A parada cardiorrespiratória (PCR) é uma situação que requer atuação imediata dos profissionais da saúde. Na maioria dos hospitais e unidades de saúde, a equipe de enfermagem é a primeira a chegar em casos de PCR, devendo ser competente em iniciar as manobras de ressuscitação cardiopulmonar (RCP). Dentre os procedimentos durante a RCP, a intubação endotraqueal é o padrão ouro para abordagem das vias aéreas, mas nem todos os profissionais de saúde estão aptos a realizá-la. A máscara laríngea é um dispositivo que permite a formação de um selo ao redor da laringe, oferecendo uma satisfatória alternativa para manejo das vias aéreas. O referencial teórico-metodológico utilizado foi o da Prática Baseada em Evidências, que preconiza a aplicação de resultados de pesquisas na prática profissional do enfermeiro. O estudo teve como objetivo identificar as evidências disponíveis na literatura sobre a abordagem de vias aéreas por meio da inserção da máscara laríngea pelo enfermeiro, na RCP, em pacientes adultos. A metodologia adotada foi a revisão integrativa da literatura cujo propósito é reunir e sintetizar o conhecimento sobre a temática proposta. As bases de dados acessadas foram: LILACS, PUBMED, CINAHL e COCHRANE com os descritores controlados laryngeal masks AND cardiopulmonary resuscitation AND nursing. Após leitura exaustiva dos artigos foram selecionadas 18 referencias. Os resultados evidenciaram que 66,5% dos estudos foram oriundos do Reino Unido, o periódico que apresentou maior número de publicações foi a Resuscitation (cinco), 50% dos estudos foram realizados somente por médicos, 28% somente por enfermeiros e 11% por ambos, conjuntamente. Em relação ao delineamento de pesquisa foram encontrados seis estudos (33,5%) de delineamento quaseexperimental, 12 (66,5%) de delineamento não-experimental, sendo três do tipo survey/descritivo/exploratório (25%), um prospectivo (8,5%) e oito relatos de experiência/opinião de especialista (66,5%). Os estudos foram agrupados em três momentos históricos (antes da publicação das diretrizes de RCP de 2000, entre as diretrizes de 2000 e 2005 e após as diretrizes de 2005). Verificou-se que o grande impacto dos estudos publicados na década de 90 foi evidenciado nas diretrizes de 2005, pois as embasaram e foram citados nas mesmas (estudos 1, 2, 3, 5, 7 e 9). Conclui-se que a mascara laríngea é de fundamental importância para manejo de vias aéreas em situações criticas, necessita de treinamento para sua utilização e, quando testada em manequins, mostrou-se eficaz, atingindo taxas de sucesso em sua inserção e nas ventilações, próximas a 100%. É um dispositivo de fácil manuseio e inserção, minimiza o risco de distensão gástrica, regurgitação e aspiração em relação à unidade bolsa-valva-máscara. A ausência de estudos com delineamento experimental acerca da temática, evidencia a necessidade de investigações cientificas envolvendo mascara laríngea, ressuscitação cardiopulmonar e enfermagem, com o intuito de subsidiar a pratica clínica do enfermeiro e sua tomada de decisão acerca do cuidado prestado ao paciente. Os enfermeiros atuaram nos estudos como sujeitos e puderam identificar, compreender e sinalizar aspectos relevantes dos atributos cognitivo, técnicos e demais habilidades para executarem tal intervenção, permitindo-se prestar assistência de enfermagem com qualidade e embasamento técnico-científico em situações de emergência. / Heart arrest (HA) is a situation that demands immediate action from health professionals. In most hospitals and health units, the nursing team is the first to arrive in cases of HA, and should be competent to start cardiopulmonary resuscitation (CPR) maneuvers. In CPR procedures, endotracheal intubation is the gold standard for the airways, but not all health professionals are apt to perform this procedure. The laryngeal mask is a device that permits forming a seal around the larynx, offering a satisfactory alternative for airway management. The theoretical-methodological reference framework of Evidence-Based Practice was used, which recommends that research results be applied in nurses professional practice. This study aimed to identify available evidence in literature about airway management by nurses through the insertion of the laryngeal mask, during CPR, in adult patients. The integrative literature review method was adopted, which aims to join and synthesize knowledge on the proposed theme. The following databases were accessed: LILACS, PUBMED, CINAHL and COCHRANE, using the controlled descriptors laryngeal masks AND cardiopulmonary resuscitation AND nursing. After exhaustive reading of the articles, 18 references were selected. The results evidenced that 66.5% of the studies came from the United Kingdom; the journal with the largest number of publications was Resuscitation (five); 50% of the studies was performed by physicians only, 28% by nurses only and 11% by both, in cooperation. As to research design, six studies (33.5%) had a quasiexperimental design and 12 (66.5%) a non-experimental design, with three survey/descriptive/exploratory studies (25%), one prospective study (8.5%) and eight experience reports/expert opinions (66.5%). Studies were grouped at three moments in time (before the publication of the 2000 CPR guidelines, between the 2000 and 2005 guidelines and after the 2005 guidelines). The strong impact of the studies published in the 1990s was evidenced in the 2005 guidelines, which constituted the base and were cited in that document (studies 1, 2, 3, 5, 7 and 9). It is concluded that the laryngeal mask is fundamentally important for airway management in critical situations, requires training for its use and showed its efficiency when tested on manikins, reaching success levels of nearly 100% for insertion and ventilations. The device is easy to manage and insert, minimizes the risk of gastric distension, regurgitation and aspiration of the bag-valve-mask unit. The lack of studies about the theme with an experimental design evidences the need for scientific research involving laryngeal mask, cardiopulmonary resuscitation and nursing, with a view to supporting clinical nursing practice and nurses decision making about patient care delivery. Nurses participated in the studies and could identify, understand and signal relevant aspects of the cognitive and technical attributes and other skills to perform this intervention, with a view to nursing care delivery with quality and theoretical-scientific support in emergency situations.

A parada cardiorrespiratória (PCR) é uma situação que requer atuação imediata dos profissionais da saúde. Na maioria dos hospitais e unidades de saúde, a equipe de enfermagem é a primeira a chegar em casos de PCR, devendo ser competente em iniciar as manobras de ressuscitação cardiopulmonar (RCP). Dentre os procedimentos durante a RCP, a intubação endotraqueal é o padrão ouro para abordagem das vias aéreas, mas nem todos os profissionais de saúde estão aptos a realizá-la. A máscara laríngea é um dispositivo que permite a formação de um selo ao redor da laringe, oferecendo uma satisfatória alternativa para manejo das vias aéreas. O referencial teórico-metodológico utilizado foi o da Prática Baseada em Evidências, que preconiza a aplicação de resultados de pesquisas na prática profissional do enfermeiro. O estudo teve como objetivo identificar as evidências disponíveis na literatura sobre a abordagem de vias aéreas por meio da inserção da máscara laríngea pelo enfermeiro, na RCP, em pacientes adultos. A metodologia adotada foi a revisão integrativa da literatura cujo propósito é reunir e sintetizar o conhecimento sobre a temática proposta. As bases de dados acessadas foram: LILACS, PUBMED, CINAHL e COCHRANE com os descritores controlados laryngeal masks AND cardiopulmonary resuscitation AND nursing. Após leitura exaustiva dos artigos foram selecionadas 18 referencias. Os resultados evidenciaram que 66,5% dos estudos foram oriundos do Reino Unido, o periódico que apresentou maior número de publicações foi a Resuscitation (cinco), 50% dos estudos foram realizados somente por médicos, 28% somente por enfermeiros e 11% por ambos, conjuntamente. Em relação ao delineamento de pesquisa foram encontrados seis estudos (33,5%) de delineamento quaseexperimental, 12 (66,5%) de delineamento não-experimental, sendo três do tipo survey/descritivo/exploratório (25%), um prospectivo (8,5%) e oito relatos de experiência/opinião de especialista (66,5%). Os estudos foram agrupados em três momentos históricos (antes da publicação das diretrizes de RCP de 2000, entre as diretrizes de 2000 e 2005 e após as diretrizes de 2005). Verificou-se que o grande impacto dos estudos publicados na década de 90 foi evidenciado nas diretrizes de 2005, pois as embasaram e foram citados nas mesmas (estudos 1, 2, 3, 5, 7 e 9). Conclui-se que a mascara laríngea é de fundamental importância para manejo de vias aéreas em situações criticas, necessita de treinamento para sua utilização e, quando testada em manequins, mostrou-se eficaz, atingindo taxas de sucesso em sua inserção e nas ventilações, próximas a 100%. É um dispositivo de fácil manuseio e inserção, minimiza o risco de distensão gástrica, regurgitação e aspiração em relação à unidade bolsa-valva-máscara. A ausência de estudos com delineamento experimental acerca da temática, evidencia a necessidade de investigações cientificas envolvendo mascara laríngea, ressuscitação cardiopulmonar e enfermagem, com o intuito de subsidiar a pratica clínica do enfermeiro e sua tomada de decisão acerca do cuidado prestado ao paciente. Os enfermeiros atuaram nos estudos como sujeitos e puderam identificar, compreender e sinalizar aspectos relevantes dos atributos cognitivo, técnicos e demais habilidades para executarem tal intervenção, permitindo-se prestar assistência de enfermagem com qualidade e embasamento técnico-científico em situações de emergência. / Heart arrest (HA) is a situation that demands immediate action from health professionals. In most hospitals and health units, the nursing team is the first to arrive in cases of HA, and should be competent to start cardiopulmonary resuscitation (CPR) maneuvers. In CPR procedures, endotracheal intubation is the gold standard for the airways, but not all health professionals are apt to perform this procedure. The laryngeal mask is a device that permits forming a seal around the larynx, offering a satisfactory alternative for airway management. The theoretical-methodological reference framework of Evidence-Based Practice was used, which recommends that research results be applied in nurses professional practice. This study aimed to identify available evidence in literature about airway management by nurses through the insertion of the laryngeal mask, during CPR, in adult patients. The integrative literature review method was adopted, which aims to join and synthesize knowledge on the proposed theme. The following databases were accessed: LILACS, PUBMED, CINAHL and COCHRANE, using the controlled descriptors laryngeal masks AND cardiopulmonary resuscitation AND nursing. After exhaustive reading of the articles, 18 references were selected. The results evidenced that 66.5% of the studies came from the United Kingdom; the journal with the largest number of publications was Resuscitation (five); 50% of the studies was performed by physicians only, 28% by nurses only and 11% by both, in cooperation. As to research design, six studies (33.5%) had a quasiexperimental design and 12 (66.5%) a non-experimental design, with three survey/descriptive/exploratory studies (25%), one prospective study (8.5%) and eight experience reports/expert opinions (66.5%). Studies were grouped at three moments in time (before the publication of the 2000 CPR guidelines, between the 2000 and 2005 guidelines and after the 2005 guidelines). The strong impact of the studies published in the 1990s was evidenced in the 2005 guidelines, which constituted the base and were cited in that document (studies 1, 2, 3, 5, 7 and 9). It is concluded that the laryngeal mask is fundamentally important for airway management in critical situations, requires training for its use and showed its efficiency when tested on manikins, reaching success levels of nearly 100% for insertion and ventilations. The device is easy to manage and insert, minimizes the risk of gastric distension, regurgitation and aspiration of the bag-valve-mask unit. The lack of studies about the theme with an experimental design evidences the need for scientific research involving laryngeal mask, cardiopulmonary resuscitation and nursing, with a view to supporting clinical nursing practice and nurses decision making about patient care delivery. Nurses participated in the studies and could identify, understand and signal relevant aspects of the cognitive and technical attributes and other skills to perform this intervention, with a view to nursing care delivery with quality and theoretical-scientific support in emergency situations.

<p>Hjärtlungräddning (HLR) är en direkt livsavgörande kunskap och förväntningar på att sådan kunskap finns bland sjukhuspersonal är trolig. Syftet med studien var att kartlägga utbildning i och attityder till undervisning i HLR bland all personal som arbetar på ett mindre sjukhus i södra Sverige. En enkät bestående av fjorton frågor besvarades av 151 personer via sjukhusets intranät. Majoriteten av svaren kom från sjuksköterskor och undersköterskor, övriga yrkeskategorier fanns också representerade fast i mindre omfattning. Majoriteten var nöjd med nuvarande HLR utbildning och de flesta önskade regelbunden utbildning. Upplevelsen av att befintliga kunskaper var tillräckliga instämde endast hälften i och likaså att handlandet i samband med hjärtstopp kändes adekvat. Anledningen till ovanstående resultat kan bara spekuleras kring men tidigare forskning pekar på att faktorer som oerfarenhet, stress, etiska dilemman och bristande HLR utbildning kan bidra till sådana upplevelser. Slutsatsen kan dras att regelbunden HLR utbildning bör ske enligt gängse riktlinjer samt att all sjukhuspersonal erbjuds, även de som inte är direkt involverade i patientomvårdnaden. Åtgärder för att förbättra kunskap och handlande i samband med hjärtstopp kan t ex göras genom tillgång till enkla återupplivningsdockor med feedback möjlighet och erbjudande om debriefing efter hjärtstopp. Kommande forskning bör fokusera på personers upplevelse av kunskap och handlande i samband med hjärtstopp relaterat till HLR utbildning.</p>

Hjärtlungräddning (HLR) är en direkt livsavgörande kunskap och förväntningar på att sådan kunskap finns bland sjukhuspersonal är trolig. Syftet med studien var att kartlägga utbildning i och attityder till undervisning i HLR bland all personal som arbetar på ett mindre sjukhus i södra Sverige. En enkät bestående av fjorton frågor besvarades av 151 personer via sjukhusets intranät. Majoriteten av svaren kom från sjuksköterskor och undersköterskor, övriga yrkeskategorier fanns också representerade fast i mindre omfattning. Majoriteten var nöjd med nuvarande HLR utbildning och de flesta önskade regelbunden utbildning. Upplevelsen av att befintliga kunskaper var tillräckliga instämde endast hälften i och likaså att handlandet i samband med hjärtstopp kändes adekvat. Anledningen till ovanstående resultat kan bara spekuleras kring men tidigare forskning pekar på att faktorer som oerfarenhet, stress, etiska dilemman och bristande HLR utbildning kan bidra till sådana upplevelser. Slutsatsen kan dras att regelbunden HLR utbildning bör ske enligt gängse riktlinjer samt att all sjukhuspersonal erbjuds, även de som inte är direkt involverade i patientomvårdnaden. Åtgärder för att förbättra kunskap och handlande i samband med hjärtstopp kan t ex göras genom tillgång till enkla återupplivningsdockor med feedback möjlighet och erbjudande om debriefing efter hjärtstopp. Kommande forskning bör fokusera på personers upplevelse av kunskap och handlande i samband med hjärtstopp relaterat till HLR utbildning.

Syftet med studien var att utifrån ambulanssjuksköterskors berättelser redogöra för upplevelsen av arbetet med HLR vid ett pre-hospitalt omhändertagande och hur fysiska och psykosociala omständigheter kan påverka deras arbetsmiljö samt att undersöka om det automatiska HLR-systemet LUCAS har påverkat arbetssituationen. En kvalitativ intervjustudie med deskriptiv design har genomförts. Undersökningsgruppen bestod av sex ambulanssjuksköterskor på en ambulansstation i Mellansverige. Intervjuerna genomfördes med semistrukturerade frågor och insamlat material analyserades utifrån en kvalitativ innehållsanalys. Utifrån analysen framkom tre kategorier samt temat ”Att känna stöd på arbetsplatsen trots brister i arbetsmiljön”. Resultatet visade att ambulanssjuksköterskorna upplevde arbetsutrymmet i somliga ambulanser så begränsande att det försvårade deras möjlighet att utföra adekvata vårdåtgärder, de upplevde sig vara beroende av LUCAS för att kunna utföra HLR. De upplevde ett svagt stöd från cheferna i frågan om inköp av ambulanser. Vidare framkom att samarbetet med räddningstjänsten var ett viktigt stöd vid HLR samt att en god stämning på arbetsplatsen främjade välbefinnandet. De riktlinjer som ambulanssjuksköterskorna hade att rätta sig efter upplevdes också som ett stöd, samt att det nya HLR-systemet LUCAS till stor del upplevdes avlastande i arbetet med HLR. Författarnas slutsats är att det finns både positiva och negativa upplevelser kring arbetsmiljön bland ambulanssjuksköterskorna och att det behövs mer forskning för att kunna förbättra ambulanssjuksköterskornas arbetsmiljö. / The aim of the study was to describe the ambulance nurses’ own experiences of working with pre-hospital CPR and how the physical and psychosocial factors effected their working environment. To investigate if the automatic CPR-system LUCAS have had any impact on their work situation. This study is based on qualitative interviews with a descriptive design. The study group consisted of six nurses who worked at an ambulance station in the central part of Sweden. The interviews were conducted with semi structured questions and the collected data was analyzed through a qualitative content analysis. The analysis resulted in three categories and a theme. The result showed that the ambulance nurses experienced that the space in some of the ambulances was too limited to be able to provide necessary care for their patients, they experienced being dependent to the LUCAS-device to be able to perform CPR. The ambulance nurses also felt a weak support from the head management when deciding on which ambulance to purchase. Furthermore, it appeared that the cooperation with the emergency services was of a great support when performing CPR as well as creating a good atmosphere between co-workers was of importance for the employee’s wellbeing. The guidelines for the ambulance nurses were also seen as a support as were the new automatic CPR-system LUCAS, which perceived as minimizing the workload on the ambulance personnel during CPR. The authors’ conclusion is that both positive and negative experiences were found in the ambulance personnel´s work environment and that more studies are required in order to improve the ambulance personnel’s work milieu.

Low survival rates following out-of-hospital cardiac arrest (OHCA) remain a serious health concern internationally. Early bystander cardiopulmonary resuscitation (CPR) and rapid defibrillation can increase the chances of survival dramatically. However, the number of OHCA patients who receive these interventions remains low. This study sought to characterize Canadian public knowledge, attitudes and willingness to perform both traditional and chest-compression-only CPR using a two-phase, mixed methods approach. Twenty-one qualitative interviews were conducted, the results of which informed an online, scenario-based, Canada-wide survey. Significant knowledge gaps regarding recognition of cardiac arrest, the precise steps of CPR and perceived survival rate were identified and common to both phases. A larger proportion of survey respondents demonstrated a willingness to perform chest-compression-only CPR compared to traditional CPR in general, and specifically in situations involving strangers and unkempt individuals. Knowledge gaps and misconceptions seem to dominate the public perspective, leading to the recommendation for a tailored knowledge translation solution.

Low survival rates following out-of-hospital cardiac arrest (OHCA) remain a serious health concern internationally. Early bystander cardiopulmonary resuscitation (CPR) and rapid defibrillation can increase the chances of survival dramatically. However, the number of OHCA patients who receive these interventions remains low. This study sought to characterize Canadian public knowledge, attitudes and willingness to perform both traditional and chest-compression-only CPR using a two-phase, mixed methods approach. Twenty-one qualitative interviews were conducted, the results of which informed an online, scenario-based, Canada-wide survey. Significant knowledge gaps regarding recognition of cardiac arrest, the precise steps of CPR and perceived survival rate were identified and common to both phases. A larger proportion of survey respondents demonstrated a willingness to perform chest-compression-only CPR compared to traditional CPR in general, and specifically in situations involving strangers and unkempt individuals. Knowledge gaps and misconceptions seem to dominate the public perspective, leading to the recommendation for a tailored knowledge translation solution.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2007. / Härtill 5 uppsatser.

Thesis (M.S.)--University of Michigan, 1970.

Thesis (M.S.)--University of Michigan, 1970.