ABSTRACT
Introduction: The treatment of COVID-19 is still challenge. So convalescent plasma can be an important alternative of treatment. Protocols with nursing care during infusion is very important to guide an effective and safety care. Objective: to analyze the evidence in the literature on the action of convalescent plasma, of the use of protocols with nursing care to use convalescent plasma and build a nursing care protocol for transfusion in patients with COVID-19. Methods: Methodological study carried out in two stages: scoping review. The search was done using the descriptors: convalescent plasma transfusion, convalescent plasma, and acute respiratory syndromes or COVID-19, to found protocols and effectiveness of convalescent plasm. Beside was done a specialist panel to build the protocol. Results: Low-evidence studies have shown improvement in the clinical signs of COVID-19 using Convalescent Plasma, reduction or elimination of viral load, benefits in the production of lymphocytes, decreases C-reactive protein, increases titers of anti-SARS-CoV-2 antibodies, positive evolution in lung involvement identified by X-rays, decrease in hospitalization. No studies were found in the databases on the protocol for clinical nursing care in plasma transfusion. Therefore, a protocol was developed with the description of clinical nursing care to be performed before, during and after the transfusion by plasma: checking of vital signs and indicative signs of transfusion reaction, measurement of oxygen saturation, assessment of venous access and checking of the level of consciousness. Conclusion: There are no evidence studies to support the use of plasma, nor anything related to bundles.
ABSTRACT
INTRODUCTION: Colonization of a pressure injury with microorganisms can negatively affect wound healing. Thus, it is necessary to evaluate which products best facilitate wound healing. OBJECTIVE: This case series evaluated the effectiveness of the antimicrobial polyhexamethylene biguanide (PHMB) on microorganisms in pressure injuries. MATERIALS AND METHODS: Fourteen patients (14 wounds) were treated with PHMB in the hospital setting after collection of a wound swab sample for microbiological analysis and determination of the risk profile using the disk diffusion method. RESULTS: Thirteen lesions (92.9%) were positive for 1 or more bacterial strains, the most prevalent of which were Staphylococcus aureus and Pseudomonas aeruginosa. Two strains of methicillin-resistant S aureus (MRSA) were also identified. Klebsiella pneumoniae demonstrated 100% resistance to the tested antibiotics, with Acinetobacter demonstrating 90% resistance, P aeruginosa 88.9%, Citrobacter freundii 87.5%, S aureus 66.7%, and MRSA 57.1%. Only Serratia marcescens demonstrated no resistance to any antibiotic tested. Polyhexamethylene biguanide was effective only against strains of S marcescens, which were not present in the second wound swab sample collected (after the application of PHMB); other microorganisms were present in the second wound swab sample collected. CONCLUSIONS: Polyhexamethylene biguanide has an immediate antimicrobial effect on S marcescens. However, it had no qualitative effect on the other microorganisms. Studies with larger populations and randomized clinical trial methodologies are necessary to elucidate additional findings concerning the effectiveness of PHMB in managing microorganisms in pressure injuries.
