Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

OBJECTIVES: To analyze the influence of lying in prone position on a specially designed stretcher on the maternal-fetal hemodynamic parameters and comfort of pregnant women. METHODS: A randomized, controlled trial with 33 pregnant women divided into 2 groups: pregnant group sequence 1 and pregnant group sequence 2. The order of positions used in sequence 1 was Fowler’s position, prone position, supine position, left lateral, Fowler’s position 2, supine position 2, prone position 2 and left lateral 2. The order of positions used in sequence 2 was Fowler’s position, prone position, left lateral, supine position, Fowler’s position 2, left lateral 2, prone position 2 and supine position 2. Each woman remained in each position for 6 minutes. For the statistical analyses, we used Wilcoxon’s test for 2 paired samples when comparing the prone position with the other positions. The variables are presented in graphs showing the means and 95% confidence intervals. Trial Registration: Clinical Trial No. ISRCTN41359519 RESULTS: All the parameters were within the standards of normality. There were no differences between positions in terms of maternal heart rate, diastolic blood pressure, oxygen saturation and fetal heart rate. However, there were significant decreases in respiratory rate and systolic blood pressure in prone position 2 compared with left lateral 2. There was an increase in oxygen saturation in prone position compared with Fowler’s position and supine position 2 in both sequences. All the women reported feeling comfortable in the prone position. CONCLUSIONS: The prone position was considered safe and comfortable and could be advantageous for improving oxygen saturation and reducing the systolic blood pressure and respiratory rate.

Definição de fluxo funcional e rotina na liberação das macas retidas nas grandes emergências do estado de Pernambuco / Definition of functional and routine flow in releasing stretchers retained in major emergencies in the state of Pernambuco

Este trabalho de intervenção propõe implantação de um fluxo funcional para os serviços de urgência/emergência hospitalar, que compõem a rede de referência macrorregional em Pernambuco. Aborda critérios relativos à estrutura (física-organizacional, recursos materiais e humanos) e ao processo (atividades de rotina), apontando que as Unidades Hospitalares devem possuir um fluxo de rotina funcional para a liberação das macas dos serviços de atendimento móvel de urgência como as viaturas do SAMU 192 e do Corpo de Bombeiros Militar de Pernambuco (CBMPE). Como também a buscativa de melhorar o desempenho quanto ao processo de trabalho (resgate, admissão no hospital e liberação da maca de resgate); Os resultados nesse trabalho evidenciam sua racionalidade, coerência, consistência e factibilidade (termos técnicos, econômicos e políticos) considerando-o válido e aceito pelos envolvidos no processo e na sua execução em todos os espaços possíveis, pois segue na direção da resolução do problema, contribuindo para o debate e o desenvolvimento de políticas públicas intersetoriais.(AU)

Innovación tecnológica y humanitarismo en el traslado de heridos de guerra: el informe de Nicasio Landa sobre un nuevo sistema de suspensión elástica de camillas (Pamplona, 29 mayo 1875) / Technological innovation and humanitarianism in the transport of war wounded: Nicasio Landa’ s report on a new elastic suspension system for stretchers (Pamplona, May 29, 1875)

Resumen En mayo de 1875, en medio de una sangrienta contienda civil en España conocida como Tercera Guerra Carlista, Nicasio Landa, oficial médico de Sanidad Militar redactó un informe demandando autorización a sus superiores para que Cruz Roja Española, de la que era inspector general, pudiera adoptar un nuevo sistema de suspensión elástica para camillas que había diseñado, desarrollado y probado. Destinado ante todo a carretas de labranza – el medio de transporte de heridos aún más frecuente entonces – se presentaba como un mecanismo económico y resistente para mejorar el confort de los trasladados, que podía también instalarse en carruajes de ambulancia, vagones de ferrocarril y buques-hospitales. Se publica una edición anotada del informe precedida de una presentación del mismo.

Abstract In May 1875, in the midst of a bloody civil conflict in Spain known as the Third Carlist War, Nicasio Landa, a medical officer with Military Health, wrote a report requesting authorization for the Spanish Red Cross, of which he was Inspector General, to adopt a new elastic suspension system for stretchers that he had designed, developed and tested. Intended above all for use in farm wagons – still the most widely-used method of transporting the wounded at the time – it was an inexpensive, sturdy mechanism that improved patient comfort and could also be installed in ambulance carriages, railway carriages and hospital ships. An annotated version of the report is included, preceded by a presentation of its contents.