Tiros na escola: algumas referências para a psicologia na assistência à comunidade escolar / School shotting: some references for psychology in school comunity support / Tíros em la escuela: algunas referencias para la psicología em la asistencia à comunidad escolar

A atuação em situações de emergências e desastres apresentam-se como um dos grandes desafios na atuação dos profissionais da Psicologia, demandando intervenções singulares, desde o primeiro contato com as vítimas e o com entorno afetado pelo ocorrido, passando pelo trabalho interdisciplinar e interinstitucional junto aos órgãos públicos de segurança, justiça, assistência e saúde. O presente artigo tem como objetivo apresentar, por meio da experiência na assistência às vítimas na Escola Estadual Raul Brasil, as particularidades e adversidades enfrentadas durante o primeiro semestre de intervenções emergenciais que antecederam a contratação de psicólogos por parte do poder público municipal para continuidade das ações. Por meio de relatos de experiência em intervenções psicológicas, obtidos em diferentes instituições para a assistência às vítimas, este trabalho também visa apresentar alternativas que possam servir de referências para a intervenção do psicólogo e da psicóloga em situações de emergências e desastres, especialmente ocorridas na comunidade escolar. Observou-se que a realização do trabalho interdisciplinar e interinstitucional somado à participação da direção da escola no planejamento das ações e a realização de plantões psicológicos e rodas de conversa junto à comunidade escolar foram fundamentais para a assistência às vítimas do ocorrido.(AU)

Timely response to emergency and disaster situations is a major challenge for Psychology professionals and require particular interventions, from initial contact with the victims and the affected environment to interdisciplinary and interinstitutional collaboration with public security, justice, assistance and health agencies. Based on the experience of providing assistance to the victims of the State School Raul Brasil, this paper presents the adversities and specificities faced during the first semester of emergency interventions implemented before psychologists were hired by municipal officials for the continuity of care. By analyzing experience reports on psychological interventions obtained from different institutions for victim assistance, this paper proposes alternatives to be used as reference for psychological intervention in emergency and disaster situations, especially those experienced by the school community. Interdisciplinary and interinstitutional collaboration with the school board for planning actions and offering psychological services and conversation circles for the school community was fundamental to assist the victims.(AU)

La actuación en situaciones de emergencias es uno de los grandes desafíos a los profesionales de la psicología, pues demanda intervenciones singulares desde el primer contacto con las víctimas y con el contexto afectado por lo ocurrido, pasando por la interdisciplinaridad e interinstitucionalidad junto a los organismos públicos de seguridad, justicia, asistencia y salud. Este artículo tiene como objetivo presentar, por medio de la experiencia de la asistencia a las víctimas del colegio estadual Raul Brasil (en São Paulo, Brasil), las particularidades y adversidades enfrentadas durante el primer semestre de las intervenciones de emergencia que antecedieron la contratación de psicólogos por parte del municipio para continuidad de las acciones. Por medio de reportes de experiencia en intervenciones psicológicas, obtenidos en diferentes instituciones para la asistencia a las víctimas, este estudio también pretende presentar alternativas que puedan servir de referencia en la intervención de psicólogos y psicólogas en situaciones de emergencia y desastres, especialmente ocurridas en la comunidad escolar. Se verificó que la realización del trabajo interdisciplinar e interinstitucional, la participación de la dirección del colegio en la implementación de acciones y la realización de guardias psicológicas y círculos de conversación con la comunidad escolar fueron fundamentales para una asistencia a las víctimas.(AU)

Pre-hospital assistance by ambulance in the context of coronavirus infections.

OBJECTIVE: To reflect on the safe care exercised by the pre-hospital care team by emergency ambulance in times of coronavirus infection. METHOD: A reflection and description of how to provide safe care to the patient and the professional during pre-hospital care in times of coronavirus infection. RESULTS: To ensure the health of all those involved in the care, health professionals who work in pre-hospital care by emergency ambulance should use the recommended Personal Protective Equipment (PPE), such as the use of surgical masks and N95, N99, N100, PFF2 or PFF3, the use of an apron or overall, goggles and face shield, gloves and a hat. The entire team must receive training and demonstrate the ability to use PPE correctly and safely. FINAL CONSIDERATIONS: The professional working in the pre-hospital care by ambulance is exposed to a series of occupational risks that need to be discussed and minimized through professional training.

Nota informativa nº 05 /2020-GST/DVAST/SVS/SES: recomendações aos gestores e profissionais da segurança pública para enfrentamento da pandemia de Coronavírus ­ COVID-19 (infecção pelo SARS-CoV-2) / Informative note nº 05/2020-GST / DVAST / SVS / SES: recommendations to managers and public security professionals to cope with the Coronavirus pandemic - COVID-19 (SARS-CoV-2 infection)

Recomendações aos gestores e trabalhadores da Segurança pública (policiais federais, rodoviários, militares, civis, municipais, bombeiros, agentes penitenciários e socioeducativos) para discussão coletiva sobre medidas que amenizem os riscos à saúde dos trabalhadores e pessoas privadas de liberdade, como também, reduzam a disseminação do COVID-19 para seus familiares e a população em geral.

Recommendations to the managers and workers of public security (police federais, rodoviários, military, civis, municipais, bombeiros, penitentiary and socio-educational agents) for collective discussion on measures that mitigate the risks to the health of two workers and people deprived of freedom, as also, also, a dissemination of COVID-19 for family members and general population.

Recomendaciones a los gerentes y trabajadores de seguridad pública (federal, vial, militar, civil, municipal, bomberos, agentes penitenciarios y socioeducativos) para la discusión colectiva sobre medidas para mitigar los riesgos para la salud de los trabajadores y personas privadas de libertad, así como reducir la difusión del COVID-19 a sus familias y población en general.

Common mental disorders in nursing technicians of a university hospital.

OBJECTIVE: To verify the prevalence of common mental disorders and associated factors in nursing technicians. METHOD: Cross-sectional analytical study conducted at a university hospital. A questionnaire with sociodemographic, educational and work-related variables and the Self Reporting Questionnaire-20 were used to verify the presence of common mental disorders. Association analysis was performed using the chi-squared test, with a significance level of 5%. RESULTS: 280 nursing technicians participated in the study. The prevalence of common mental disorders was 46.9%. The variables family income (p=0.021) and working exclusively in health area (p<0.001) were associated with the outcome. There was a higher prevalence of CMD among individuals with a family income below four minimum wages (PR=1.41) and among professionals who worked exclusively in the health area (PR=1.95). CONCLUSION: Approximately half of the nursing technicians of the university hospital presented common mental disorders, which were associated with economic and work-related variables.

Cut and rip and cut alone techniques versus usual practice in the removal of trauma patient clothing.

IntroductionRapid exposure of a trauma patient is an essential component of the primary survey. No gold standard exists regarding the best technique to remove clothing from a trauma patient. The purpose of this study is to compare two techniques of clothing removal versus usual practice using standard trauma shears. METHODS: Advanced Care Paramedic (ACP) students were randomized to either the Cut and Rip (CAR) or Cut Alone (CAL) techniques to remove clothing from a standardized trauma mannequin. Practicing paramedics were recruited to remove clothing from the mannequin using Usual Practice (UP). Total time and time for removal of individual pieces of clothing was recorded. RESULTS: Twenty-four participants (8 per group) were recruited to participate. The student groups (CAR, CAL) were similar in mean age (29, 27), years of practice (1 student >5 years) and male gender (63, 43%). The UP group was older (mean 34), more experienced (63% practice >5 years), and had a higher level of training (63% ACP) but a similar percentage of males (63%). Removal time was significantly less in the CAR group compared to the CAL group (mean 104 seconds, 95% CI 88-120 vs. mean 136 seconds, 95% CI 119-154, p=0.02). Removal times in the UP group were not significantly different from the other groups (mean 124 seconds, 95% CI 108-140, p>0.05). CONCLUSION: The CAR technique is faster than both CAL and UP groups to remove clothing from a standard trauma mannequin.

[Emergency Medical Technician profile in Spain]. / Perfil del técnico de emergencias sanitarias en España.

OBJECTIVE: The emergency medical technician plays a fundamental role and is the most important figure quantitatively in pre-hospital emergencies. The aim was to asses the socio-demographic, work-related, health characteristics and technical skills of an Emergency Medical Technician in Spain. METHODS: Cross-sectional descriptive study. An ad hoc questionnaire was managed using Google Docs® that was delivered between April-June 2014 via email and social networks. A total of 705 questionnaires were collected. Statistical analysis was performed with SPSS ® 20.0 Windows version. A significance level p≤0.05 was used for all analyzes. RESULTS: The data analyzed show that the profile of the Emergency Medical Technician in Spain is an 39 year-old man, married or living as a couple and has a child. The average BMI is 27 kg/m2, does regular exercise, does not smoke. His seniority in the company is 10 years and has the Medium Cycle of Emergency Medical Technician. The analysis for gender shows that men have an average of 40, an average BMI of 27, 5 kg/m2 and work in an advanced life support unit; while women have an average of 36,5 years, an average BMI of 24,7 kg/m2, mainly work in Basic Life Support Unit and her seniority in the company is 6,76 years. CONCLUSIONS: Emergency Medical Technician profile is a overweight men, who refer to practise regular exercise, his seniority in the company is 10 years and is in possession of CMTES; differences were observed according to gender in BMI, resource where they perform their work, seniority and age.

OBJETIVO: El Técnico de Emergencias Sanitarias desempeña una labor fundamental y es la figura cuantitativamente más importante en las emergencias extrahospitalarias. El objetivo fue conocer las características socio-demográficas, laborales, de salud del técnico y formativas en emergencias sanitarias en España. METODOS: Estudio descriptivo transversal. Se realizó un cuestionario ad hoc mediante Google Docs® que se distribuyó entre Abril­Junio 2014 mediante correo electrónico y redes sociales. Se recogieron un total de 705 cuestionarios. El análisis estadístico se realizó con SPSS ® versión 20.0 versión Windows. Se utilizó un nivel de significación P≤0.05 en todos los análisis. RESULTADOS: Los datos analizados muestran como el perfil del Técnico de Emergencias Sanitarias (TES) en España es el de un hombre de 39 años, que vive en pareja o está casado con un hijo. El IMC medio es de 27 kg/m2, realiza ejercicio de forma regular, no fuma. Su antigüedad en la empresa es de 10 años y tienen el Ciclo Medio de Técnico Emergencias Sanitarias (CMTES). El análisis por sexos muestra como los hombres tienen una media de 40 años, un IMC medio de 27,5kg/m2 y desarrollan su labor profesional en una unidad de soporte vital avanzado, mientras que las mujeres tienen una media de 36,5 años, un IMC medio de 24,7kg/m2, trabajan principalmente en unidades de soporte vital básico y su antigüedad en la empresa es de 6,76 años. CONCLUSIONES: El perfil del TES en España es hombre con sobrepeso, que refiere realizar ejercicio físico, lleva 10 años trabajando y está en posesión del CMTES; se observan diferencias en función del sexo en IMC, recurso donde desempeña su trabajo, antigüedad y edad.

Development and Evaluation of a Continuing Education Program for Nursing Technicians at a Pediatric Cardiac Intensive Care Unit in a Developing Country.

BACKGROUND: The nursing profession faces continuous transformations demonstrating the importance of professional continuing education to extend knowledge following technological development without impairing quality of care. Nursing assistants and technicians account for nearly 80% of nursing professionals in Brazil and are responsible for uninterrupted patient care. Extensive knowledge improvement is needed to achieve excellence in nursing care. The objective was to develop and evaluate a continuing education program for nursing technicians at a pediatric cardiac intensive care unit (PCICU) using a virtual learning environment entitled EDUCATE. METHODS: From July to September 2015, a total of 24 nursing technicians working at the PCICU at a children's hospital located in the northwestern region of São Paulo state (Brazil) fully participated in the continuing education program developed in a virtual learning environment using Wix platform, allowing access to video classes and pre- and post-training theoretical evaluation questionnaires outside the work environment. The evaluation tools recorded participants' knowledge evolution, technological difficulties, educational, and overall rating. RESULTS: Knowledge development was descriptively presented as positive in more than 66.7%. Content and training were considered "excellent" by most participants and 90% showed an interest in the use of technological resources. Technical difficulties were found and quickly resolved by 40% of participants including Internet access, login, and lack of technical expertise. CONCLUSION: The continuing education program using a virtual learning environment positively contributed to the improvement in theoretical knowledge of nursing technicians in PCICU.

Fatores de risco para doenças cardiovasculares e osteomusculares relacionadas ao trabalho em profissionais do atendimento pre hospitalar de urgência: uma revisão sistemática / Risk factors for cardiovascular and musculoskeletal work related diseases among prehospital emergency care workers: a systematic review

Contexto: Pesquisas com o trabalhador do atendimento pré-hospitalar de urgências têm investigado o estresse relacionado ao trabalho e suas repercussões na saúde mental e física desses profissionais. Objetivo: Identificar os fatores de risco para doenças cardiovasculares (DCV) e doenças osteomusculares (DOM) nos trabalhadores do atendimento pré-hospitalar de urgências. Métodos: Realizou-se uma busca sistemática nas bases de dados PubMed, EBSCO, Embase e Science Direct, com os seguintes critérios de inclusão: abordar fatores de risco para as DCV e DOM e envolver trabalhadores pré-hospitalar de urgências. Resultados: Inicialmente, foram encontrados 370 artigos, dos quais 11 foram incluídos na presente revisão. Os estudos considerados identificam fatores de risco para as DCV, como índice de massa corporal e sedentarismo, porém com limitado nível de evidência, bem como para as DOM, entre eles idade e atividade profissional dos socorristas, com forte nível de evidência. Não é possível afirmar os fatores de risco cardiovasculares em virtude da carência de estudos que analisem esses aspectos. Conclusão: Os fatores de risco osteomusculares, mais claros na literatura, referem-se à idade e à atividade profissional dos socorristas.(AU)

Background: Studies conducted with prehospital emergency care workers investigated work-related stress and its repercussions on the workers mental and physical health. Objective: To identify risk factors for development of cardiovascular (CVD) and musculoskeletal (MSD) work-related diseases among prehospital emergency care workers. Methods: We conducted a systematic search in databases PubMed, EBSCO, EMBASE and Science Direct. The inclusion criteria were: risk factors for CVD and MSD among prehospital emergency care workers. Results: From 370 articles, 11 were included for review. The included studies identified risk factors for CVD, such as body mass index and sedentary lifestyle, however, with limited level of evidence. For MSD, age and working as first responder were shown to behave as risk factors, with high level of evidence. We were not able to establish which the cardiovascular risk factors are, due to lack of studies that analyzed these aspects. Conclusion: The most evident musculoskeletal risk factors in the literature are age and working as first responder.(AU)

Agresiones contra personal médico en emergencia del Hospital Nacional Arzobispo Loayza. Diciembre 2013 - Enero 2014 / Attacks against medical personnel in emergency at the National Hospital Arzobispo Loayza. December 2013 - January 2014

OBJETIVOS: Determinar los factores relacionados a la ocurrencia de las agresiones al personal médico de Emergencia del Hospital Nacional Arzobispo Loayza en los meses de Diciembre 2013-Enero 2014. DISEÑO DE ESTUDIO: estudio, transversal, descriptivo. LUGAR: Emergencias Hospital Nacional Arzobispo Loayza. MATERIALES Y METODOS: Encuestas a personal médico de emergencia de HNAL. RESULTADOS: El personal médico de pediatría con un 92 por ciento fue la especialidad que sufrió más agresiones, seguida de medicina interna con un 76 por ciento, cirugía 75 por ciento, y gineco-obstetricia con un 68 por ciento de personal agredido. El grupo etario de 20 a 28 años con 39 por ciento fue el más agredido. La población masculina con el 53 por ciento fue la más agredida. La población que sufrió agresiones más de tres veces en el último año fue el 17 por ciento. La mayor cantidad de agresiones fueron las verbales de pacientes con un 58 por ciento. Las agresiones fueron cometidas por una sola persona en un 66 por ciento. El 69 por ciento de agresiones se cometieron mientras el personal médico estaba acompañado por colegas. La respuesta ante la agresión fue tratar de controlar la situación mediante el diálogo con un 82 por ciento. La sensación de inseguridad en emergencia fue 58,6 por ciento. El principal desencadenante de la agresión fue por demora en atención 52 por ciento. CONCLUSIONES: El personal médico de emergencia de pediatría es el más agredido, la población más agredida son los internos. La población masculina es la que sufre más agresiones, la principal causa de agresión fue la demora en la atención.

OBJECTIVES: Determine the factors related to the occurrence of assaults on emergency medical personnel at National Hospital Arzobispo Loayza in the months of December 2013-January 2014. STUDY DESIGN: cross-sectional study, descriptive. LOCATION: Emergency of National Hospital Arzobispo Loayza. MATERIALS AND METHODS: Surveys emergency medical personnel HNAL. RESULTS: Pediatric medical staff with 92 per cent was the specialty that suffered more attacks, followed by internal medicine with 76 per cent, surgery 75 per cent, gynecology and obstetrics with 68 per cent of staff assaulted; the age group 20 to 28 years with 39 per cent was the most attacked. The male population with 53 per cent was the most attacked. The population suffered more attacks than three times in the last year was 17 per cent. As many attacks were verbal patient with 58 per cent. The attacks were committed by one person in 66 per cent. 69 per cent of assaults were committed while the medical staff was accompanied by colleagues. The response to the attack was to try to control the situation through dialogue with 82 per cent. The feeling of insecurity in emergency was 58.6 per cent. The main trigger of aggression delay in care was 52 per cent. CONCLUSIONS: The pediatric medical staff is the most attacked, the medical intern was the most attacked, the male population is suffering more attacks and the leading cause of aggression was the delay in care.

Prehospital Sepsis Project (PSP): knowledge and attitudes of United States advanced out-of-hospital care providers.

INTRODUCTION: Severe sepsis and septic shock are common and often fatal medical problems. The Prehospital Sepsis Project is a multifaceted study that aims to improve the out-of-hospital care of patients with sepsis by means of education and enhancement of skills. The objective of this Project was to assess the knowledge and attitudes in the principles of diagnosis and management of sepsis in a cohort of United States out-of-hospital care providers. METHODS: This was cross-sectional study. A 15-item survey was administered via the Web and e-mailed to multiple emergency medical services list-servers. The evaluation consisted of four clinical scenarios as well as questions on the basics of sepsis. For intra-rater reliability, the first and the fourth scenarios were identical. Chi-square and Fisher's Exact testing were used to assess associations. Relative risk (RR) was used for strength of association. Statistical significance was set at .05. RESULTS: A total of 226 advanced EMS providers participated with a 85.4% (n = 193) completion rate, consisting of a 30.7% rural, 32.3% urban, and 37.0% suburban mix; 82.4% were paramedics and 72.5% had worked in EMS >10 years. Only 57 (29.5%) participants scored both of the duplicate scenarios correctly, and only 19 of the 193 (9.8%) responded to all scenarios correctly. Level of training was not a predictor of correctly scoring scenarios (P = .71, RR = 1.25, 95% CI = 0.39-4.01), nor was years of service (P = .11, RR = 1.64, 95% CI = 0.16-1.21). CONCLUSIONS: Poor understanding of the principles of diagnosis and management of sepsis was observed in this cohort, suggesting the need for enhancement of education. Survey items will be used to develop a focused, interactive Web-based learning program. Limitations include potential for self-selection and data accuracy.

Supporting information use and retention of pre-hospital information during trauma resuscitation: a qualitative study of pre-hospital communications and information needs.

Pre-hospital communication is a critical first step towards ensuring efficient management of critically injured patients during trauma resuscitation. Information about incoming patients received from the field and en route serves a critical role in helping emergency medical teams prepare for patient care. Despite many efforts, inefficiencies persist. In this paper, we examine the pre-hospital communications between pre-hospital and hospital providers, including the types of information transferred during en-route calls, as well as the information needs of trauma teams. Our findings show that Emergency Medical Services (EMS) teams report a great deal of information from the field, most of which match the needs of trauma teams. We discuss design implications for a computerized system to support the use and retention of pre-hospital information during trauma resuscitation.

La evaluación del estrés traumático secundario: estudio comparado en bomberos y paramédicos de los Servicios de Emergencia de Guadalajara, México / Secondary traumatic stress assesment: compared study in firemen and paramedics in emergency services

El estrés traumático secundario, se refiere a un proceso por el cual "un individuo que observa el sufrimiento de otro, experimenta paralelamente las mismas respuestas emocionales a las emociones reales o esperadas de la otra persona", Moreno, Morante, Rodríguez & Garrosa (2004). A partir de esta noción, Moreno, Garrosa, Morante, Rodríguez & Losada (2004b) diseñaron el cuestionario de estrés traumático secundario (CETS). Se presenta un estudio comparado en dos muestras de bomberos y paramédicos con un total de 427 sujetos. Los paramédicos se percibieron con mayor presión social y mayor nivel de comprensibilidad, los bomberos con mayor percepción de sobrecarga laboral, mayor nivel de empatía y consecuencias sociales. Las mujeres se percibieron con mayor presión social en el trabajo y los hombres con mayor sobrecarga laboral y sentido del humor. Se reportan correlaciones entre las sub escalas del CETS, que confirman la relación entre las dimensiones de un modelo procesual desarrollado por Moreno, Morante, Rodríguez & Rodríguez (2008).

The concept of secondary traumatic stress refers to a process whereby "an individual who observes the suffering of another, parallel experience the same emotional responses to actual or anticipated emotions of another person," Moreno, Morante, Rodríguez & Garrosa (2004). Based in this model Moreno, Garrosa, Morante, Rodríguez & Losada (2004b) designed the secondary traumatic stress questionnaire (STSQ). This study presents a comparative study of secondary traumatic stress realized with 427 subjects divided in two samples of firefighters and emergency paramedics. Emergency paramedics perceived more social pressure and a higher level of comprehension, while firefighters had a higher perception of work overload, high level of empathy and social consequences. Gender differences show that women perceived more social pressure at work and men perceived more overload and sense of humor. Correlations between the subscales of STSQ, confirm the relationship between the dimensions of the process model developed by Moreno, Morante, Rodríguez & Rodríguez (2008).

Exploratory factor analysis of the Brazilian version of the Post-Traumatic Stress Disorder Checklist: civilian version (PCL-C).

OBJECTIVE: To evaluate the factor structure of the Brazilian Portuguese version of the Post-Traumatic Stress Disorder Checklist-civilian version (PCL-C), in order to complement its validation process in Brazil. METHOD: An exploratory factor analysis with promax rotation was conducted in 175 ambulance workers of the Emergence Rescue Group (GSE from Portuguese) of the Rio de Janeiro fire brigade and 343 military police officers (MP) (150 from an elite unit of the state of Goiás). RESULTS The results revealed a two-factor solution: re-experience/avoidance, numbing/hyperarousal. All variables loaded highly in at least one factor, except for one; variable 16. This item may have had a bad performance because the analysis was based on a sample of police officers, whose professional activity demands hypervigilance as one of its basic characteristics. Internal consistency values were acceptable. CONCLUSIONS: Avoidance and numbing seem to be independent dimensions, differently from what is expected according to the DSM-IV. Therefore, new trials should be carried out in other populations, with victims of different kinds of trauma, and including females, to verify these findings.

Exploratory factor analysis of the brazilian version of the Post-Traumatic Stress Disorder Checklist: civilian version (PCL-C) / Análise fatorial exploratória da versão brasileira da Post-Traumatic Stress Disorder Checklist: versão civil (PCL-C)

OBJECTIVE: To evaluate the factor structure of the Brazilian Portuguese version of the Post-Traumatic Stress Disorder Checklist - civilian version (PCL-C), in order to complement its validation process in Brazil. METHOD: An exploratory factor analysis with promax rotation was conducted in 175 ambulance workers of the Emergence Rescue Group (GSE from Portuguese) of the Rio de Janeiro fire brigade and 343 military police officers (MP) (150 from an elite unit of the state of Goiás). RESULTS The results revealed a two-factor solution: re-experience/avoidance, numbing/hyperarousal. All variables loaded highly in at least one factor, except for one; variable 16. This item may have had a bad performance because the analysis was based on a sample of police officers, whose professional activity demands hypervigilance as one of its basic characteristics. Internal consistency values were acceptable. CONCLUSIONS: Avoidance and numbing seem to be independent dimensions, differently from what is expected according to the DSM-IV. Therefore, new trials should be carried out in other populations, with victims of different kinds of trauma, and including females, to verify these findings.

OBJETIVO: Avaliar a estrutura de fatores da versão brasileira em português da Post-Traumatic Stress Disorder Checklist - versão civil (PCL-C) - para complementar seu processo de validação no Brasil. MÉTODO: Uma análise fatorial exploratória com rotação promax foi realizada em 175 funcionários de ambulâncias do Grupo de Socorro de Emergência (GSE) dos bombeiros da cidade do Rio de Janeiro e em 343 soldados da polícia militar (PM) (150 dos quais de uma unidade de elite do estado de Goiás). RESULTADOS: Os resultados revelaram uma solução com dois fatores: revivência/evitação e embotamento/hiperativação. Todas as variáveis apresentaram uma carga elevada em pelo menos um fator, exceto pela variável 16. Esse item pode ter tido um desempenho fraco pela análise ter sido baseada em uma amostra de policiais, cuja atividade profissional exige a hipervigilância como uma de suas características básicas. Os valores de consistência interna foram aceitáveis. CONCLUSÕES: A evitação e o embotamento parecem ser dimensões independentes, diferentemente do que era esperado de acordo com a DSM-IV. Portanto, novos ensaios clínicos devem ser realizados em outras populações, com vítimas de diferentes tipos de trauma e incluindo mulheres, para se comprovar esses achados.

Avaliação do pico de pressão e da frequência respiratória durante o uso de balão autoinflável por socorristas do Corpo de Bombeiros em um modelo de pulmão neonatal pré-termo / Evaluation of peak inspiratory pressure and respiratory rate during ventilation of a preterm infant lung model with a self-inflating bag by paramedics of the Fire Department

OBJETIVO: Avaliar o pico de pressão inspiratória e a frequência ventilatória obtidos por socorristas do Corpo de Bombeiros com a utilização de balão autoinflável em modelo de pulmão neonatal pré-termo. MÉTODOS: Estudo observacional descritivo incluindo 31 voluntários dentre 68 socorristas convidados, componentes de duas turmas do Programa de Capacitação Continuada do Corpo de Bombeiros. Durante três minutos, os socorristas ventilaram um simulador analógico de pulmão neonatal pré-termo, utilizando balão autoinflável de tamanho neonatal. Foram captados os picos de pressão inspiratória e a frequência respiratória por meio de um pneumotacógrafo e um monitor gráfico de ventilação. Os dados eram gravados e posteriormente analisados. RESULTADOS: A média do pico de pressão foi de 14,6±8,2cmH2O, sendo menor que 20 em 77,4 por cento das vezes, maior que 40 em 3,2 por cento das vezes, e entre 20 e 40cmH2O em 19,4 por cento das vezes. A média da frequência ventilatória foi de 38,3±10,3 ciclos por minuto, sendo menor que 40 em 51,6 por cento das vezes e entre 40 e 60 ciclos por minuto em 48,4 por cento das vezes; em nenhuma das vezes a pressão atingiu 60 ciclos por minuto. CONCLUSÕES: Os socorristas, na maioria das vezes, não atingiram o nível mínimo desejado de pressão de ventilação e frequência respiratória recomendados em protocolos internacionais durante a ventilação pulmonar neonatal com o balão autoinflável.

OBJECTIVE: To evaluate the peak inspiratory pressure and the ventilation rate obtained by paramedics of the Fire Department of Brasília, Brazil, when using a neonatal self-inflating bag on a preterm lung model. METHODS: Descriptive observational study including 31 volunteers, from 68 paramedics invited, who were components of two groups of the Fire Department's Continuous Training Program. For three minutes, the paramedics ventilated an analogical simulator of preterm infant lung using a neonatal self-inflating bag. The peak inspiratory pressure and the respiratory rate were captured by a pneumotachograph and a graphical monitor of ventilation. Data were recorded and analyzed. RESULTS: Mean peak pressures in cmH2O for test lung were 14.6±8.2, being less than 20 in 77.4 percent of the analyzed pressure curves, more than 40 in 3.2 percent, and between 20 and 40cmH2O in 19.4 percent of the curves. Mean ventilation rates were 38.3±10.3 cycles per minute, being less than 40 in 51.6 percent of the analyzed pressure curves, more than 60 in zero, and between 40 and 60 in 48.4 percent. In no occasion the pressure reached 60 cycles per minute. CONCLUSIONS: The paramedics, most of the time, did not achieve the advised minimum level of ventilation pressure and ventilation rates recommended by international guide lines during ventilation of a neonatal lung model with a self-inflating bag.

Estrategias de afrontamiento del equipo de enfermería de la Unidad de Cuidados Intensivos Med-Quirúrgicos Hospital Regional Concepción posterremoto y Tsunami 27/02 / Coping strategies of the nursing staff of an intensive care unit after the earthquake and tsunami 27/02

Introducción: El terremoto y tsunami ocurrido recientemente en nuestro país, ha producido una crisis abrupta en la sociedad. El ambiente hospitalario ha debido actuar rápidamente frente al rescate, pero las capacidades de los funcionarios para hacerle frente a una nueva amenaza se desconocen, para esto se explora la teoría de Callista Roy “Proceso de afrontamiento y adaptación”. Objetivo: Conocer las estrategias de afrontamiento del equipo de enfermería de la UCI, HGGB. Metodología: Estudio descriptivo relacional con muestra probabilística estratificada, con n =57. Se utiliza el instrumento “Estrategias de Afrontamiento y Adaptación de "Callista Roy" aplicándose a los profesionales de enfermería, paramédicos y auxiliares de servicio de la unidad. Los puntajes se dividen en 5 factores, tres de ellos miden el comportamiento generado frente a un estímulo estresante y los otros 2 miden el tipo de estrategia de afrontamiento. Resultados: el 91 por ciento de los funcionarios son mujeres, el promedio de edad es de 35 años, el promedio de años de servicio es de 8,6 +/- 9 años. El 3,5 por ciento de los funcionarios tiene una baja capacidad de afrontamiento y adaptación, mientras que 96,5 por ciento presenta una alta capacidad. A través de la prueba de χ2 se determina que existe una buena asociación entre el tipo de reacción referido por los funcionarios y el puntaje obtenido en ESCAPS para medir el tipo de reacción física y enfocada. La prueba de t- student determina diferencias estadísticamente significativas entre la edad, los años de servicio y el factor 4 de ESCAPS. Conclusiones: El equipo de enfermería posee un alta capacidad capacidad para enfrentar situaciones estresantes, reacciona con actitudes alertas, centradas y recursivas, y utiliza estrategias de afrontamiento sistemáticas. La edad de funcionario y los años de servicio se relacionan con una mejor capacidad de generar estrategias de afrontamiento.

Introduction: The recent earthquake and tsunami has produced a crisis in society. The hospital had to act quickly against the bailout, but the staff ability to face a new threat is unknown, the coping capacity is explores trough the middle-range theory of Callista Roy “Coping and Adaptation Processing” Objective: Determinate the coping strategies of the nursing staff of ICU, HGGB. Methodology: A descriptive relational stratified random sample with n = 57. It’s used Roy’s “Coping and Adaptation Processing Scale” to apply to nurses, paramedics and auxiliary service. The scores are divided into 5 factors, three of them, measures the behavior generated against a stressor and the other two, measures the type of coping strategy. Results: 91 percent of staff are women, 54.4 percent consists of paramedical, followed by nurses with 31, 6 percent and auxiliary service at 14 percent. The average years of service are 8.6 +/- 9 years. 3.5 percent of staff has a low capacity for coping and adaptation, while 96.5 percent has a high capacity. Through a Pearson’s x2 to determine that there is a good association between the types of reaction reported by staff and their scores on CAPS to measure the kind of physical reaction and focused. The T- score determined statistically significant differences between ages, years of service and the factor 4 CAPS. Conclusions: The nursing team has a high ability to cope with stressful situations, reacts with alertness, focused and resourceful and coping strategies used systematic. The age and years of service are related to the ability to generate coping strategies.