• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 51
  • 43
  • 37
  • 10
  • 7
  • 2
  • 2
  • 2
  • 1
  • 1
  • 1
  • Tagged with
  • 162
  • 162
  • 69
  • 59
  • 55
  • 49
  • 46
  • 33
  • 33
  • 25
  • 24
  • 24
  • 24
  • 20
  • 20
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
131

Tradução e validação para a língua portuguesa do \"in - hospital utstein style\" / Translation and validation of the \"in - hospital utstein style\" into portuguese language

Avansi, Patricia do Amaral 21 May 2007 (has links)
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
132

Mort subite au cours d’une activité sportive : étude en population générale / Sports-related sudden death : study in the general population

Marijon, Eloi 13 September 2013 (has links)
Contexte ─ L’incidence, les caractéristiques, et le pronostic (vital et fonctionnel) de la mort subite du sportif n’ont pas été étudiés en population générale. Méthodes ─ Etude observationnelle prospective menée par l’Institut National de la Santé et de la Recherche Médicale en collaboration avec le Service d’Aide Médicale Urgente (SAMU) dans 60 départements français (2005–2010) incluant les sujets de 10 à 75 ans présentant une mort subite (récupérée ou non) au cours d’une activité sportive de loisir ou de compétition. La détection des cas a été assurée par deux sources indépendantes. L’information a été recueillie selon le modèle d’Utstein. Les incidences ont été calculées par million d’habitants et million de participants sportifs, en considérant les 20ème et 80ème percentiles des départements les plus participants. Des analyses complémentaires ont été menées chez les femmes et pour les sports les plus en cause. Compte tenu de disparités régionales importantes en termes de survie, la distribution des facteurs (individuels et communautaires) classiquement associés à la survie (à la sortie de l’hôpital) a été examinée dans 4 groupes de survie (<10%, 10–20, 20–40, et >40%). L’analyse des facteurs associés à la survie a été effectuée par régression logistique.Résultats ─ Au total, 820 cas ont été collectés, et l’incidence totale a été évaluée entre 5 et 17 cas par million d’habitants par an en France. Seulement 6% des cas sont survenus chez le jeune athlète de compétition. Après considération des taux de participation sportive, l’incidence chez l’homme a été estimée entre 11,2 (95% IC 10,4–12,1) et 33,8 (95% IC 30,9–36,8) cas par million de participants et par an, l’incidence chez la femme étant, en comparaison avec l’homme, extrêmement faible, en particulier chez les 40–54 ans avec un risque relatif de 0,03 (95% IC 0,01–0,07). L’incidence augmentait significativement avec l’âge chez l’homme (risque relatif 2,51, 95 % IC 2,10–3,01, quand âge >35 ans), et était plus importante dans certains sports (cyclisme vs. natation, p<0,0001). L’âge moyen des sujets était de 46±15 ans. Des antécédents cardiovasculaires étaient rapportés dans 12% des cas. Le taux de survie moyen à la sortie de l’hôpital était de 15,7% (95% IC 13,2–18,2), avec cependant des disparités départementales majeures (de 0 à 47%), alors que le pronostic neurologique restait favorable chez 80% des survivants. La description en 4 groupes de survie a démontré l’absence de différence significative en termes de caractéristiques des sujets, de circonstances de survenue, de délai de prise en charge, et de mortalité intra-hospitalière. A l’inverse, des différences majeures ont été observées concernant l’initiation du massage cardiaque par le témoin (15% à 81%, p<0,001), le rythme initialement choquable (29% à 79%, p<0,001), le niveau de formation de la population aux premiers secours (p<0,001) et la densité de défibrillateurs extra-hospitaliers dans le département (p<0,001). Le défibrillateur n’a que rarement été utilisé par les témoins avant l’arrivée des premiers secours (<1%). Au final, les facteurs individuels suivants étaient indépendamment associés à la survie à la sortie de l’hôpital : massage cardiaque par témoin (OR 3,73, 95% IC 2,19–6,39, p<0,0001), délai d’intervention (OR 1,32, 95% IC 1,08–1,61, p=0,006), présence d’un rythme choquable initial (OR 3,71, 95% IC 2,07–6,64, p<0,0001). Après ajustement sur les facteurs pronostiques individuels, seul le niveau de formation de la population aux premiers secours restait associé de façon significative à la survie (OR 1,64, 95% IC 1,17–2,31, p=0,004).Conclusions et perspectives ─ La mort subite est un problème de santé publique faisant intervenir les pompiers, le SAMU, les réanimateurs, les cardiologues, les épidémiologistes. Sa prise en charge est nécessairement multidisciplinaire et les progrès viendront d’une action concertée de santé publique. Concernant la mort subite du sportif, nos conclusions sont que (...) / Background – Although such data are available for young competitive athletes, the prevalence, characteristics and outcome of sports-related sudden cardiac death have not previously been assessed in the general population.Methods – A prospective and comprehensive national survey was carried out throughout France by the French Institute of Health and Medical Research from 2005 to 2010, involving subjects aged 10–75 years. Case detection for sports-related sudden cardiac death, during competitive or leisure activities, including resuscitated cardiac arrest, was undertaken via emergency medical services (Service d’Aide Médicale Urgente, SAMU) reporting and web-based screening of media releases. Data were collected according to Utstein’s style. Incidence calculations were reported by million of inhabitants as well as million of sports participants. Specific analyses were also carried out among women and specific sports. After having documented major regional survival disparities, we identified to which extent conventional evidence-based individual factors, known to be associated to survival, were distributed among different groups of survival. Moreover, we assessed if functional outcome was variable among groups of survival. Factors associated with survival were analyzed using regression logistic model.Results – The overall burden of sports-related sudden cardiac death was estimated between 5 and 17 cases per million inhabitants per year. Only 6% of cases occurred among young competitive athletes, with a specific incidence calculated to 9.8 (95% CI 3.7–16.0) per million per year. After considering participation rates, incidence in men sport participants was estimated from 11.2 (95% CI 10.4–12.1) to 33.8 (95% CI 30.9–36.8) per million of participants per year, dramatically higher than women-related incidence, particularly in the 45–54 year range (relative risk 0.03, 95% CI 0.01 to 0.07). By contrast with women, the incidence of sports-related sudden cardiac death in men significantly increased over age categories (p<0.0001), and incidence rates were substantially higher in men aged >35 years than men aged 35 years or less (RR 2.51, 95% CI 2.10–3.01). The mean survival rate at hospital discharge was 15.7% (95% CI 13.2–18.2), with major regional disparities among districts (from 0 to 47%), with however a highly similar favorable neurological outcome (80%). No difference was observed regarding subjects’ characteristics and circumstances of occurrence (including presence of witnesses, delays of intervention and public use of automatic external defibrillators) across survival groups. By contrast, major differences were noted regarding bystander initiation of cardiopulmonary resuscitation (15% to 81%, p<0.001) and presence of initial shockable rhythm (29% to 79%, p<0.001). Public use of automatic external defibrillator was dramatically low (<1%). Independent factors for survival included bystander cardiopulmonary resuscitation (OR 3.73, 95% CI 2.19–6.39, p<0.0001), initial shockable rhythm (OR 3.71, 95% CI 2.07–6.64, p<0.0001) and short delay between cardiac arrest and resuscitation (OR 1.32, 95% CI 1.08–1.61, p=0.006). After adjustment on individual factors, only population education to Basic Life Support was significantly associated with survival (OR 1.64, 95% CI 1.17–2.31, p=0.004).Conclusions and perspectives – Sudden cardiac death is a public health issue, with the need for a multidisciplinary approach involving Emergency Cares, Cardiology, and Epidemiology. Regarding sports-related sudden death, our conclusions are the following (...)
133

Cardiopulmonary Resuscitation : Pharmacological Interventions for Augmentation of Cerebral Blood Flow

Johansson, Jakob January 2004 (has links)
<p>Cardiac arrest results in immediate interruption of blood flow. The primary goal of cardiopulmonary resuscitation (CPR) is to re-establish blood flow and hence oxygen delivery to the vital organs. This thesis describes different pharmacological interventions aimed at increasing cerebral blood flow during CPR and after restoration of spontaneous circulation (ROSC).</p><p>In a porcine model of cardiac arrest, continuous infusion of adrenaline generated higher cortical cerebral blood flow during CPR as compared to bolus administration of adrenaline. While bolus doses resulted in temporary peaks in cerebral blood flow, continuous infusion led to a sustained increase in this flow.</p><p>Administration of vasopressin resulted in higher cortical cerebral blood flow and a lower cerebral oxygen extraction ratio as compared to continuous infusion of adrenaline during CPR. In addition, vasopressin generated higher coronary perfusion pressure during CPR and increased the likelihood of achieving ROSC.</p><p>Parameters of coagulation and inflammation were measured after successful resuscitation from cardiac arrest. Immediately after ROSC, thrombin-antithrombin complex, a marker of thrombin generation, was elevated and eicosanoid levels were increased, indicating activation of coagulation and inflammation after ROSC. The thrombin generation was accompanied by a reduction in antithrombin. In addition, there was substantial haemoconcentration in the initial period after ROSC.</p><p>By administration of antithrombin during CPR, supraphysiological levels of antithrombin were achieved. However, antithrombin administration did not increase cerebral circulation or reduce reperfusion injury, as measured by cortical cerebral blood flow, cerebral oxygen extraction and levels of eicosanoids, after ROSC. </p><p>In a clinical study, the adrenaline dose interval was found to be longer than recommended in the majority of cases of cardiac arrest. Thus, the adherence to recommended guidelines regarding the adrenaline dose interval seems to be poor. </p>
134

Cardiopulmonary Resuscitation : Pharmacological Interventions for Augmentation of Cerebral Blood Flow

Johansson, Jakob January 2004 (has links)
Cardiac arrest results in immediate interruption of blood flow. The primary goal of cardiopulmonary resuscitation (CPR) is to re-establish blood flow and hence oxygen delivery to the vital organs. This thesis describes different pharmacological interventions aimed at increasing cerebral blood flow during CPR and after restoration of spontaneous circulation (ROSC). In a porcine model of cardiac arrest, continuous infusion of adrenaline generated higher cortical cerebral blood flow during CPR as compared to bolus administration of adrenaline. While bolus doses resulted in temporary peaks in cerebral blood flow, continuous infusion led to a sustained increase in this flow. Administration of vasopressin resulted in higher cortical cerebral blood flow and a lower cerebral oxygen extraction ratio as compared to continuous infusion of adrenaline during CPR. In addition, vasopressin generated higher coronary perfusion pressure during CPR and increased the likelihood of achieving ROSC. Parameters of coagulation and inflammation were measured after successful resuscitation from cardiac arrest. Immediately after ROSC, thrombin-antithrombin complex, a marker of thrombin generation, was elevated and eicosanoid levels were increased, indicating activation of coagulation and inflammation after ROSC. The thrombin generation was accompanied by a reduction in antithrombin. In addition, there was substantial haemoconcentration in the initial period after ROSC. By administration of antithrombin during CPR, supraphysiological levels of antithrombin were achieved. However, antithrombin administration did not increase cerebral circulation or reduce reperfusion injury, as measured by cortical cerebral blood flow, cerebral oxygen extraction and levels of eicosanoids, after ROSC. In a clinical study, the adrenaline dose interval was found to be longer than recommended in the majority of cases of cardiac arrest. Thus, the adherence to recommended guidelines regarding the adrenaline dose interval seems to be poor.
135

Cerebral Protection in Experimental Cardiopulmonary Resuscitation : With Special Reference to the Effects of Methylene Blue

Miclescu, Adriana January 2009 (has links)
Although survival rates are increasing, brain injury continues to be a leading cause of death after cardiac arrest (CA). Permanent brain damage after CA is determined by limited tolerance to ischemia from CA and cardiopulmonary resuscitation (CPR), as well as the unique cerebral response to reperfusion after return of spontaneous circulation (ROSC). A major pathway leading to neurotoxic cascade and neuronal injury after CA involves the increased presence of reactive oxygen and nitrogen species generated during ischemia and reperfusion. The magnitude of cerebral oxidative injury induced by free radicals increased with the duration of CA (Paper I). Nitric oxide (NO), a free radical responsible for the formation of reactive nitrogen species, is increased during global ischemia from CA and reperfusion (Paper IV). Hypothetically, the administration of a drug that counteracts the overproduction of NO and also acts as a scavenger of oxygen free radicals might be warranted in order to reduce the damage caused by nitrosative and oxidative stress. For these purposes we used methylene blue (MB), an old dye that has been used in medicine for almost half a century, and an experimental pig model of 20 min of ventricular fibrillation (VF) to reflect a clinical scenario of ischemia/reperfusion injury. Administration of MB added to a hypertonic-hyperoncotic solution (MBHSD) that was started during CPR and continued for 50 min after ROSC increased short-term survival by decreasing myocardial damage, as well as cerebral peroxidation and inflammatory injury (Paper II). Immunostaining of cerebral tissue collected at different time points after CA and ROSC (Paper IV) provided experimental evidence that cortical blood-brain barrier (BBB) disruption begins as early as  during the initial phase of untreated as well as treated CA. The results indicated that MB administration reduced the neurologic injury and BBB disruption considerably, but did not reverse the ongoing detrimental processes. The demonstrated positive effects of MB were related to a decrease of nitrite/nitrate tissue content, and thus to a decrease of excess NO due to the MB inhibitory effects on NOS isoforms. A mixture of MB in hypertonic sodium lactate (MBL) was investigated to facilitate administration of MB in “the field.” Based on findings that MBL cardio- and neuroprotective properties were similar to those of MBHSD, there is reason to believe that the use of MBL might be extended during ongoing CPR and after ROSC (Paper III). It would therefore make sense to try using MB as a pharmacological neuroprotectant during or after clinical CPR in order to expand the temporal therapeutic window before other measures for neuroprotection such as hypothermia are available.
136

Från hjärtstopp till hjärtstart på sjukhus : Vilka faktorer påverkar överlevnaden? / From heart arrest to heartbeat in hospital : What factors affect survival?

Schjetlein, Anne-Marie January 2011 (has links)
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.
137

Strukturelle Erwägungen zur Implementierung der automatisierten externen Defibrillation im Landkreis Göttingen / Structural thoughts for implementing of automated external defibrillators in the district of Goettingen

Strutz, Joanna 16 April 2012 (has links)
No description available.
138

Znalosti žáků středních škol v oblasti poskytování první pomoci ve vybrané lokalitě Jihočeského kraje / Knowledge od secondary school pupils in the field of first aid in a selected locality of the South Bohemian region

PETROVIČ, Pavel January 2018 (has links)
This diploma thesis was compiled on the topic of first aid. First aid is always actual problem, which needs attention. It is suitable to start with the first aid education at a very young age and throughout the years add more difficult situations first aid in CBRNE substance attack, first aid in extraordinary situations (floods, car accidents with a big number of injured). The aim of the thesis was to find out the knowledge of the pupils in secondary schools about providing the first aid, and subsequent comparation of the results between secondary medical school and other, nonmedical schools. The knowledge of the first aid was found out by means of questionnaires. In this statistical research were involved 400 pupils form 5 secondary schools in the South Bohemian region, including one secondary medical school. The questionnaires were evaluated and processed. To verify the hypotheses, x2 test of a good match was used (to verify the normality) and a t-test was used as well, to verify zero and alternative hypotheses. The pupils of secondary medical school reached in questioning research better results than pupils of nonmedical schools. Therefore it was possible to accept set hypotheses. The secondary schools, which took part in the statistical research, were provided with a feedback. This diploma thesis could serve as a study material, eventually also as a motive for other qualification theses. According to my opinion, a thesis about knowledge of pedagogues about providing the first aid would be beneficial.
139

Tradução para o português e validação de um instrumento de avaliação de qualidade de ressuscitação cardio-pulmonar no atendimento pré hospitalar: utstein style / Translation and validation of the utstein style out of hospital into portuguese language

Adriana Mandelli Garcia 22 May 2007 (has links)
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
140

Tradução e validação para a língua portuguesa do \"in - hospital utstein style\" / Translation and validation of the \"in - hospital utstein style\" into portuguese language

Patricia do Amaral Avansi 21 May 2007 (has links)
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

Page generated in 0.3304 seconds