Norma técnica de los centros de atención prehospitalaria móviles: acuerdo ministerial No. 221-2015 / Technical standard for mobile prehospital care centers: ministerial agreement No. 221-2015

El documento tiene algunos problemas de nitidez, que dificultan un tanto su lectura. Su objetivo es la regulación del procedimiento de autorización y funcionamiento en dichas unidades móviles (tipo ambulancia). Se establecen así mismo, los requisitos y características que deberán cumplirse en estas unidades, tanto terrestres, marítimas como aéreas. Esto incluye al personal que las maneja. Incluye un listado de términos técnicos referidos al tema principal. Presenta también las características técnicas así como el perfil del personal que las maneja además de la infraestructura y el equipo de deben contener para proveer del cuidado médico adecuado.

A implantação do projeto de atendimento Móvel de Urgência em Salvador/BA: panorama e desafios / Implantation of the Emergency Ambulance Service in Salvador, Bahia: reality and challenges / La implantación del proyecto de Atención de Urgencia Móvil en Salvador/BAHIA: panorama y retos

O estudo objetivou relatar a experiência na implantação e estruturação do projeto do Serviço Móvel de Urgência (SAMU-192), em Salvador, cujas bases legais foram portarias do Ministério da Saúde e a Norma Operacional de Assistência à Saúde 02/2002. O serviço tem como finalidade prestar assistência gratuita ao indivíduo, em um primeiro nível de atenção, com agravos de natureza clínica, cirúrgica, traumática e psiquiátrica que acarretam sofrimento, seqüelas ou morte e ocorrem fora do ambiente hospitalar. O objetivo específico foi garantir o atendimento às situações de urgência e emergência por meio do SAMU-192, regulado, hierarquizado e integrado ao Sistema Único de Saúde, assegurando recursos públicos inclusive integrados à rede complementar de assistência. Despesas para sua instalação foram pactuadas no município e em comissões intergestoras federal e estadual. Os desafios do serviço incluem educação comunitária, capacitação profissional, avaliação de recursos humanos e materiais, na dinâmica e qualidade da atenção.

The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192). The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS) of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.

El estudio tuvo por objetivo narrar la experiencia sobre la implantación y estructuración del proyecto de Servicio de Urgencia Móvil (SAMU-192) en Salvador, basado legalmente por decretos del Ministerio de Salud y la Norma Operacional de Asistencia a la Salud 02/2002. La finalidad del servicio es brindar asistencia gratuita fuera del hospital al individuo en un primer nivel de atención, en casos de tipo clínico, quirúrgico, traumático y psiquiátrico que provocan sufrimiento, secuelas o muerte. El objetivo específico fue garantizar la atención en casos de urgencia y emergencia a través del SAMU-192, reglamentado, jerarquizado e integrado al Sistema Único de Salud, asegurando recursos públicos, inclusive integrados a la red complementaria de asistencia. Gastos por instalación fueron establecidos entre la municipalidad y comisiones inter-gestoras federales y estatales. Como retos en la dinámica y calidad de la atención: educación comunitaria, capacitación profesional, evaluación de recursos humanos y materiales.

[Implantation of the emergency ambulance service in Salvador, Bahia: reality and challenges]. / A implantação do projeto de atendimento Móvel de Urgência em Salvador/BA: panorama e desafios.

The goal of this study was to describe the implementation of the emergency ambulance service of Salvador, Bahia (SAMU-192). The Ministry of Health provided the legal basis and regulations for its implementation. The main purpose of this service is the provision of free primary level healthcare to individuals, with clinical, surgical, traumatic and psychiatric aggravations that cause suffering, sequels or death and occur outside the hospital environment. The specific goals of SAMU-192 was to grant free healthcare to urgency and emergency situations, under the hierarchy and regulations of the Single Health System (SUS) of the Brazilian government, assuring that public resources will be available and integrated to the complementary healthcare network. Investments for the installation of the service were agreed on in the city and with federal and state management commissions. To turn SAMU-192 into reality, several challenges need to be accomplished, including community education, professional qualification and evaluation of human and material resources so as to provide basic emergency care with the appropriate quality.

The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study.

BACKGROUND: The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded the hospitals, mainly the ones of higher complexity. The knowledge of this phenomenon induced Ribeirão Preto to implement the Medical Regulation Office and the Mobile Emergency Attendance System. The objective of this study was to analyze the impact of these services on the gravity profile of non-traumatic afflictions in a University Hospital. METHODS: The study conducted a retrospective analysis of the medical records of 906 patients older than 13 years of age who entered the Emergency Care Unit of the Hospital of the University of São Paulo School of Medicine at Ribeirão Preto. All presented acute non-traumatic afflictions and were admitted to the Internal Medicine, Surgery or Neurology Departments during two study periods: May 1996 (prior to) and May 2001 (after the implementation of the Medical Regulation Office and Mobile Emergency Attendance System). Demographics and mortality risk levels calculated by Acute Physiology and Chronic Health Evaluation II (APACHE II) were determined. RESULTS: From 1996 to 2001, the mean age increased from 49 +/- 0.9 to 52 +/- 0.9 (P = 0.021), as did the percentage of co-morbidities, from 66.6 to 77.0 (P = 0.0001), the number of in-hospital complications from 260 to 284 (P = 0.0001), the mean calculated APACHE II mortality risk increased from 12.0 +/- 0.5 to 14.8 +/- 0.6 (P = 0.0008) and mortality rate from 6.1 to 12.2 (P = 0.002). The differences were more significant for patients admitted to the Internal Medicine Department. CONCLUSION: The implementation of the Medical Regulation and Mobile Emergency Attendance System contributed to directing patients with higher gravity scores to the Emergency Care Unit, demonstrating the potential of these services for hierarchical structuring of pre-hospital networks and referrals.