[Practicing silence: educational intervention for reducing noise in the intensive care unit]. / Praticando o silêncio: intervenção educativa para a redução do ruído em Unidade de Terapia Intensiva.

The objective of this study was to evaluate whether the sound pressure levels are decreased in the ICU after an educational intervention with the multidisciplinary team. Noise levels were measured inside the ICU (using a decibelimeter installed near the bedside of a patient) for seven days, and repeated the procedure after an educational intervention, which consisted of lectures, posters and dramatizations, among others. There was a large reduction in noise level between the pre and postintervention period, at all times evaluated. The main sources of noise in the ICU were the own team. The noise levels were higher than recommended. The study showed that with an educational intervention with the ICU staff and their awareness of the mechanisms and effects, it is possible to have reduced levels of noise and consequent estresse environment.

Praticando o silêncio: intervenção educativa para a redução do ruído em Unidade de Terapia Intensiva / Practicing silence: educational intervention for reducing noise in the Intensive Care Unit / Practicando el silencio: intervención educativa en la reducción del ruido en la Unidad de Cuidados Intensivos

O objetivo deste estudo foi avaliar se os níveis de pressão sonora dentro da UTI são diminuídos após intervenção educativa com a equipe multiprofissional. Foram mensurados os níveis de ruído no interior da UTI (através de um decibelímetro instalado próximo à cabeceira de um paciente) durante sete dias, sendo repetido o procedimento após uma intervenção educativa, a qual consistiu de palestras, cartazes e dramatizações, entre outros. Houve grande redução do nível de ruído entre o período pré e pós-intervenção, em todos os horários avaliados. As principais fontes de ruídos dentro da UTI foram da própria equipe. Os níveis de ruído encontrados estiveram acima do recomendado. O estudo mostrou que, com uma intervenção educacional junto à equipe da UTI e sua conscientização sobre os mecanismos e efeitos, é possível haver redução dos níveis de ruído e consequente eestressee do ambiente.

The objective of this study was to evaluate whether the sound pressure levels are decreased in the ICU after an educational intervention with the multidisciplinary team. Noise levels were measured inside the ICU (using a decibelimeter installed near the bedside of a patient) for seven days, and repeated the procedure after an educational intervention, which consisted of lectures, posters and dramatizations, among others. There was a large reduction in noise level between the pre and postintervention period, at all times evaluated. The main sources of noise in the ICU were the own team. The noise levels were higher than recommended. The study showed that with an educational intervention with the ICU staff and their awareness of the mechanisms and effects, it is possible to have reduced levels of noise and consequent estresse environment.

El objetivo de este estudio fue evaluar si los niveles de presión sonora se redujeron en la UCI después de una intervención educativa con el equipo multidisciplinario. Se midieron los niveles de ruido en la UCI (utilizando un decibelímetro instalado cerca de la cabecera de un paciente) durante siete días, y se repite el procedimiento después de una intervención educativa con el equipo, que consistió en conferencias, carteles y dramatizaciones, entre otros. Hubo una gran reducción en el nivel de ruido entre el período pre y post-intervención, en todos los tiempos evaluados. Las principales fuentes de ruido en la UCI fueron del proprio equipo. Los niveles de ruidos encontrados eran más altos que los recomendados. Este estudio mostró que con una intervención educativa y de sensibilización acerca de los mecanismos y los efectos del ruido con el personal de la UCI, es posible lograr la reducción de los niveles de ruido y el estrés ambiental consecuente.

Monitoramento auditivo na ototoxidade / Auditory monitoring in ototoxicity

Algumas drogas, denominadas ototóxicas, têm a capacidade de lesar os sistemas auditivo e vestibular. O avanço tecnológico tem disponibilizado inúmeros recursos para realizar o monitoramento da audição, porém, apesar da disponibilização de protocolos de avaliação internacionais, existem controvérsias quanto à escolha do procedimento de maior sensibilidade e especificidade para este fim. OBJETIVO: Analisar os procedimentos audiológicos utilizados no monitoramento auditivo dos indivíduos expostos à medicação ototóxica. METODOLOGIA: Realizou-se busca eletrônica nas bases de dados MEDLINE e LILACS, a partir da combinação entre os descritores que caracterizaram as temáticas monitoramento auditivo, ototoxicidade e câncer. A literatura apontou dois principais procedimentos efetivos no monitoramento: a audiometria de altas freqüências e as emissões otoacústicas. Ambos permitem que a alteração no sistema auditivo seja identificada antes que haja um comprometimento dos limiares tonais na faixa de freqüências convencional, e conseqüentemente na habilidade de compreensão da fala. CONCLUSÃO: O protocolo de monitoramento auditivo foi sugerido considerando a capacidade do paciente em responder aos testes comportamentais e a etapa do monitoramento (primeira avaliação ou subseqüentes). No caso de portadores de câncer, o monitoramento auditivo deve ser disponibilizado no local de tratamento do indivíduo.

Some pharmaceutical products are capable of damaging the human auditory system. Technological progress has provided numerous resources to monitor hearing but there still is some controversy regarding the selection of the most sensitive and specific tests. OBJECTIVE: to analyze audiological procedures used in the auditory monitoring of individuals exposed to ototoxic medication. METHODS: we searched the MEDLINE and LILACS literature databases, using terms pertinent to audiological monitoring, ototoxicity and cancer. The pertaining literature analysis identified two procedures often used worldwide for the early detection of auditory lesions induced by ototoxic pharmaceutical drugs: high-frequency audiometry and evoked otoacoustic emissions. Both allow early identification of hearing disorders before changes are seen in conventional pure-tone audiometry and, consequently, before speech understanding is compromised. CONCLUSION: we suggest a hearing monitoring protocol, considering the patientÆs capability to respond to behavioral tests and monitoring timing (first test/follow up). For cancer patients, hearing monitoring should be performed in the patientÆs treatment venue.

Auditory monitoring in ototoxicity.

UNLABELLED: Some pharmaceutical products are capable of damaging the human auditory system. Technological progress has provided numerous resources to monitor hearing but there still is some controversy regarding the selection of the most sensitive and specific tests. OBJECTIVE: to analyze audiological procedures used in the auditory monitoring of individuals exposed to ototoxic medication. METHODS: we searched the MEDLINE and LILACS literature databases, using terms pertinent to audiological monitoring, ototoxicity and cancer. The pertaining literature analysis identified two procedures often used worldwide for the early detection of auditory lesions induced by ototoxic pharmaceutical drugs: high-frequency audiometry and evoked otoacoustic emissions. Both allow early identification of hearing disorders before changes are seen in conventional pure-tone audiometry and, consequently, before speech understanding is compromised. CONCLUSION: we suggest a hearing monitoring protocol, considering the patients capability to respond to behavioral tests and monitoring timing (first test/follow up). For cancer patients, hearing monitoring should be performed in the patients treatment venue.