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3.
Chest ; 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33065105

RESUMO

Drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid". According to WHO, drowning claim the lives of more than 40 people every hour of every day. Drowning involves some physiological principles and medical interventions that are unique. It occurs in a deceptively hostile environment that involves an underestimation of the dangers or an overestimation of water competency. It has been estimated that more than 90% are preventable. When water is aspirated into the airways, coughing is the initial reflex response. The acute lung injury alters the exchange of O2 in different proportions. The combined effects of fluid in the lungs, loss of surfactant and increased capillary-alveolar permeability result in decreased lung compliance, increased right-to-left shunting in the lungs, atelectasis, and alveolitis, a non-cardiogenic pulmonary edema. Salt and fresh water aspiration cause similar pathology. If the person is not rescued, aspiration continues and hypoxemia leads to loss of consciousness and apnea in seconds to minutes. As a consequence, hypoxic cardiac arrest occurs. The decision to admit to an ICU should consider patient´s drowning severity and co-or-premorbid conditions. Ventilation therapy should achieve an intrapulmonary shunt of 20% or less, or PaO2:FiO2 of 250 or more. Premature ventilatory weaning may cause the return of pulmonary edema with the need for re-intubation, and an anticipation of prolonged hospital stays and further morbidity. This review includes all the essentials steps from the first call to action until the best practice at the pre-hospital, emergency department, and hospitalization.

4.
Am J Emerg Med ; 38(11): 2395-2399, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33039225

RESUMO

OBJECTIVE: Introducing a new, simple and inexpensive portable equipment for lifeguards, consisting of a pre-assembled full-size plastic blanket with a mask and HEPA filter, which could offer significant time-saving advantages to reduce COVID-19 risk transmission in the first few minutes of CPR after water rescue, avoiding the negative impact of delayed ventilation. METHOD: A pilot study was carried out to determine the feasibility of the pre-assembled kit of face-mask and HEPA filter adapted on a pre-set plastic-blanket. The first step consisted of washing hands, putting on safety glasses and gloves as the first personal protection equipment (PPE) and then covering the victim with an assembled plastic blanket. The second step consisted of 10 min of cardiopulmonary resuscitation (CPR) with PPE and plastic blanket, following the technical recommendations for ventilation during COVID-19. RESULTS: Ten rescuers took part in the pilot study. The average time to wear PPE and place the pre-assembly kit on the victim was 82 s [IC 58-105]. After 10 min the quality of the resuscitation (QCPR) was 91% [87-94]. Quality chest compressions (CC) were 22% better than ventilations (V). Most of the rescuers (60%) thought that placing the plastic blanket on the victim on the beach was somewhat simple or very simple. CONCLUSIONS: Resuscitation techniques in COVID-19 era at the beach have added complexities for the correct use of PPE. Plastic blanket plus basic ventilations equipment resource could be a new alternative to be considered for lifeguards to keep ventilation on use while reducing risk transmission.

5.
Inj Prev ; 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32737057

RESUMO

BACKGROUND: Lifeguards are integral to beach safety and collect data which is used for a variety of purposes, although guidelines and best practice have yet to be established. This study served to identify and characterise existing beach lifeguard service provider (BLSP) data collection procedures in order to identify the degree of uniformity and areas for improvement. METHODS: The 'International Beach Lifeguard Data Collection and Reporting' online survey was distributed via the International Drowning Researchers' Alliance to BLSP supervisors and managers. The survey included questions on beach conditions and lifeguard activity data collection practices, and respondent's opinions on their own BLSP's methods. RESULTS: Variability in data collection practices was evident in surveys obtained from 55 lifeguard leaders in 12 countries. Discrepancies exist in definitions for 'rescue' among BLSPs, a significant amount of information related to beach conditions are recorded and beach visitation is primarily obtained by visual estimate. Respondents expressed challenges with getting frontline staff to collect information in the field and ensuring reporting consistency between recorders. They identified rescue victim demographic factors as key data they would like to collect in the future. CONCLUSIONS: Inconsistencies in lifeguard data collection present challenges to operations, safety education and prevention efforts, research and policy relying on these data. Variation in definitions, methods and collected variables generally restricts analysis to a single BLSP with limited generalisability to other beach settings. Some gaps in lifeguard data collection may soon be addressed by technology, but developing uniform, internationally acceptable standards and definitions should be prioritised.

6.
Rev Esp Salud Publica ; 942020 Jun 30.
Artigo em Espanhol | MEDLINE | ID: mdl-32601267

RESUMO

Severe acute respiratory syndrome (SARS-CoV-2), which causes coronavirus disease 2019 (Covid-19), is highly contagious. Lifeguards are the first line of response in aquatic emergencies and they will suffer a strong exposure to risk this first summer of the Covid-19 era, so their occupational health must be rethought in their professional practice during the new normal. The main public health measure to prevent drowning is prevention, but when this fails and assistance or rescue is required, in most interventions, distancing will not be possible. The limitation of personal protective equipment (PPE) for rescue is a reality that must be known and that can affect the health of the lifeguard. A review of the current literature aimed at avoiding or minimizing the risk of contagion in the interventions carried out by rescuers in the Covid-19 era was performed. This article provides structured information on the prevention of contagion in lifeguards, the potential risks, the available PPE, and the recommendations for its proper use during rescue or prehospital care in aquatic settings.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Saúde do Trabalhador , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Ressuscitação , Natação , Betacoronavirus , Emergências , Humanos , Afogamento Iminente , Espanha
7.
Rev. esp. salud pública ; 94: 0-0, 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192975

RESUMO

El síndrome respiratorio agudo severo (SARS-CoV-2), que causa la enfermedad por coronavirus 2019 (Covid-19), es altamente contagioso. Los socorristas son la primera línea de respuesta en las emergencias acuáticas y van a sufrir una fuerte exposición al riesgo este primer verano de la era Covid-19, por lo que su salud laboral debe ser replanteada en su práctica profesional durante la nueva normalidad. La principal medida de salud pública para evitar ahogamientos es la prevención, pero cuando esta falla y se requiere la asistencia o el rescate, en la mayor parte de las intervenciones el distanciamiento no será posible. La limitación de los equipos de protección personal (EPI) para el rescate es una realidad que debe conocerse y que puede afectar a la salud del socorrista. Se realizó una revisión de la literatura actual orientada a evitar o minimizar el riesgo de contagio en las intervenciones realizadas por rescatadores en la era Covid-19. Este artículo ofrece una información estructurada sobre la prevención del contagio en los socorristas, los riesgos potenciales, los EPI disponibles y las recomendaciones para su adecuado uso durante los rescates o la atención prehospitalaria en los entornos acuáticos


Severe acute respiratory syndrome (SARS-CoV-2), which causes coronavirus disease 2019 (Covid-19), is highly contagious. Lifeguards are the first line of response in aquatic emergencies and they will suffer a strong exposure to risk this first summer of the Covid-19 era, so their occupational health must be rethought in their professional practice during the new normal. The main public health measure to prevent drowning is prevention, but when this fails and assistance or rescue is required, in most interventions, distancing will not be possible. The limitation of personal protective equipment (PPE) for rescue is a reality that must be known and that can affect the health of the lifeguard. A review of the current literature aimed at avoiding or minimizing the risk of contagion in the interventions carried out by rescuers in the Covid-19 era was performed. This article provides structured information on the prevention of contagion in lifeguards, the potential risks, the available PPE, and the recommendations for its proper use during rescue or prehospital care in aquatic settings


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Síndrome Respiratória Aguda Grave/prevenção & controle , Vírus da SARS/patogenicidade , Salvamento Aquático , Reanimação Cardiopulmonar/métodos , Precauções Universais/métodos , Infecções por Coronavirus/epidemiologia , Controle de Doenças Transmissíveis/métodos , Exposição Ocupacional/prevenção & controle , Socorristas/estatística & dados numéricos
8.
Arq Bras Cardiol ; 113(3): 449-663, 2019 10 10.
Artigo em Português | MEDLINE | ID: mdl-31621787
9.
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, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP | ID: biblio-1038561
10.
Cleve Clin J Med ; 85(7): 529-535, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30004377

RESUMO

Drowning is a common and often preventable cause of death, especially in children. The mass media often propagate misinformation about "dry" and "secondary" drowning, diverting attention from appropriate efforts to prevent drowning and rescue and treat those who do drown.


Assuntos
Afogamento/epidemiologia , Adolescente , Reanimação Cardiopulmonar , Criança , Pré-Escolar , Afogamento/prevenção & controle , Humanos , Lactente , Saúde Pública
11.
Resuscitation ; 129: 103-106, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29928958

RESUMO

International data severely underestimates actual drowning numbers. Almost all victims are able to help themselves or are rescued in time. This study aims to report the occurrence of Drowning Chain of Survival actions and resuscitations needed in a fully operational lifeguard service. METHODOLOGY: Data was collected from Dec-2009 to Mar-2015 by lifeguards at a 6km-long beach in Brazil. The Drowning Chain of Survival links were summarized into 3 main action-response sections: Prevention; rescue; and provide care. Rescues were classified by severity. RESULTS: Lifeguards reported 1,565,699 actions during the study period. Preventative actions comprised 1,563,300(99.8%) and 2044 (0.1%) involved recognizing a person in stress/distress and rescuing them. Of those requiring rescue, 355(0.02%) needed medical assistance due to respiratory symptoms, isolated respiratory arrest, or cardiopulmonary arrest. Those cases were classified by severity as: Grade 1 = 234(65.9%), grade 2 = 78(22%), grade 3 = 22(6.2%), grade 4 = 7(2%), grade 5 = 4(1.1%), and Grade 6 = 10(2.8%). From all 2044 rescues, 14(0.7%) were grade 5 and 6 and needed respiratory or cardiorespiratory resuscitation. An estimative incident rate for each day at a lifeguarded beach revealed: 1 rescue for every 4.227 beach attendances, 1 drowning for every 24,338 beach attendances, and 1 instance of CPR being performed for every 617,142 beach attendances. The prevalent misconception that majority of drowning require resuscitation is perpetuated by the media and publishers. We are only just seeing the tip of the iceberg and urgently need to look at the problem in its entirety. Considering all the intervention undertaken by lifeguards in a fully operational system, the incidence of resuscitation being performed is only one in every 112,000 lifeguarding actions (0.0009%).


Assuntos
Reanimação Cardiopulmonar/métodos , Afogamento/epidemiologia , Parada Cardíaca/terapia , Adulto , Brasil/epidemiologia , Feminino , Parada Cardíaca/epidemiologia , Parada Cardíaca/etiologia , Humanos , Incidência , Masculino , Estudos Retrospectivos , Taxa de Sobrevida/tendências
13.
Rev Soc Bras Med Trop ; 51(1): 115-117, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29513832

RESUMO

The most frequent jellyfish in Southern Brazil causes mainly local pain and skin plaques. A 3-year-old female bather presented an erythematous, irregular plaque on the left forearm after contact with a jellyfish and intense facial angioedema with facial flushing. The lungs had vesicular murmur, wheezes, and snorts, and pink and spumous secretion in the airways with intercostal retraction. She was administered subcutaneous adrenaline (0.1mg/kg) and hydrocortisone intravenous (10mg/kg) with total recovery in a few minutes. The manifestations of anaphylactic reactions are distinct from those of envenomations, and prompt and adequate care is fundamental in these situations.


Assuntos
Anafilaxia/etiologia , Angioedema/etiologia , Mordeduras e Picadas/complicações , Cnidários/classificação , Venenos de Cnidários , Anafilaxia/diagnóstico , Angioedema/diagnóstico , Animais , Pré-Escolar , Feminino , Humanos
14.
Rev. Soc. Bras. Med. Trop ; 51(1): 115-117, Jan.-Feb. 2018. graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-897045

RESUMO

Abstract The most frequent jellyfish in Southern Brazil causes mainly local pain and skin plaques. A 3-year-old female bather presented an erythematous, irregular plaque on the left forearm after contact with a jellyfish and intense facial angioedema with facial flushing. The lungs had vesicular murmur, wheezes, and snorts, and pink and spumous secretion in the airways with intercostal retraction. She was administered subcutaneous adrenaline (0.1mg/kg) and hydrocortisone intravenous (10mg/kg) with total recovery in a few minutes. The manifestations of anaphylactic reactions are distinct from those of envenomations, and prompt and adequate care is fundamental in these situations.

16.
Artigo em Inglês | MEDLINE | ID: mdl-28716971

RESUMO

BACKGROUND: Utstein-style guidelines use an established consensus process, endorsed by the international resuscitation community, to facilitate and structure resuscitation research and publication. The first "Guidelines for Uniform Reporting of Data From Drowning" were published over a decade ago. During the intervening years, resuscitation science has advanced considerably, thus making revision of the guidelines timely. In particular, measurement of cardiopulmonary resuscitation elements and neurological outcomes reporting have advanced substantially. The purpose of this report is to provide updated guidelines for reporting data from studies of resuscitation from drowning. METHODS: An international group with scientific expertise in the fields of drowning research, resuscitation research, emergency medical services, public health, and development of guidelines met in Potsdam, Germany, to determine the data that should be reported in scientific articles on the subject of resuscitation from drowning. At the Utstein-style meeting, participants discussed data elements in detail, defined the data, determined data priority, and decided how data should be reported, including scoring methods and category details. RESULTS: The template for reporting data from drowning research was revised extensively, with new emphasis on measurement of quality of resuscitation, neurological outcomes, and deletion of data that have proved to be less relevant or difficult to capture. CONCLUSIONS: The report describes the consensus process, rationale for selecting data elements to be reported, definitions and priority of data, and scoring methods. These guidelines are intended to improve the clarity of scientific communication and the comparability of scientific investigations.


Assuntos
Pesquisa Biomédica/normas , Reanimação Cardiopulmonar/normas , Afogamento , Parada Cardíaca/terapia , Projetos de Pesquisa/normas , Consenso , Afogamento/mortalidade , Parada Cardíaca/diagnóstico , Parada Cardíaca/etiologia , Parada Cardíaca/mortalidade , Humanos , Comunicação Interdisciplinar , Cooperação Internacional
17.
Scand J Trauma Resusc Emerg Med ; 25(1): 72, 2017 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-28716063

RESUMO

BACKGROUND: In 2002, the World Congress on Drowning developed a uniform definition for drowning. The aim of this study is to determine the prevalence of "non-uniform drowning terminology" (NUDT) and "non-uniform drowning definitions" (NUDD) in peer-reviewed scientific literature from 2010 to 2016, and compare these findings with those from our unpublished study performing a similar analysis on literature from 2003 to 2010. METHODS: A systematic review was performed using drowning-specific search terms in Pubmed and Web of Science. Titles and abstracts published between July 2010 and January 2016 were screened for relevance to the study focus. Articles meeting screening criteria were reviewed for exclusion criteria to produce the final group of studies. These articles were reviewed by four reviewers for NUDT and NUDD. The Fisher exact test was used to determine any statistically significant changes. RESULTS: The final group of studies included 167 articles. A total of 53 articles (32%) utilized NUDT, with 100% of these including the term "near drowning". The proportion of articles utilizing NUDT was significantly less than reported by our previous study (p < 0.05). In addition, 32% of the articles included a definition for drowning (uniform or non-uniform), with 15% of these utilizing NUDD. DISCUSSION: Our study reveals a statistically significant improvement over the past thirteen years in the use of uniform drowning terminology in peer-reviewed scientific literature, although year-to-year variability over the current study period does not yield an obvious trend. CONCLUSIONS: Of the articles reviewed during the 2010-2016 study period, 32% included outdated and non-uniform drowning terminology and definitions. While this reveals an absolute decrease of 11% as compared with the previous study period (2003-2010), there is still significant room for improvement.


Assuntos
Afogamento/diagnóstico , Terminologia como Assunto , Seguimentos , Humanos
19.
Resuscitation ; 118: 147-158, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28728893

RESUMO

BACKGROUND: Utstein-style guidelines use an established consensus process, endorsed by the international resuscitation community, to facilitate and structure resuscitation research and publication. The first "Guidelines for Uniform Reporting of Data From Drowning" were published over a decade ago. During the intervening years, resuscitation science has advanced considerably, thus making revision of the guidelines timely. In particular, measurement of cardiopulmonary resuscitation elements and neurological outcomes reporting have advanced substantially. The purpose of this report is to provide updated guidelines for reporting data from studies of resuscitation from drowning. METHODS: An international group with scientific expertise in the fields of drowning research, resuscitation research, emergency medical services, public health, and development of guidelines met in Potsdam, Germany, to determine the data that should be reported in scientific articles on the subject of resuscitation from drowning. At the Utstein-style meeting, participants discussed data elements in detail, defined the data, determined data priority, and decided how data should be reported, including scoring methods and category details. RESULTS: The template for reporting data from drowning research was revised extensively, with new emphasis on measurement of quality of resuscitation, neurological outcomes, and deletion of data that have proved to be less relevant or difficult to capture. CONCLUSIONS: The report describes the consensus process, rationale for selecting data elements to be reported, definitions and priority of data, and scoring methods. These guidelines are intended to improve the clarity of scientific communication and the comparability of scientific investigations.


Assuntos
Reanimação Cardiopulmonar/normas , Afogamento , Parada Cardíaca/terapia , Consenso , Serviços Médicos de Emergência/normas , Parada Cardíaca/diagnóstico , Parada Cardíaca/etiologia , Parada Cardíaca/mortalidade , Humanos , Cooperação Internacional
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