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1.
Braz J Anesthesiol ; 2020 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-32836520

RESUMO

The care for patients suffering from cardiopulmonary arrest in a context of a COVID-19 pandemic has particularities that should be highlighted. The following recommendations from the Brazilian Association of Emergency Medicine (ABRAMEDE), the Brazilian Society of Cardiology (SBC) and the Brazilian Association of Intensive Medicine (AMIB) and the Brazilian Society of Anesthesiology (SBA), associations and societies official representatives of specialties affiliated to the Brazilian Medical Association (AMB), aim to guide the various assistant teams, in a context of little solid evidence, maximizing the protection of teams and patients. It is essential to wear full Personal Protective Equipment (PPE) for aerosols during the care of Cardiopulmonary Resuscitation (CPR) and it is imperative to consider and treat the potential causes in these patients, especially hypoxia and arrhythmias caused by changes in the QT interval or myocarditis. The installation of an advanced invasive airway must be obtained early and the use of High Efficiency Particulate Arrestance (HEPA) filters at the interface with the valve bag is mandatory; situations of occurrence of CPR during mechanical ventilation and in a prone position demand peculiarities that are different from the conventional CPR pattern. Faced with the care of a patient diagnosed or suspected of COVID-19, the care follows the national and international protocols and guidelines 2015 ILCOR (International Alliance of Resuscitation Committees), AHA 2019 Guidelines (American Heart Association) and the Update of the Cardiopulmonary Resuscitation and Emergency Care Directive of the Brazilian Society of Cardiology 2019.

2.
Arq Bras Cardiol ; 114(6): 1078-1087, 2020 06.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32638902

RESUMO

Care for patients with cardiac arrest in the context of the coronavirus disease 2019 (COVID-19) pandemic has several unique aspects that warrant particular attention. This joint position statement by the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Society of Cardiology (SBC), Brazilian Association of Intensive Care Medicine (AMIB), and Brazilian Society of Anesthesiology (SBA), all official societies representing the corresponding medical specialties affiliated with the Brazilian Medical Association (AMB), provides recommendations to guide health care workers in the current context of limited robust evidence, aiming to maximize the protection of staff and patients alike. It is essential that full aerosol precautions, which include wearing appropriate personal protective equipment, be followed during resuscitation. It is also imperative that potential causes of cardiac arrest of particular interest in this patient population, especially hypoxia, cardiac arrhythmias associated with QT prolongation, and myocarditis, be considered and addressed. An advanced invasive airway device should be placed early. Use of HEPA filters at the bag-valve interface is mandatory. Management of cardiac arrest occurring during mechanical ventilation or during prone positioning demands particular ventilator settings and rescuer positioning for chest compressions which deviate from standard cardiopulmonary resuscitation techniques. Apart from these logistical issues, care should otherwise follow national and international protocols and guidelines, namely the 2015 International Liaison Committee on Resuscitation (ILCOR) and 2019 American Heart Association (AHA) guidelines and the 2019 Update to the Brazilian Society of Cardiology Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guideline.


Assuntos
Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/terapia , Coronavirus , Pandemias , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Comitês Consultivos , Betacoronavirus , Brasil/epidemiologia , Reanimação Cardiopulmonar/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Sociedades Médicas , Estados Unidos
3.
Artigo em Inglês | MEDLINE | ID: mdl-32552523

RESUMO

Endovascular Therapeutic hypothermia (ETH) reduces the damage caused by postischemia reperfusion injury syndrome in cardiopulmonary arrest and has already established its role in patients with sudden death; however, its role in ST-segment elevation myocardial infarction (STEMI) remains controversial. The objectives of this study were to investigate the safety, feasibility, and 30-day efficacy of rapid induction of therapeutic hypothermia as adjunctive therapy to percutaneous coronary intervention (PCI) in patients with anterior and inferior STEMIs. This was a prospective, controlled, randomized, two-arm, prospective, interventional study of patients admitted to the emergency department within 6 hours of angina onset, with anterior or inferior STEMI eligible for PCI. Subjects were randomized to the hypothermia group (primary PCI+ETH) or to the control group (primary PCI) at a 4:1 ratio. The ETH was induced by 1 L cold saline (1-4°C) associated with the Proteus™ System, by cooling for at least 18 minutes before coronary reperfusion with a target temperature of 32°C ± 1°C. Maintenance of ETH was conducted for 1-3 hours, and active reheating was done at a rate of 1°C/h for 4 hours. Primary safety outcomes were the feasibility of ETH in the absence of (1) door-to-balloon (DTB) delay; (2) major adverse cardiac events (MACE) within 30 days after randomization. The primary outcomes of effectiveness were infarct size (IS) and left ventricular ejection fraction (LVEF) at 30 days. An as-treated statistical analysis was performed. Fifty patients were included: 35 (70%) randomized to the hypothermia group and 15 (30%) to the control group. The mean age was 58 ± 12 years; 78% were men; and associated diseases were 60% hypertension, 42% diabetes, and 72% dyslipidemia. The compromised myocardial wall was anterior in 38% and inferior in 62%, and the culprit vessels were left anterior descending artery (LAD) (40%), right coronary artery (38%), and left circumflex (18%). All 35 patients who attempted ETH (100%) had successful cooling, with a mean endovascular coronary reperfusion temperature of 33.1°C ± 0.9°C. The mean ischemic time was 375 ± 89.4 minutes in the hypothermia group and 359.5 ± 99.4 minutes in the control group. The mean DTB was 92.1 ± 20.5 minutes in the hypothermia group and 87 ± 24.4 minutes in the control group. The absolute difference of 5.1 minutes was not statistically significant (p = 0.509). The MACE rates were similar between both groups (21.7% vs. 20% respectively, p = 0.237). In the comparison between the hypothermia and control groups, no statistically significant differences were observed at 30 days between mean IS (13.9% ± 8% vs. 13.8% ± 10.8%, respectively, p = 0.801) and mean final LVEF (43.3% ± 11.2% vs. 48.3 ± 10.9%, respectively; p = 0.194). Hypothermia as an adjunctive therapy to primary PCI in STEMI is feasible and can be implemented without delay in coronary reperfusion. Hypothermia was safe regarding the incidence of MACE at 30 days. However, there was a higher incidence of arrhythmia and in-hospital infection in the hypothermia group, with no increase in mortality. Regarding efficacy, there was no difference in IS or LVEF at 30 days that would suggest additional myocardial protection with ETH. ClinicalTrials.gov: NCT02664194.

4.
Arq Bras Cardiol ; 113(3): 449-663, 2019 10 10.
Artigo em Português | MEDLINE | ID: mdl-31621787
5.
Bernoche, Claudia; Timerman, Sergio; Polastri, Thatiane Facholi; Giannetti, Natali Schiavo; Siqueira, Adailson Wagner da Silva; Piscopo, Agnaldo; Soeiro, Alexandre de Matos; Reis, Amélia Gorete Afonso da Costa; Tanaka, Ana Cristina Sayuri; Thomaz, Ana Maria; Quilici, Ana Paula; Catarino, Andrei Hilário; Ribeiro, Anna Christina de Lima; Barreto, Antonio Carlos Pereira; Azevedo, Antonio Fernando Barros de Filho; Pazin, Antonio Filho; Timerman, Ari; Scarpa, Bruna Romanelli; Timerman, Bruno; Tavares, Caio de Assis Moura; Martins, Cantidio Soares Lemos; Serrano, Carlos Vicente Junior; Malaque, Ceila Maria Sant'Ana; Pisani, Cristiano Faria; Batista, Daniel Valente; Leandro, Daniela Luana Fernandes; Szpilman, David; Gonçalves, Diego Manoel; Paiva, Edison Ferreira de; Osawa, Eduardo Atsushi; Lima, Eduardo Gomes; Adam, Eduardo Leal; Peixoto, Elaine; Evaristo, Eli Faria; Azeka, Estela; Silva, Fabio Bruno da; Wen, Fan Hui; Ferreira, Fatima Gil; Lima, Felipe Gallego; Fernandes, Felipe Lourenço; Ganem, Fernando; Galas, Filomena Regina Barbosa Gomes; Tarasoutchi, Flavio; Souza, Germano Emilio Conceição; Feitosa, Gilson Soares Filho; Foronda, Gustavo; Guimarães, Helio Penna; Abud, Isabela Cristina Kirnew; Leite, Ivanhoé Stuart Lima; Linhares, Jaime Paula Pessoa Filho; Moraes, Junior João Batista de Moura Xavier; Falcão, João Luiz Alencar de Araripe; Ramires, Jose Antônio Franchini; Cavalini, José Fernando; Saraiva, José Francisco Kerr; Abrão, Karen Cristine; Pinto, Lecio Figueira; Bianchi, Leonardo Luís Torres; Lopes, Leonardo Nícolau Geisler Daud; Piegas, Leopoldo Soares; Kopel, Liliane; Godoy, Lucas Colombo; Tobase, Lucia; Hajjar, Ludhmila Abrahão; Dallan, Luís Augusto Palma; Caneo, Luiz Fernando; Cardoso, Luiz Francisco; Canesin, Manoel Fernandes; Park, Marcelo; Rabelo, Marcia Maria Noya; Malachias, Marcus Vinícius Bolívar; Gonçalves, Maria Aparecida Batistão; Almeida, Maria Fernanda Branco de; Souza, Maria Francilene Silva; Favarato, Maria Helena Sampaio; Carrion, Maria Julia Machline; Gonzalez, Maria Margarita; Bortolotto, Maria Rita de Figueiredo Lemos; Macatrão-Costa, Milena Frota; Shimoda, Mônica Satsuki; Oliveira-Junior, Mucio Tavares de; Ikari, Nana Miura; Dutra, Oscar Pereira; Berwanger, Otávio; Pinheiro, Patricia Ana Paiva Corrêa; Reis, Patrícia Feitosa Frota dos; Cellia, Pedro Henrique Moraes; Santos Filho, Raul Dias dos; Gianotto-Oliveira, Renan; Kalil Filho, Roberto; Guinsburg, Ruth; Managini, Sandrigo; Lage, Silvia Helena Gelas; Yeu, So Pei; Franchi, Sonia Meiken; Shimoda-Sakano, Tania; Accorsi, Tarso Duenhas; Leal, Tatiana de Carvalho Andreucci; Guimarães, Vanessa; Sallai, Vanessa Santos; Ávila, Walkiria Samuel; Sako, Yara Kimiko.
Arq. bras. cardiol ; 113(3): 449-663, Sept. 2019. tab, graf
Artigo em Português | LILACS-Express | LILACS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1038561
6.
Rev Esc Enferm USP ; 51: e03288, 2018 Mar 26.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-29590239

RESUMO

OBJECTIVE: To develop and evaluate an online course on Basic Life Support. METHOD: Technological production research of online course guided by the ADDIE (Analysis, Design, Development, Implementation, Evaluation) instructional design model based on Andragogy and the Meaningful Learning Theory. The online course was constructed in the platform Moodle, previously assessed by a group of experts, and then presented to the students of the Nursing School of the University of São Paulo, who assessed it at the end of the course. RESULTS: The course was evaluated by the experts and obtained a mean score of 0.92 (SD 0.15), considered as good quality (between 0.90-0.94), and by the students, with a mean score of 0.95 (SD 0.03), considered as high quality (0.95-1.00). CONCLUSION: The instructional design used was found to be appropriate to the development of the online course. As an active educational strategy, it contributed to the learning on Basic Life Support during cardiac arrest-related procedures in adults. In view of the need for technological innovations in education and systematization of care in cardiopulmonary resuscitation, the online course allows the establishment of continuous improvement processes in the quality of resuscitation in the care provided by students and professionals.


Assuntos
Reanimação Cardiopulmonar/educação , Educação em Enfermagem/métodos , Parada Cardíaca/terapia , Estudantes de Enfermagem , Adulto , Brasil , Educação a Distância/métodos , Tecnologia Educacional/métodos , Feminino , Humanos , Masculino , Adulto Jovem
7.
Rev Lat Am Enfermagem ; 25: e2942, 2017 Oct 30.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-29091127

RESUMO

OBJECTIVE: to evaluate students' learning in an online course on basic life support with immediate feedback devices, during a simulation of care during cardiorespiratory arrest. METHOD: a quasi-experimental study, using a before-and-after design. An online course on basic life support was developed and administered to participants, as an educational intervention. Theoretical learning was evaluated by means of a pre- and post-test and, to verify the practice, simulation with immediate feedback devices was used. RESULTS: there were 62 participants, 87% female, 90% in the first and second year of college, with a mean age of 21.47 (standard deviation 2.39). With a 95% confidence level, the mean scores in the pre-test were 6.4 (standard deviation 1.61), and 9.3 in the post-test (standard deviation 0.82, p <0.001); in practice, 9.1 (standard deviation 0.95) with performance equivalent to basic cardiopulmonary resuscitation, according to the feedback device; 43.7 (standard deviation 26.86) mean duration of the compression cycle by second of 20.5 (standard deviation 9.47); number of compressions 167.2 (standard deviation 57.06); depth of compressions of 48.1 millimeter (standard deviation 10.49); volume of ventilation 742.7 (standard deviation 301.12); flow fraction percentage of 40.3 (standard deviation 10.03). CONCLUSION: the online course contributed to learning of basic life support. In view of the need for technological innovations in teaching and systematization of cardiopulmonary resuscitation, simulation and feedback devices are resources that favor learning and performance awareness in performing the maneuvers.


Assuntos
Reanimação Cardiopulmonar/educação , Retroalimentação , Treinamento por Simulação , Feminino , Humanos , Masculino , Fatores de Tempo , Adulto Jovem
8.
Rev. latinoam. enferm. (Online) ; 25: e2942, 2017. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-961108

RESUMO

ABSTRACT Objective: to evaluate students' learning in an online course on basic life support with immediate feedback devices, during a simulation of care during cardiorespiratory arrest. Method: a quasi-experimental study, using a before-and-after design. An online course on basic life support was developed and administered to participants, as an educational intervention. Theoretical learning was evaluated by means of a pre- and post-test and, to verify the practice, simulation with immediate feedback devices was used. Results: there were 62 participants, 87% female, 90% in the first and second year of college, with a mean age of 21.47 (standard deviation 2.39). With a 95% confidence level, the mean scores in the pre-test were 6.4 (standard deviation 1.61), and 9.3 in the post-test (standard deviation 0.82, p <0.001); in practice, 9.1 (standard deviation 0.95) with performance equivalent to basic cardiopulmonary resuscitation, according to the feedback device; 43.7 (standard deviation 26.86) mean duration of the compression cycle by second of 20.5 (standard deviation 9.47); number of compressions 167.2 (standard deviation 57.06); depth of compressions of 48.1 millimeter (standard deviation 10.49); volume of ventilation 742.7 (standard deviation 301.12); flow fraction percentage of 40.3 (standard deviation 10.03). Conclusion: the online course contributed to learning of basic life support. In view of the need for technological innovations in teaching and systematization of cardiopulmonary resuscitation, simulation and feedback devices are resources that favor learning and performance awareness in performing the maneuvers.


RESUMO Objetivo: avaliar o aprendizado de estudantes no curso online sobre suporte básico de vida com dispositivos de retroalimentação imediata, em simulação de atendimento em parada cardiorrespiratória. Método: pesquisa quase-experimental, do tipo antes-depois. Foi desenvolvido curso online sobre suporte básico e aplicado aos participantes, como intervenção educacional. O aprendizado teórico foi avaliado por meio de pré e pós-teste e, para verificar a prática, utilizou-se simulação com dispositivos de retroalimentação imediata. Resultados: 62 concluintes, sendo 87% mulheres, 90% do primeiro e segundo ano de faculdade, idade média de 21,47 (desvio-padrão 2,39). Com índice de confiabilidade de 95%, a média das notas no pré-teste foi 6,4 (desvio-padrão 1,61) e, no pós-teste, 9,3 (desvio-padrão 0,82), p<0,001; na prática, 9,1 (desvio-padrão 0,95) e, de acordo com o dispositivo de feedback com desempenho equivalente à reanimação cardiopulmonar básica, 43,7 (desvio-padrão 26,86), médias de duração do ciclo de compressões por segundo de 20,5 (desvio-padrão 9,47), número de compressões de 167,2 (desvio-padrão 57,06), profundidade de compressões por milímetro de 48,1 (desvio-padrão 10,49), volume de ventilação de 742,7 (desvio-padrão 301,12), percentual de fração de fluxo de 40,3 (desvio-padrão 10,03). Conclusão: com o curso online houve contribuição para o aprendizado do suporte básico de vida. Em face da necessidade de inovações tecnológicas no ensino e na sistematização da reanimação cardiopulmonar, simulação e dispositivos de retroalimentação são recursos que favorecem o aprendizado e a consciência da performance na realização das manobras.


RESUMEN Objetivo: evaluar el aprendizaje de estudiantes en curso online sobre soporte vital básico de vida con dispositivos de retroalimentación inmediata, en simulación de asistencia en paro cardiorrespiratorio. Método: investigación casi-experimental, del tipo antes-después. Se desarrolló un curso online sobre soporte básico y aplicado a los participantes, como intervención educacional. El aprendizaje teórico fue evaluado por medio de pre y pos-test y, para verificar la práctica, se utilizó una simulación con dispositivos de retroalimentación inmediata. Resultados: 62 graduados, el 87% mujeres, el 90% del primero y segundo año de facultad, edad media de 21.47 (desviación estándar 2.39). Con índice de confiabilidad del 95%, la media de las notas en pre-test fue de 6.4 (desviación estándar1.61) y, en pos-test, 9.3 (desviación estándar 0.82), p<0.001; en la práctica, 9.1 (desviación estándar 0.95) y, de acuerdo con el dispositivo de retroalimentación con desempeño equivalente a la reanimación cardiopulmonar básica, 43.7 (desviación estándar 26.86), medias de duración del ciclo de compresiones por segundo de 20.5 (desviación estándar 9.47), número de compresiones de 1672 (desviación estándar 57.06), profundidad de compresiones por milímetro de 48.1 (desviación estándar 10.49), volumen de ventilación de 742.7 (desviación estándar 301.12), porcentual de fracción de flujo de 40.3 (desviación estándar 10.03). Conclusión: con el curso online hubo contribución al aprendizaje del soporte vital básico. En vista de la necesidad de innovaciones tecnológicas en la enseñanza y en la sistematización de la reanimación cardiopulmonar, simulación y dispositivos de retroalimentación son recursos que favorecen el aprendizaje y la consciencia del desempeño en la realización de las maniobras.


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Reanimação Cardiopulmonar/educação , Retroalimentação , Treinamento por Simulação , Fatores de Tempo
9.
Rev. Esc. Enferm. USP ; 51: e03288, 2017. tab
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-956618

RESUMO

ABSTRACT Objective To develop and evaluate an online course on Basic Life Support. Method Technological production research of online course guided by the ADDIE (Analysis, Design, Development, Implementation, Evaluation) instructional design model based on Andragogy and the Meaningful Learning Theory. The online course was constructed in the platform Moodle, previously assessed by a group of experts, and then presented to the students of the Nursing School of the University of São Paulo, who assessed it at the end of the course. Results The course was evaluated by the experts and obtained a mean score of 0.92 (SD 0.15), considered as good quality (between 0.90-0.94), and by the students, with a mean score of 0.95 (SD 0.03), considered as high quality (0.95-1.00). Conclusion The instructional design used was found to be appropriate to the development of the online course. As an active educational strategy, it contributed to the learning on Basic Life Support during cardiac arrest-related procedures in adults. In view of the need for technological innovations in education and systematization of care in cardiopulmonary resuscitation, the online course allows the establishment of continuous improvement processes in the quality of resuscitation in the care provided by students and professionals.


RESUMEN Objetivo Desarrollar y evaluar el curso en línea acerca del Soporte Básico de Vida. Método Investigación de producción tecnológica de curso en línea, orientada por el modelo de diseño instruccional ADDIE (Analysis, Design, Development, Implementation, Evaluation), fundamentada en la Andragogía y la Teoría del Aprendizaje Significativo. El modelo fue construido en la plataforma Moodle, evaluado previamente por un grupo de especialistas, y luego presentado a los estudiantes en la Escuela de Enfermería de la Universidad de São Paulo, siendo evaluado por estos al término del curso. Resultados El curso fue evaluado por los expertos y obtuvo promedio 0,92 (DE 0,15), considerado de buena calidad (entre 0,90-0,94), y por los estudiantes, con promedio 0,95 (DE 0,03), considerado de alta calidad (0,95-1,00). Conclusión El diseño instruccional utilizado se mostró adecuado al desarrollo del curso en línea. Como estrategia educativa activa, contribuyó al aprendizaje acerca del Soporte Básico de Vida, durante las maniobras en el paro cardiorrespiratorio del adulto. Frente a la necesidad de innovaciones tecnológicas en la enseñanza y de sistematización de la atención en la reanimación cardiopulmonar, el curso en línea permite establecer procesos de mejora continua de la calidad de reanimación en atenciones prestadas por estudiantes y profesionales.


RESUMO Objetivo Desenvolver e avaliar o curso on-line sobre Suporte Básico de Vida. Método Pesquisa de produção tecnológica de curso on-line, orientada pelo modelo de design instrucional ADDIE (Analysis, Design, Development, Implementation, Evaluation), fundamentada na Andragogia e na Teoria da Aprendizagem Significativa. O modelo foi construído na plataforma Moodle, avaliado previamente por um grupo de especialistas, e então apresentado aos estudantes na Escola de Enfermagem da Universidade de São Paulo, sendo avaliado por estes ao término do curso. Resultados O curso foi avaliado pelos especialistas e obteve média 0,92 (DP 0,15), considerado de boa qualidade (entre 0,90-0,94), e pelos estudantes, com média 0,95 (DP 0,03), considerado de alta qualidade (0,95-1,00). Conclusão O design instrucional utilizado mostrou-se adequado ao desenvolvimento do curso on-line. Como estratégia educacional ativa, contribuiu para o aprendizado sobre Suporte Básico de Vida, durante as manobras na parada cardiorrespiratória do adulto. Frente à necessidade de inovações tecnológicas no ensino e de sistematização do atendimento na reanimação cardiopulmonar, o curso on-line permite estabelecer processos de melhoria contínua da qualidade de reanimação, em atendimentos prestados por estudantes e profissionais.


Assuntos
Reanimação Cardiopulmonar/educação , Educação a Distância , Educação em Enfermagem , Tecnologia Educacional
10.
Arq Bras Cardiol ; 100(2): 105-13, 2013 Feb.
Artigo em Inglês, Português | MEDLINE | ID: mdl-23503818

RESUMO

Despite advances related to the prevention and treatment in the past few years, many lives are lost to cardiac arrest and cardiovascular events in general in Brazil every year. Basic Life Support involves cardiovascular emergency treatment mainly in the pre-hospital environment, with emphasis on the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.


Assuntos
Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Adulto , Brasil , Desfibriladores , Serviços Médicos de Emergência , Humanos , Parada Cardíaca Extra-Hospitalar/terapia , Respiração Artificial/métodos , Taquicardia Ventricular/terapia , Fibrilação Ventricular/terapia
11.
Arq. bras. cardiol ; 100(2): 105-113, fev. 2013. ilus, tab
Artigo em Português | LILACS | ID: lil-667950

RESUMO

Apesar de avanços nos últimos anos relacionados à prevenção e a tratamento, muitas são as vidas perdidas anualmente no Brasil relacionado à parada cardíaca e a eventos cardiovasculares em geral. O Suporte Básico de Vida envolve o atendimento às emergências cardiovasculares principalmente em ambiente pré-hospitalar, enfatizando reconhecimento e realização precoces das manobras de ressuscitação cardiopulmonar com foco na realização de compressões torácicas de boa qualidade, assim como na rápida desfibrilação, por meio da implementação dos programas de acesso público à desfibrilação. Esses aspectos são de fundamental importância e podem fazer diferença no desfecho dos casos como sobrevida hospitalar sem sequelas neurológicas. O início precoce do Suporte Avançado de Vida em Cardiologia também possui papel essencial, mantendo, durante todo o atendimento, a qualidade das compressões torácicas, adequado manejo da via aérea, tratamento específico dos diferentes ritmos de parada, desfibrilação, avaliação e tratamento das possíveis causas. Mais recentemente dá-se ênfase a cuidados pós-ressuscitação, visando reduzir a mortalidade por meio do reconhecimento precoce e tratamento da síndrome pós-parada cardíaca. A hipotermia terapêutica tem demonstrado melhora significativa da lesão neurológica e deve ser realizada em indivíduos comatosos pós-parada cardíaca. Para os médicos que trabalham na emergência ou unidade de terapia intensiva é de grande importância o aperfeiçoamento no tratamento desses pacientes por meio de treinamentos específicos, possibilitando maiores chances de sucesso e maior sobrevida.


Despite advances related to the prevention and treatment in the past few years, many lives are lost to cardiac arrest and cardiovascular events in general in Brazil every year. Basic Life Support involves cardiovascular emergency treatment mainly in the pre-hospital environment, with emphasis on the early recognition and delivery of cardiopulmonary resuscitation maneuvers focused on high-quality thoracic compressions and rapid defibrillation by means of the implementation of public access-to-defibrillation programs. These aspects are of the utmost importance and may make the difference on the patient's outcomes, such as on hospital survival with no permanent neurological damage. Early initiation of the Advanced Cardiology Life Support also plays an essential role by keeping the quality of thoracic compressions; adequate airway management; specific treatment for the different arrest rhythms; defibrillation; and assessment and treatment of the possible causes during all the assistance. More recently, emphasis has been given to post-resuscitation care, with the purpose of reducing mortality by means of early recognition and treatment of the post-cardiac arrest syndrome. Therapeutic hypothermia has provided significant improvement of neurological damage and should be performed in comatose individuals post-cardiac arrest. For physicians working in the emergency department or intensive care unit, it is extremely important to improve the treatment given to these patients by means of specific training, thus giving them the chance of higher success and of better survival rates.


Assuntos
Adulto , Humanos , Reanimação Cardiopulmonar/métodos , Parada Cardíaca/terapia , Brasil , Desfibriladores , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar/terapia , Respiração Artificial/métodos , Taquicardia Ventricular/terapia , Fibrilação Ventricular/terapia
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