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1.
Rev Esp Salud Publica ; 942020 01 16.
Artigo em Espanhol | MEDLINE | ID: mdl-31942868

RESUMO

OBJECTIVE: There are few epidemiological studies on acute poisonings from pesticides, industrials and household products in Spain. The objective of this work is to describe the epidemiological and clinical profile of acute poisonings by chemical products in our country, and analyze their annual evolution. METHODS: The Spanish Toxicovigilance System (SETv) is a prospective registry that includes 32 Emergency Departments and Intensive Care Units in Spain. An observational descriptive study of acute poisoning by chemical agents (excluding pharmacological products and illicit drugs) was carried out, within 1999-2014. Statistical analysis was performed using Chi-square or exact Fisher's tests. Non-parametric continuous variables were compared using the Mann-Whitney U test. P-value less than 0.05 were considered significant. RESULTS: The 10,548 cases studied had a mean age of 38.41 (±22.07) years, being significantly higher in women (p=0.0001). 67.7% of the poisonings occurred at home, and the most frequent routes of exposure were respiratory (48.3%), digestive (35.3%) and ocular (13.1%). The most frequent toxic groups were toxic gases (31%), caustics (25.6%) and irritant gases (12.1%). Of the patients that required treatment (76.2%), antidotes were used in 27.2%. 20.6% of the patients were admitted at Hospital, with a median stay of 32 (±151.94) days, with significant differences for pesticides and solvents (p=0.02). Sequelae were presented at discharge in 2.1% of patients. Mortality was 1.4% (146 patients) with a mean age of 62.08 years (±19.58) (p=0.0001). CONCLUSIONS: The reduction of chemical poisonings should be prevented in the domestic environment, taking into account the sources of exposure to carbon monoxide and the handling of household cleaning products, both caustic liquids and the generation of irritating gases when mixed.

2.
An. pediatr. (2003. Ed. impr.) ; 92(1): 37-45, ene. 2020. tab
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-4022

RESUMO

Objetivo: Describir las características de los pacientes pediátricos con sospecha de intoxicación atendidos por unidades de soporte vital avanzado (SVA) y evaluar los indicadores de calidad (IC) para la atención urgente prehospitalaria de estos pacientes. Método: Estudio observacional de los pacientes menores de 18 años con exposición a tóxicos, que fueron atendidos por una unidad de SVA del Sistema de Emergencias Médicas en Cataluña, durante un año. Se definieron criterios de clínica grave. Se evaluaron 8 IC para la atención urgente prehospitalaria de los pacientes pediátricos intoxicados. Resultados: Se incluyó a 254 pacientes. La edad mediana fue de 14 años (p25-75 = 7-16), con exposición intencionada en el 50,8% de los casos. El tóxico más frecuentemente implicado fue el monóxido de carbono (CO) (33,8%). Presentó clínica de toxicidad el 48,8%, siendo grave en el 16,5%. La intencionalidad (OR 5,1; intervalo de confianza del 95%: 1,9-13,8) y el desconocimiento del tiempo transcurrido desde el contacto (OR 3,1; intervalo de confianza del 95%: 1,3-7,3) fueron factores de riesgo independientes asociados a clínica grave. Cinco IC no alcanzaron el estándar de calidad: disponibilidad de guías de actuación específicas, administración de carbón activado en pacientes seleccionados, aplicación de oxigenoterapia a la máxima concentración posible en intoxicación por CO, valoración electrocardiográfica en pacientes expuestos a sustancias cardiotóxicas y registro del conjunto mínimo de datos. Conclusiones: Los pacientes pediátricos expuestos a tóxicos y atendidos por unidades SVA presentan características propias. Destacan la implicación del CO y de los adolescentes con intoxicaciones voluntarias. La evaluación de los IC ha sido útil para detectar puntos débiles en la calidad asistencial de estos pacientes y desarrollar estrategias de mejora


Objective: To describe the characteristics of paediatric patients with suspected poisoning treated by advanced life support (ALS) units, and to evaluate quality indicators (QI) for the prehospital emergency care of these patients. Method: A one-year observational study of patients under 18 years of age exposed to poisoning and treated by an ALS unit of the Medical Emergency System in Catalonia. Severe clinical criteria were defined, with 8 QI being evaluated for prehospital emergency care of poisoned paediatric patients. Results: The study included a total of 254 patients, with a median age of 14 years-old (p25-75 = 7-16), with intentional poisoning in 50.8% of cases. The most frequently involved toxic agent was carbon monoxide (CO) (33.8%). Poisoning was found in 48.8% of those patients, being serious in 16.5%. Intentionally (OR 5.1; 95% CI: 1.9-13.8) and knowledge of the time of exposure (OD 3.1; 95% CI: 1.3-7.3) were independent risk factors associated with the appearance of severe clinical symptoms. Five QI did not reach the quality standard and included, availability of specific clinical guidelines, activated charcoal administration in selected patients, oxygen therapy administration at maximum possible concentration in carbon monoxide poisoning, electrocardiographic assessment in patients exposed to cardiotoxic substances, and recording of the minimum data set. Conclusions: Paediatric patients attended by ALS units showed specific characteristics, highlighting the involvement of CO and adolescents with voluntary poisoning. The QI assessment was useful to detect weak points in the quality of care of these patients and to develop strategies for improvement

3.
An Pediatr (Barc) ; 92(1): 37-45, 2020 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-31129026

RESUMO

OBJECTIVE: To describe the characteristics of paediatric patients with suspected poisoning treated by advanced life support (ALS) units, and to evaluate quality indicators (QI) for the prehospital emergency care of these patients. METHOD: A one-year observational study of patients under 18 years of age exposed to poisoning and treated by an ALS unit of the Medical Emergency System in Catalonia. Severe clinical criteria were defined, with 8 QI being evaluated for prehospital emergency care of poisoned paediatric patients. RESULTS: The study included a total of 254 patients, with a median age of 14 years-old (p25-75 = 7-16), with intentional poisoning in 50.8% of cases. The most frequently involved toxic agent was carbon monoxide (CO) (33.8%). Poisoning was found in 48.8% of those patients, being serious in 16.5%. Intentionally (OR 5.1; 95% CI: 1.9-13.8) and knowledge of the time of exposure (OD 3.1; 95% CI: 1.3-7.3) were independent risk factors associated with the appearance of severe clinical symptoms. Five QI did not reach the quality standard and included, availability of specific clinical guidelines, activated charcoal administration in selected patients, oxygen therapy administration at maximum possible concentration in carbon monoxide poisoning, electrocardiographic assessment in patients exposed to cardiotoxic substances, and recording of the minimum data set. CONCLUSIONS: Paediatric patients attended by ALS units showed specific characteristics, highlighting the involvement of CO and adolescents with voluntary poisoning. The QI assessment was useful to detect weak points in the quality of care of these patients and to develop strategies for improvement.

4.
Emergencias ; 31(5): 341-345, 2019 Oct.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31625306

RESUMO

OBJECTIVES: To study the epidemiology of emergency department visits for transient global amnesia (TGA) by itself or associated with substance abuse or sexual assault. MATERIAL AND METHODS: Retrospective study of cases treated from January to December 2018. Data for all patients with TGA were extracted, and cases were classified as associated with substance abuse (TGASUB), sexual assault (TGASEX), or neither (TGAONLY). RESULTS: A total of 287 TGA cases were found: 169 (58.9%) were TGASEX, 62 (21.6%) TGAONLY, and 56 (19.5%) TGASUB. Two hundred eighteen (76%) were female and 69 (24%) were male. Ages ranged from 16 to 90 years; 174 (60.6%) were under the age of 30 years. Two hundred one patients (72.8%) reported consuming alcohol; and 105 (49.1%) were positive on testing (mean blood alcohol concentration, 0.74 g/L; maximum, 3.9 g/L. Twenty patients (7.1%) reported using cannabis, and 39 (17.3%) had positive test results; 14 reported using cocaine (4.9%) and 28 (12.4%) tested positive; 5 (1.7%) reported using amphetamines and 20 (8.8%) tested positive. Fifty-eight (20.1%) had symptoms of intoxication. Four were admitted in coma. A computed tomography scan was ordered for 66 patients (23%), 7 patients were hospitalized, and none died. CONCLUSION: The prevalence of TGA is higher if cases of substance abuse and sexual assault are counted. Toxicolgy testing changes the epidemiology of TGA in emergencies.

5.
Emergencias (Sant Vicenç dels Horts) ; 31(5): 341-345, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184124

RESUMO

Objetivo. Conocer la epidemiología de las consultas en urgencias por amnesia global transitoria (AGT), ya sea pura, asociada al consumo de tóxicos o en el contexto de una agresión sexual. Método. Estudio retrospectivo de enero a diciembre de 2018. Se revisaron las AGT atendidas en intoxicados (AGTtox), en víctimas de agresiones sexuales (AGTsex) y las amnesias puras (AGTpur), evaluando la presencia de tóxicos. Resultados. Se identificaron 287 AGT: 169 AGTsex (58,9%), 62 AGTpur (21,6%) y 56 AGTtox (19,5%). De ellas, 218 (76%) fueron mujeres y la edad osciló entre 16 y 90 años (60,6% menores de 30 años). Reconocieron consumo de alcohol 201 casos (72,8%), con etanolemia positiva en 105 (49,1%) (media de 0,74 g/l y máxima de 3,9 g/l). Admitieron consumo de cannabis 20 pacientes (7,1%), con analítica positiva en 39 casos (17,3%); cocaína 14 (4,9%), con analítica positiva en 28 (12,4%), y anfetaminas 5 (1,7%), con analítica positiva en 20 (8,8%). Presentaron sínto-mas de intoxicación 58 casos (20,1%). Cuatro pacientes ingresaron en coma. Se realizó una tomografía computariza-da (TC) craneal a 66 pacientes (23%), se hospitalizaron 7 y no hubo ningún fallecimiento. Conclusiones. La prevalencia de AGT es mayor si se incluyen los intoxicados y las agresiones sexuales, modificando la determinación de tóxicos la epidemiología de la AGT en urgencias


Objectives. To study the epidemiology of emergency department visits for transient global amnesia (TGA) by itself or associated with substance abuse or sexual assault. Methods. Retrospective study of cases treated from January to December 2018. Data for all patients with TGA were extracted, and cases were classified as associated with substance abuse (TGASUB), sexual assault (TGASEX), or neither (TGAONLY). Results. A total of 287 TGA cases were found: 169 (58.9%) were TGASEX, 62 (21.6%) TGAONLY, and 56 (19.5%) TGASUB. Two hundred eighteen (76%) were female and 69 (24%) were male. Ages ranged from 16 to 90 years; 174 (60.6%) were under the age of 30 years. Two hundred one patients (72.8%) reported consuming alcohol; and 105 (49.1%) were positive on testing (mean blood alcohol concentration, 0.74 g/L; maximum, 3.9 g/L. Twenty patients (7.1%) reported using cannabis, and 39 (17.3%) had positive test results; 14 reported using cocaine (4.9%) and 28 (12.4%) tested positive; 5 (1.7%) reported using amphetamines and 20 (8.8%) tested positive. Fifty-eight (20.1%) had symptoms of intoxication. Four were admitted in coma. A computed tomography scan was ordered for 66 patients (23%), 7 patients were hospitalized, and none died. Conclusions. The prevalence of TGA is higher if cases of substance abuse and sexual assault are counted. Toxicolgy testing changes the epidemiology of TGA in emergencies


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Amnésia Global Transitória/complicações , Amnésia Global Transitória/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Serviços Médicos de Emergência/métodos , Delitos Sexuais , Sintomas Toxicológicos/efeitos adversos , Estudos Retrospectivos , Coma/complicações , Coma/diagnóstico por imagem , Tomografia Computadorizada de Emissão , Etanol/toxicidade , Cocaína/toxicidade , Cannabis/toxicidade , Anfetaminas/toxicidade , Análise de Variância
8.
Emergencias (Sant Vicenç dels Horts) ; 31(1): 39-42, feb. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-182435

RESUMO

Introducción: La intoxicación digitálica es un motivo frecuente de consulta en los servicios de urgencias hospitalarios (SUH). El objetivo de este estudio es conocer la mortalidad asociada a dicha intoxicación. Método: Estudio descriptivo y observacional de las intoxicaciones digitálicas atendidas en los SUH de 4 hospitales de Cataluña durante los años 2013-15. Se recogieron datos relativos a la intoxicación, la mortalidad inmediata y a los 30 días. Se analizó la existencia de posibles factores asociados a la mortalidad. Resultados: Se registraron 171 intoxicaciones digitálicas. Siete eran agudas (4,1%) y 164 (95,9%) crónicas. La mortalidad inmediata fue del 6,4% y a los 30 días fue del 13,4%. El análisis binario no identificó ningún factor relacionado con la mortalidad inmediata. En cuanto a la mortalidad a 30 días, los pacientes que fallecieron tenían con mayor frecuencia una intoxicación aguda (13% vs 2,7%; p= 0,05), había más intoxicaciones con intencionalidad suicida (8,7% vs 0,7%; p= 0,048), más afectación renal (21,7% vs 9,5%; p= 0,037), menos sintomatología neurológica (4,3% vs 17,8%; p= 0,005), mayor digoxinemia (4,7 mg/dl vs 3,7 mg/dl; p= 0,027) y menor puntuación en el índice de Barthel (IB) (49,1 (33,4) vs 70,3 (28,5); p= 0,006). El análisis de regresión logística identificó la digoxinemia como un factor independiente de mortalidad inmediata y la puntuación en el IB en la mortalidad a 30 días. Conclusiones: La digoxinemia se relaciona con la mortalidad inmediata y el IB se relaciona con la mortalidad a 30 días


Background and objective: Digoxin poisoning is a frequent reason for seeking emergency care. This study aimed to assess mortality related to digoxin poisoning. Methods: Descriptive observational study of digoxin poisonings attended in the emergency departments of 4 hospitals in Catalonia from 2013 through 2015. We gathered data relevant to the poisonings and recorded immediate and 30-day mortality. Factors possibly related to mortality were explored. Results: A total of 171 digoxin poisonings were attended. Seven (4.1%) were acute and 164 (95.9%) were chronic. The immediate and 30-day mortality rates were 6.4% and 13.4%, respectively. Bivariate analysis did not identify factors related to immediate mortality. However, the variables more often associated with 30-day mortality in this analysis were acute poisoning (after which 13% died vs 2.7% of those with chronic poisoning, P=.05), suicide attempts (8.7% of whom died vs 0.7%, P=.048), more compromised renal function (21.7% vs 9.5%, P=.037), fewer neurologic symptoms (4.3% vs 17.8% with more symptoms, P=.005), higher mean digoxin concentrations (4.7 mg/dL in those who died vs 3.7 mg/dL, P=.027), and a lower Barthel index (mean [SD] 49.1 [33.4] in those who died vs 70.3 [28.5]; P=.006). Logistic regression analysis identified serum digoxin concentration to be independently associated with immediate mortality. A lower Barthel index was associated with 30-day mortality. Conclusions: Immediate mortality is related to a high digoxin concentration in serum, and 30-day mortality to a low Barthel index


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Digoxina/envenenamento , Inibidores Enzimáticos/envenenamento , Envenenamento/mortalidade , Digoxina/sangue , Serviço Hospitalar de Emergência , Inibidores Enzimáticos/sangue , Envenenamento/sangue , Envenenamento/diagnóstico , Espanha/epidemiologia
9.
Emergencias ; 31(1): 39-42, 2019 02.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30656872

RESUMO

OBJECTIVES: Digoxin poisoning is a frequent reason for seeking emergency care. This study aimed to assess mortality related to digoxin poisoning. MATERIAL AND METHODS: Descriptive observational study of digoxin poisonings attended in the emergency departments of 4 hospitals in Catalonia from 2013 through 2015. We gathered data relevant to the poisonings and recorded immediate and 30-day mortality. Factors possibly related to mortality were explored. RESULTS: A total of 171 digoxin poisonings were attended. Seven (4.1%) were acute and 164 (95.9%) were chronic. The immediate and 30-day mortality rates were 6.4% and 13.4%, respectively. Bivariate analysis did not identify factors related to immediate mortality. However, the variables more often associated with 30-day mortality in this analysis were acute poisoning (after which 13% died vs 2.7% of those with chronic poisoning, P=.05), suicide attempts (8.7% of whom died vs 0.7%, P=.048), more compromised renal function (21.7% vs 9.5%, P=.037), fewer neurologic symptoms (4.3% vs 17.8% with more symptoms, P=.005), higher mean digoxin concentrations (4.7 mg/dL in those who died vs 3.7 mg/dL, P=.027), and a lower Barthel index (mean [SD] 49.1 [33.4] in those who died vs 70.3 [28.5]; P=.006). Logistic regression analysis identified serum digoxin concentration to be independently associated with immediate mortality. A lower Barthel index was associated with 30-day mortality. CONCLUSION: Immediate mortality is related to a high digoxin concentration in serum, and 30-day mortality to a low Barthel index.


Assuntos
Digoxina/envenenamento , Inibidores Enzimáticos/envenenamento , Envenenamento/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Digoxina/sangue , Serviço Hospitalar de Emergência , Inibidores Enzimáticos/sangue , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Envenenamento/sangue , Envenenamento/diagnóstico , Espanha/epidemiologia
11.
Rev. Rol enferm ; 41(10): 666-670, oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179758

RESUMO

Objetivos: Medir la intensidad de los cuidados enfermeros que precisan los intoxicados que acuden a Urgencias. Método: Durante cuatro meses se registraron los intoxicados remitidos a Urgencias y se seleccionó un subgrupo en el que se midieron los tiempos consumidos por enfermería en cada una de las actividades asistenciales. Resultados: Se registraron 155 intoxicados. La intoxicación medicamentosa fue más frecuente en días laborables (p < 0.05) y la alcohólica en los no laborables (p < 0.05). Al 72 % se les realizó una extracción de sangre y al 55 % de orina para identificar la presencia de tóxicos. Al 79 % se le administró alguna medicación y al 25% carbón activado. El consumo de tiempo en la comunicación verbal fue mayor en el grupo intoxicado con fármacos (p < 0.001). Conclusiones: La ingesta de fármacos ha sido la intoxicación atendida con mayor frecuencia, en particular en días laborables. El intoxicado por medicamentos es el que requiere más tiempo de comunicación verbal


Objectives: To describe and measure the intensity of nursing care in intoxicated patients attended by different levels of emergency care, depending on the day of admission and type of poison involved. Methods: Observational, cross-sectional, descriptive study. For four months, patients referred to the emergency department for acute poisoning were recorded. Of the total patients, a subgroup in which the nursing time used in each activity of the care process were measured was selected. Epidemiological variables (sex, age, date and time of admission to the emergency room), toxicology (type of poison), level of triage, nursing activities and patient outcomes were recorded. Results: 155 cases of poisoning were recorded. Drug poisoning was more common in working days (p < 0.05) and alcoholic in nonworking (p < 0.05). 72 % of patients underwent a blood test and 55 % a urine test to detect the presence of toxic substances. 79 % was administered any medication and 25 % activated carbon. The use of time in verbal communication was greater in patients consuming medicaments (p < 0.001) compared with patients consuming alcohol or illicit drugs. Conclusions: The intake of drugs has been the most frequently attended poisoning, particularly on working days. The intoxicated by drugs is the most time-consuming verbal communication


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tratamento de Emergência/enfermagem , Enfermagem em Emergência/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Envenenamento/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Envenenamento/enfermagem , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Custos de Cuidados de Saúde/estatística & dados numéricos
12.
Emergencias (Sant Vicenç dels Horts) ; 30(2): 126-132, abr. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-171591

RESUMO

Las urgencias por mordeduras de serpientes ibéricas en España son poco frecuentes pero potencialmente graves. De las trece especies autóctonas, sólo cinco son venenosas (2 especies de colúbridos y las 3 especies de vipéridos) y pueden suponer un riesgo para la vida del paciente. La identificación de las especies puede ser sencilla teniendo en cuenta una serie de rasgos del ofidio. Las manifestaciones clínicas debidas al envenenamiento de las víboras, así como su tratamiento, han experimentado modificaciones en los últimos años (AU)


Emergencies due to snakebites, although unusual in Spain, are potentially serious. Of the 13 species native to the Iberian peninsula, only 5 are poisonous: 2 belong to the Colubridae family and 3 to the Viperidae family. Bites from these venemous snakes can be life-threatening, but the venomous species can be easily identified by attending to certain physical traits. Signs denoting poisoning from vipers, and the appropriate treatment to follow, have changed in recent years (AU)


Assuntos
Humanos , Mordeduras de Serpentes/epidemiologia , Serviço Hospitalar de Emergência , Envenenamento , Mordeduras de Serpentes/terapia , Espanha/epidemiologia , Serviços Médicos de Emergência/métodos
13.
Emergencias ; 30(2): 126-132, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29547237

RESUMO

OBJECTIVES: Emergencies due to snakebites, although unusual in Spain, are potentially serious. Of the 13 species native to the Iberian peninsula, only 5 are poisonous: 2 belong to the Colubridae family and 3 to the Viperidae family. Bites from these venemous snakes can be life-threatening, but the venomous species can be easily identified by attending to certain physical traits. Signs denoting poisoning from vipers, and the appropriate treatment to follow, have changed in recent years.


Assuntos
Mordeduras de Serpentes/epidemiologia , Adulto , Animais , Antivenenos/uso terapêutico , Criança , Emergências , Feminino , Humanos , Masculino , Mordeduras de Serpentes/classificação , Mordeduras de Serpentes/cirurgia , Mordeduras de Serpentes/terapia , Venenos de Serpentes/envenenamento , Serpentes/anatomia & histologia , Serpentes/fisiologia , Espanha/epidemiologia , Especificidade da Espécie
14.
Rev. Rol enferm ; 41(2): 102-110, feb. 2018. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-170947

RESUMO

Los productos químicos, ya sea en el ámbito doméstico, agrícola o industrial, pueden tener como órgano diana de su acción tóxica la piel y las mucosas, y producir desde una irritación a una quemadura, o utilizar estas vías para la absorción y la generación de toxicidad sistémica. La descontaminación precoz de piel y mucosas es fundamental para evitar la absorción del tóxico y así reducir o evitar lesiones locales y secuelas generales que pueden ser graves o incluso mortales. Para ello es necesario disponer de un área de descontaminación química, conocer las técnicas y métodos principales de descontaminación y disponer de protocolos de actuación (AU)


Chemicals, whether domestic, agricultural or industrial, may have a toxic effect on the skin and mucous membranes, with consequences ranging from irritation to burns, or even to systemic toxicity after absorption. Early decontamination of skin and mucous membranes is essential to prevent absorption of the toxicant and reduce or avoid local injury and general sequels that can be serious or even fatal. It is therefore necessary to have a chemical decontamination area, to be aware of the main decontamination techniques and methods and to have action protocols (AU)


Assuntos
Humanos , Compostos Químicos/efeitos adversos , Distúrbios Induzidos Quimicamente/enfermagem , Descontaminação/métodos , Queimaduras Químicas/enfermagem , Substâncias Perigosas/efeitos adversos , Substâncias Tóxicas , Equipamento de Proteção Individual , Acidentes e Eventos com Materiais Perigosos , Absorção Fisiológica
15.
Med. clín (Ed. impr.) ; 150(1): 16-19, ene. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-169654

RESUMO

Antecedentes y objetivo: Los antídotos pueden tener un papel relevante en el tratamiento de las intoxicaciones y el tiempo hasta su administración puede condicionar la supervivencia del paciente. Pacientes y método: Estudio realizado mediante cuestionario a principios del año 2015 en 70 hospitales de Cataluña que atienden urgencias. La disponibilidad cualitativa para cada antídoto se consideró adecuada cuando estaba presente en al menos el 80% de los hospitales. La disponibilidad cuantitativa se consideró adecuada cuando se disponía de la cantidad recomendada en al menos el 80% de los hospitales del nivel oportuno. Resultados: Para hospitales de menor complejidad, el porcentaje de antídotos con disponibilidad cualitativa y cuantitativa adecuada fue del 66,7 y 42,9%. En hospitales de mayor complejidad, las disponibilidades cualitativas y cuantitativas fueron adecuadas en un 64,5 y 38,7% de los antídotos. No se observaron diferencias significativas entre las diferentes regiones sanitarias, pero hubo una correlación positiva (p<0,05) entre las urgencias atendidas por los hospitales y el porcentaje de disponibilidad cualitativa adecuada. Conclusiones: La disponibilidad de antídotos en los hospitales de Cataluña es en general baja y muestra diferencias en función de la región sanitaria y de la complejidad asistencial de los hospitales (AU)


Background and objective: Antidotes may have a relevant role in acute intoxication management and the time until its administration can influence patient survival. Patients and method: Study conducted by a questionnaire sent in early 2015 to 70 hospitals in Catalonia providing emergency services. Qualitative availability on each antidote was considered adequate when present in at least 80% of hospitals. The quantitative availability was considered adequate when at least 80% of hospitals had the number of units of antidote recommended. Results: Lower complexity hospitals (level A) showed a percentage of adequate qualitative and quantitative availability of 66.7 and 42.9% respectively. In higher complexity hospitals (level B) qualitative and quantitative availability was adequate in 64.5 and 38.7% of the antidotes respectively. Data showed no differences between the different health regions as well as a positive correlation (p<.05) between the number of emergencies attended and the percentage of adequate qualitative availability. Conclusions: The availability of antidotes in Catalonia hospitals is generally low and shows differences across health regions and depending on level of complexity (AU)


Assuntos
Humanos , Antídotos/provisão & distribução , Hospitais/normas , Serviços Médicos de Emergência/tendências , Kit Médico de Emergência , Envenenamento/epidemiologia , Envenenamento/prevenção & controle , Administração Hospitalar/normas , Inquéritos e Questionários , Aprovisionamento , Estudos Transversais/métodos
16.
Med Clin (Barc) ; 150(1): 16-19, 2018 Jan 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28705416

RESUMO

BACKGROUND AND OBJECTIVE: Antidotes may have a relevant role in acute intoxication management and the time until its administration can influence patient survival. PATIENTS AND METHOD: Study conducted by a questionnaire sent in early 2015 to 70 hospitals in Catalonia providing emergency services. Qualitative availability on each antidote was considered adequate when present in at least 80% of hospitals. The quantitative availability was considered adequate when at least 80% of hospitals had the number of units of antidote recommended. RESULTS: Lower complexity hospitals (level A) showed a percentage of adequate qualitative and quantitative availability of 66.7 and 42.9% respectively. In higher complexity hospitals (level B) qualitative and quantitative availability was adequate in 64.5 and 38.7% of the antidotes respectively. Data showed no differences between the different health regions as well as a positive correlation (p<.05) between the number of emergencies attended and the percentage of adequate qualitative availability. CONCLUSIONS: The availability of antidotes in Catalonia hospitals is generally low and shows differences across health regions and depending on level of complexity.


Assuntos
Antídotos/provisão & distribução , Serviço Hospitalar de Emergência , Recursos em Saúde/provisão & distribução , Estudos Transversais , Hospitais , Humanos , Espanha
19.
Farm. hosp ; 41(3): 317-333, mayo-jun. 2017. ilus, tab, mapas
Artigo em Inglês | IBECS | ID: ibc-162871

RESUMO

Objective: To design a virtual antidote network between hospitals that could help to locate on-line those hospitals that stocked those antidotes with the highest difficulty in terms of availability, and ensured that the medication was loaned in case of necessity. Methods: The application was developed by four hospital pharmacists and two clinical toxicologists with the support of a Healthcare Informatics Consultant Company. Results: The antidotes network in Catalonia, Spain, was launched in July 2015. It can be accessed through the platform: www.xarxaantidots.org. The application has an open area with overall information about the project and the option to ask toxicological questions of non-urgent nature. The private area is divided into four sections: 1) Antidotes: data of interest about the 15 antidotes included in the network and their recommended stock depending on the complexity of the hospital, 2) Antidote stock management: virtual formulary, 3) Loans: location of antidotes through the on-line map application Google Maps, and virtual loan request, and 4) Documentation: As of June, 2016, 40 public and private hospitals have joined the network, from all four provinces of Catalonia, which have accessed the private area 2102 times, requested two loans of silibinin, one of hydroxocobalamin, three of antiophidic serum and three of botulism antitoxin. Thirteen toxicological consultations have been received. Conclusions: The implementation of this network improves the communication between centers that manage poisoned patients, adapts and standardizes the stock of antidotes in hospitals, speeds up loans if necessary, and improves the quality of care for poisoned patients (AU)


Objetivo: Diseñar una red virtual de antídotos entre hospitales que permitiese localizar, de forma online, en qué hospitales están ubicados los antídotos con mayor dificultad de disponibilidad y facilitase el préstamo de la medicación en caso de necesidad. Método: La aplicación fue desarrollada por cuatro farmacéuticos de hospital, dos toxicólogos clínicos y el soporte de una empresa informática. Resultados: La red de antídotos de Cataluña entró en funcionamiento en julio de 2015. Puede accederse a través de la plataforma: www.xarxaantidots.org. La aplicación consta de una zona abierta con información general del proyecto y la posibilidad de realizar consultas toxicológicas de carácter no urgente. La zona privada se divide en cuatro secciones: 1) Antídotos: datos de interés de los 15 antídotos en red y dotación recomendada en función de la complejidad del hospital, 2) Gestión del stock de antídotos: botiquines virtuales, 3) Préstamos: localización de antídotos mediante el servidor de aplicaciones de mapas en la web, Google Maps, y solicitud de préstamo virtual y 4) Documentación: Hasta junio de 2016 son 40 los hospitales públicos y privados de las cuatro provincias de Cataluña adheridos; se han registrado 2.102 accesos a la zona privada, solicitado dos préstamos de silibinina, uno de hidroxocobalamina, tres de suero antiofídico y tres de suero antibotulínico. Se han recibido 13 consultas toxicológicas. Conclusiones: La puesta en marcha de la red mejora la comunicación entre centros que atienden a pacientes intoxicados, adecua y homogeneiza la dotación de antídotos de los hospitales, agiliza los préstamos en caso necesario y aumenta la calidad de la atención a los pacientes intoxicados (AU)


Assuntos
Humanos , Antídotos/provisão & distribução , Serviço de Farmácia Hospitalar/organização & administração , Envenenamento/tratamento farmacológico , Redes de Comunicação de Computadores/organização & administração , Envenenamento/epidemiologia , Sistemas de Comunicação no Hospital/organização & administração
20.
Farm Hosp ; 41(3): 317-333, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28478747

RESUMO

Objetive: To design a virtual antidote network between hospitals that could help to locate on-line those hospitals that stocked those antidotes with the highest difficulty in terms of availability, and ensured that the medication was loaned in case of necessity. METHODS: The application was developed by four hospital pharmacists and two clinical toxicologists with the support of a Healthcare Informatics Consultant Company. RESULTS: The antidotes network in Catalonia, Spain, was launched in July 2015. It can be accessed through the platform: www.xarxaantidots.org. The application has an open area with overall information about the project and the option to ask toxicological questions of non-urgent nature. The private area is divided into four sections: 1) Antidotes: data of interest about the 15 antidotes included in the network and their recommended stock depending on the complexity of the hospital, 2) Antidote stock management: virtual formulary, 3) Loans: location of antidotes through the on-line map application Google Maps, and virtual loan request, and 4) Documentation: As of June, 2016, 40 public and private hospitals have joined the network, from all four provinces of Catalonia, which have accessed the private area 2 102 times, requested two loans of silibinin, one of hydroxocobalamin, three of antiophidic serum and three of botulism antitoxin. Thirteen toxicological consultations have been received. CONCLUSIONS: The implementation of this network improves the communication between centers that manage poisoned patients, adapts and standardizes the stock of antidotes in hospitals, speeds up loans if necessary, and improves the quality of care for poisoned patients.


Assuntos
Antídotos/provisão & distribução , Serviço de Farmácia Hospitalar/organização & administração , Comunicação , Simulação por Computador , Serviço Hospitalar de Emergência , Formulários de Hospitais como Assunto , Hospitais , Humanos , Espanha , Inquéritos e Questionários
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