para melhorar a quantidade e qualidade de registros, tornam possíveis, através da aplicação do Utstein Style conhecer cada atendimento feito e toda a assistência prestada, identificando prováveis falhas e principalmente investindo em qualidade de vida após o evento / Cardiopulmonary Arrest is a potentially lethal event in which the quality of the service rendered depends on agility, knowledge and the skills of all of the involved team. The development of the first guide identifying the significant points to be taken during the procedure of an in-hospital CPA appeared in 1997, with the creation of the In-Hospital Utstein Style by a task force of personnel specialized in attendance and research of CPA. This guide brings together information concerning CPA attendance and contains a standardized report for collecting data which is divided into the following variables: patient, event, and the outcome, as well as some other additional information. The creation of this standardized report for collecting data made it possible to standardize the language as well as to develop new research based on the same model. With the intended goal of making available, the In-hospital Utstein Style for Brazilian professionals, this instrument underwent a process of translation and cultural adaptation in the following steps: translation into Portuguese, back-translation into its original language and finally analysis by a committee of judges to evaluate semantics, idiomatic, cultural and conceptual equivalences. The outcome of this process resulted in a pre-test instrument applied to 20 patients who had had CPA in order to verify the behavior of this instrument according to our reality. The outcome variables were not collected, because it involved accompanying these patients over a lengthy period of time. The sample consisted of 60% men, with an average age of 63 years ±16, 17. The most common CPA rhythm was pulseless electrical activity (65%); the defibrillation average time was 1.25 minutes. Therefore, as verified by international researchers, there is a loss of information during the attendance, which is not-recorded, thus hindering the collection of data concerning the moment of the CPA. With the data analysis, we can conclude that the instrument is adaptable to the Brazilian reality, enabling further comparisons with international studies, therefore improving the care administered during the CPA event. The failure to complete some of the items principally those referencing the variables of the CPA event (that should have been collected at the CPA moment) could result in critical data being lost if not properly answered in the report done by attending medical and nursing personnel. Personnel trained and encouraged to improve the quantity and quality of date collection can make it possible, through the utilization of the Utstein Style, to better understand each attendance and assistance rendered, identifying possible failures and, above all, enabling further investments in quality of life after the arrest