Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.920
Filtrar
1.
Scand J Trauma Resusc Emerg Med ; 29(1): 19, 2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504366

RESUMO

BACKGROUND: Futile resuscitation for out-of-hospital cardiac arrest (OHCA) patients in the coronavirus disease (COVID)-19 era can lead to risk of disease transmission and unnecessary transport. Various existing basic or advanced life support (BLS or ALS, respectively) rules for the termination of resuscitation (TOR) have been derived and validated in North America and Asian countries. This study aimed to evaluate the external validation of these rules in predicting the survival outcomes of OHCA patients in the COVID-19 era. METHODS: This was a multicenter observational study using the WinCOVID-19 Daegu registry data collected during February 18-March 31, 2020. The subjects were patients who showed cardiac arrest of presumed cardiac etiology. The outcomes of each rule were compared to the actual patient survival outcomes. The sensitivity, specificity, false positive value (FPV), and positive predictive value (PPV) of each TOR rule were evaluated. RESULTS: In total, 170 of the 184 OHCA patients were eligible and evaluated. TOR was recommended for 122 patients based on the international basic life support termination of resuscitation (BLS-TOR) rule, which showed 85% specificity, 74% sensitivity, 0.8% FPV, and 99% PPV for predicting unfavorable survival outcomes. When the traditional BLS-TOR rules and KoCARC TOR rule II were applied to our registry, one patient met the TOR criteria but survived at hospital discharge. With regard to the FPV (upper limit of 95% confidence interval < 5%), specificity (100%), and PPV (> 99%) criteria, only the KoCARC TOR rule I, which included a combination of three factors including not being witnessed by emergency medical technicians, presenting with an asystole at the scene, and not experiencing prehospital shock delivery or return of spontaneous circulation, was found to be superior to all other TOR rules. CONCLUSION: Among the previous nine BLS and ALS TOR rules, KoCARC TOR rule I was most suitable for predicting poor survival outcomes and showed improved diagnostic performance. Further research on variations in resources and treatment protocols among facilities, regions, and cultures will be useful in determining the feasibility of TOR rules for COVID-19 patients worldwide.


Assuntos
/prevenção & controle , Reanimação Cardiopulmonar/normas , Técnicas de Apoio para a Decisão , Futilidade Médica , Parada Cardíaca Extra-Hospitalar/terapia , Idoso , Idoso de 80 Anos ou mais , Serviços Médicos de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sistema de Registros , República da Coreia , Ordens quanto à Conduta (Ética Médica)
2.
Rev. enferm. UERJ ; 28: e50721, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1103402

RESUMO

Objetivo: apresentar atualizações para a ressuscitação cardiopulmonar em pacientes suspeitos e confirmados com COVID-19. Método: revisão compreensiva da literatura, com síntese narrativa das evidências de diretrizes e recomendações da Organização Mundial de Saúde, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma e National Association of Emergency Medical Technicians. Resultados: as principais atualizações trazem informações sobre especificidades das manobras de ressuscitação cardiopulmonar; preparação do ambiente, recursos humanos e materiais, reconhecimento da parada cardiorrespiratória e ações iniciais; estratégias de ventilação e acesso invasivo da via aérea; ajustes do ventilador mecânico e manobras de ressuscitação cardiopulmonar em pacientes pronados. Considerações finais: profissionais de saúde envolvidos no atendimento à parada cardiorrespiratória de pacientes suspeitos e/ou confirmados com COVID-19 podem encontrar inúmeros desafios, portanto devem seguir com rigor o protocolo estabelecido para maximizar a efetividade das manobras de ressuscitação e minimizar o risco de contágio pelo vírus e sua disseminação.


Objective: to present updates for cardiopulmonary resuscitation in suspected and confirmed patients with COVID-19. Method: comprehensive literature review with narrative synthesis of the evidence of guidelines and recommendations from World Health Organization, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Results: the main updates bring information about the specifics of cardiopulmonary resuscitation maneuvers; preparation of the environment and human and material resources, recognition of cardiorespiratory arrest and initial actions; ventilation and invasive airway access strategies; mechanical ventilator adjustments and cardiopulmonary resuscitation maneuvers in patients in the prone position. Final considerations: health professionals involved in the care of cardiorespiratory arrest of suspected and/or confirmed patients with COVID-19 can face numerous challenges, so they must strictly follow the protocol established to maximize the effectiveness of resuscitation maneuvers and minimize the risk of contagion by the virus and its spread.


Objetivo: apresentar actualizaciones para la reanimación cardiopulmonar en pacientes sospechos os y confirmados con COVID-19. Método: revisión exhaustiva de la literatura con síntesis narrativa de la evidencia de guías y recomendaciones de la Organización Mundial de la Salud, Associação de Medicina Intensiva Brasileira, American Heart Association, Resuscitation Council UK, American College of Surgions Committee on Trauma and National Association of Emergency Medical Technicians. Resultados: las principales actualizaciones aportan información sobre los detalles de las maniobras de reanimación cardiopulmonar; preparación del medio ambiente y recursos humanos y materiales, reconocimiento de paro cardiorrespiratorio y acciones iniciales; estrategias de ventilación y acceso invasivo a las vías aéreas; ajustes del ventilador mecánico y maniobras de reanimación cardiopulmonar en pacientes en decúbito prono. Consideraciones finales: los profesionales de la salud involucrados en la atención del paro cardiorrespiratorio de pacientes sospechosos y/o confirmados con COVID-19 pueden enfrentar numerosos desafíos, por lo que deben seguir estrictamente el protocolo establecido para maximizar la efectividad de las maniobras de reanimación y minimizar el riesgo de contagio por el virus y supropagación.


Assuntos
Humanos , Masculino , Feminino , Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/complicações , Betacoronavirus , Parada Cardíaca/etiologia , Respiração Artificial/métodos , Protocolos Clínicos/normas , Reanimação Cardiopulmonar/métodos , Contenção de Riscos Biológicos/normas , Parada Cardíaca/reabilitação , Massagem Cardíaca/métodos , Equipe de Enfermagem/normas
3.
Med. intensiva (Madr., Ed. impr.) ; 44(9): 566-576, dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-189899

RESUMO

La pandemia por SARS-CoV-2 ha generado nuevos escenarios que requieren modificaciones de los protocolos habituales de reanimación cardiopulmonar. Las guías clínicas vigentes sobre el manejo de la parada cardiorrespiratoria no incluyen recomendaciones para situaciones aplicables a este contexto. Por ello, el Plan Nacional de Reanimación Cardiopulmonar de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias, en colaboración con el Grupo Español de RCP Pediátrica y Neonatal y con el programa de Enseñanza de Soporte Vital en Atención Primaria de la Sociedad Española de Medicina Familiar y Comunitaria, ha redactado las siguientes recomendaciones, que están divididas en 5 partes que tratan los principales aspectos para cada entorno asistencial. En este artículo se presenta un resumen ejecutivo de las mismas


The SARS-CoV-2 pandemic has created new scenarios that require modifications to the usual cardiopulmonary resuscitation protocols. The current clinical guidelines on the management of cardiorespiratory arrest do not include recommendations for situations that apply to this context. Therefore, the National Cardiopulmonary Resuscitation Plan of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), in collaboration with the Spanish Group of Pediatric and Neonatal CPR and with the Teaching Life Support in Primary Care program of the Spanish Society of Family and Community Medicine (SEMFyC), have written these recommendations, which are divided into 5 parts that address the main aspects for each healthcare setting. This article consists of an executive summary of them


Assuntos
Humanos , Infecções por Coronavirus/diagnóstico , Reanimação Cardiopulmonar/normas , Reanimação Cardiopulmonar/instrumentação , Parada Cardíaca/complicações , Reação em Cadeia da Polimerase , Sociedades Médicas/normas , Segurança do Paciente , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/transmissão
4.
Artigo em Inglês | MEDLINE | ID: mdl-32933179

RESUMO

Survival outcomes increase significantly when cardiopulmonary resuscitation (CPR) is provided correctly, but rescuer's fatigue can compromise CPR delivery. We investigated the effect of a 100-m maximal run on CPR and physiological variables in 14 emergency medical technicians (age 29.2 ± 5.8 years, height 171.2 ± 1.1 cm and weight 73.4 ± 13.1 kg). Using an adult manikin and a compression-ventilation ratio of 30:2, participants performed 4-min CPR after 4-min baseline conditions (CPR) and 4-min CPR after a 100-m maximal run carrying emergency material (CPR-run). Physiological variables were continuously measured during baseline and CPR conditions using a portable gas analyzer (K4b2, Cosmed, Rome, Italy) and analyzed using two HD video cameras (Sony, HDR PJ30VE, Japan). Higher VO2 (14.4 ± 2.1 and 22.0 ± 2.5 mL·kg-1·min-1) and heart rate (123 ± 17 and 148 ± 17 bpm) were found for CPR-run. However, the compression rate was also higher during the CPR-run (373 ± 51 vs. 340 ± 49) and between every three complete cycles (81 ± 9 vs. 74 ± 14, 99 ± 14 vs. 90 ± 10, 99 ± 10 vs. 90 ± 10, and, 101 ± 15 vs. 94 ± 11, for cycle 3, 6, 9 and 12, respectively). Fatigue induced by the 100-m maximal run had a strong impact on physiological variables, but a mild impact on CPR emergency medical technicians' performance.


Assuntos
Reanimação Cardiopulmonar/normas , Fadiga/etiologia , Parada Cardíaca/terapia , Esforço Físico , Adulto , Reanimação Cardiopulmonar/métodos , Feminino , Humanos , Itália , Japão , Masculino , Manequins , Roma , Fatores de Tempo
5.
Food Chem Toxicol ; 145: 111742, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32916218

RESUMO

SARS-CoV-2 (Covid-19) infection has recently become a worldwide challenge with dramatic global economic and health consequences. As the pandemic is still spreading, new data concerning Covid-19 complications and related mechanisms become increasingly available. Accumulating data suggest that the incidence of cardiac arrest and its outcome are adversely affected during the Covid-19 period. This may be further exacerbated by drug-related cardiac toxicity of Covid-19 treatment regimens. Elucidating the underlying mechanisms that lead to Covid-19 associated cardiac arrest is imperative, not only in order to improve its effective management but also to maximize preventive measures. Herein we discuss available epidemiological data on cardiac arrest during the Covid-19 pandemic as well as possible associated causes and pathophysiological mechanisms and highlight gaps in evidence warranting further investigation. The risk of transmission during cardiopulmonary resuscitation (CPR) is also discussed in this review. Finally, we summarize currently recommended guidelines on CPR for Covid-19 patients including CPR in patients with cardiac arrest due to suspected drug-related cardiac toxicity in an effort to underscore the most important common points and discuss discrepancies proposed by established international societies.


Assuntos
Arritmias Cardíacas/epidemiologia , Arritmias Cardíacas/fisiopatologia , Betacoronavirus , Infecções por Coronavirus/complicações , Parada Cardíaca/epidemiologia , Parada Cardíaca/fisiopatologia , Pneumonia Viral/complicações , Arritmias Cardíacas/etiologia , Reanimação Cardiopulmonar/normas , Cardiotoxicidade/epidemiologia , Cardiotoxicidade/etiologia , Cardiotoxicidade/fisiopatologia , Infecções por Coronavirus/tratamento farmacológico , Transmissão de Doença Infecciosa/prevenção & controle , Parada Cardíaca/etiologia , Humanos , Pandemias , Pneumonia Viral/tratamento farmacológico
7.
J Contin Educ Nurs ; 51(9): 399-401, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32833029

RESUMO

In light of the COVID-19 pandemic and uncertainties around risk of transmission, urgent hospital resuscitation (also known as "Code Blue") efforts are needed, pivoting to protect health care workers. This article provides teaching tips for "Protected Code Blues." [J Contin Educ Nurs. 2020;51(9):399-401.].


Assuntos
Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/enfermagem , Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/enfermagem , Pessoal de Saúde/educação , Recursos Humanos de Enfermagem no Hospital/educação , Pneumonia Viral/enfermagem , Treinamento por Simulação/organização & administração , Adulto , Betacoronavirus , Currículo , Educação Continuada em Enfermagem/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Guias de Prática Clínica como Assunto
8.
Med J Aust ; 213(3): 126-133, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32656798

RESUMO

INTRODUCTION: The global pandemic of coronavirus disease 2019 (COVID-19) has caused significant worldwide disruption. Although Australia and New Zealand have not been affected as much as some other countries, resuscitation may still pose a risk to health care workers and necessitates a change to our traditional approach. This consensus statement for adult cardiac arrest in the setting of COVID-19 has been produced by the Australasian College for Emergency Medicine (ACEM) and aligns with national and international recommendations. MAIN RECOMMENDATIONS: In a setting of low community transmission, most cardiac arrests are not due to COVID-19. Early defibrillation saves lives and is not considered an aerosol generating procedure. Compression-only cardiopulmonary resuscitation is thought to be a low risk procedure and can be safely initiated with the patient's mouth and nose covered. All other resuscitative procedures are considered aerosol generating and require the use of airborne personal protective equipment (PPE). It is important to balance the appropriateness of resuscitation against the risk of infection. Methods to reduce nosocomial transmission of COVID-19 include a physical barrier such as a towel or mask over the patient's mouth and nose, appropriate use of PPE, minimising the staff involved in resuscitation, and use of mechanical chest compression devices when available. If COVID-19 significantly affects hospital resource availability, the ethics of resource allocation must be considered. CHANGES IN MANAGEMENT: The changes outlined in this document require a significant adaptation for many doctors, nurses and paramedics. It is critically important that all health care workers have regular PPE and advanced life support training, are able to access in situ simulation sessions, and receive extensive debriefing after actual resuscitations. This will ensure safe, timely and effective management of the patients with cardiac arrest in the COVID-19 era.


Assuntos
Reanimação Cardiopulmonar/métodos , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/organização & administração , Parada Cardíaca/terapia , Pandemias , Pneumonia Viral/epidemiologia , Adulto , Algoritmos , Austrália/epidemiologia , Betacoronavirus , Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Nova Zelândia/epidemiologia , Equipamento de Proteção Individual , Pneumonia Viral/transmissão
9.
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
11.
Pediatr Res ; 88(5): 705-716, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32634818

RESUMO

BACKGROUND: Fewer children than adults have been affected by the COVID-19 pandemic, and the clinical manifestations are distinct from those of adults. Some children particularly those with acute or chronic co-morbidities are likely to develop critical illness. Recently, a multisystem inflammatory syndrome (MIS-C) has been described in children with some of these patients requiring care in the pediatric ICU. METHODS: An international collaboration was formed to review the available evidence and develop evidence-based guidelines for the care of critically ill children with SARS-CoV-2 infection. Where the evidence was lacking, those gaps were replaced with consensus-based guidelines. RESULTS: This process has generated 44 recommendations related to pediatric COVID-19 patients presenting with respiratory distress or failure, sepsis or septic shock, cardiopulmonary arrest, MIS-C, those requiring adjuvant therapies, or ECMO. Evidence to explain the milder disease patterns in children and the potential to use repurposed anti-viral drugs, anti-inflammatory or anti-thrombotic therapies are also described. CONCLUSION: Brief summaries of pediatric SARS-CoV-2 infection in different regions of the world are included since few registries are capturing this data globally. These guidelines seek to harmonize the standards and strategies for intensive care that critically ill children with COVID-19 receive across the world. IMPACT: At the time of publication, this is the latest evidence for managing critically ill children infected with SARS-CoV-2. Referring to these guidelines can decrease the morbidity and potentially the mortality of children effected by COVID-19 and its sequalae. These guidelines can be adapted to both high- and limited-resource settings.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Cuidados Críticos/normas , Unidades de Terapia Intensiva Pediátrica/normas , Pandemias , Pneumonia Viral/terapia , Adolescente , África/epidemiologia , América/epidemiologia , Antivirais/uso terapêutico , Ásia/epidemiologia , Reanimação Cardiopulmonar/métodos , Reanimação Cardiopulmonar/normas , Criança , Pré-Escolar , Terapia Combinada , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Cuidados Críticos/métodos , Infecção Hospitalar/prevenção & controle , Europa (Continente)/epidemiologia , Oxigenação por Membrana Extracorpórea/normas , Feminino , Humanos , Lactente , Recém-Nascido , Controle de Infecções/métodos , Controle de Infecções/normas , Masculino , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Respiração Artificial/normas , /terapia , Choque/etiologia , Choque/terapia , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/terapia
12.
J Cardiothorac Vasc Anesth ; 34(10): 2595-2603, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32620487

RESUMO

Cardiopulmonary resuscitation (CPR) in patients with severe acute respiratory syndrome coronavirus-2-associated disease (coronavirus disease 2019) poses a unique challenge to health- care providers due to the risk of viral aerosolization and disease transmission. This has caused some centers to modify existing CPR procedures, limit the duration of CPR, or consider avoiding CPR altogether. In this review, the authors propose a procedure for CPR in the intensive care unit that minimizes the number of personnel in the immediate vicinity of the patient and conserves the use of scarce personal protective equipment. Highlighting the low likelihood of successful resuscitation in high-risk patients may prompt patients to decline CPR. The authors recommend the preemptive placement of central venous lines in high-risk patients with intravenous tubing extensions that allow for medication delivery from outside the patients' rooms. During CPR, this practice can be used to deliver critical medications without delay. The use of a mechanical compression system for CPR further reduces the risk of infectious exposure to health- care providers. Extracorporeal membrane oxygenation should be reserved for patients with few comorbidities and a single failing organ system. Reliable teleconferencing tools are essential to facilitate communication between providers inside and outside the patients' rooms. General principles regarding the ethics and peri-resuscitative management of coronavirus 2019 patients also are discussed.


Assuntos
Betacoronavirus , Reanimação Cardiopulmonar/métodos , Infecções por Coronavirus/terapia , Cuidados Críticos/métodos , Parada Cardíaca/terapia , Unidades de Terapia Intensiva , Pneumonia Viral/terapia , Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/epidemiologia , Cuidados Críticos/normas , Parada Cardíaca/epidemiologia , Humanos , Unidades de Terapia Intensiva/normas , Pandemias , Pneumonia Viral/epidemiologia , Fluxo de Trabalho
13.
Resuscitation ; 153: 45-55, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32525022

RESUMO

Coronavirus disease 2019 (COVID-19) has had a substantial impact on the incidence of cardiac arrest and survival. The challenge is to find the correct balance between the risk to the rescuer when undertaking cardiopulmonary resuscitation (CPR) on a person with possible COVID-19 and the risk to that person if CPR is delayed. These guidelines focus specifically on patients with suspected or confirmed COVID-19. The guidelines include the delivery of basic and advanced life support in adults and children and recommendations for delivering training during the pandemic. Where uncertainty exists treatment should be informed by a dynamic risk assessment which may consider current COVID-19 prevalence, the person's presentation (e.g. history of COVID-19 contact, COVID-19 symptoms), likelihood that treatment will be effective, availability of personal protective equipment (PPE) and personal risks for those providing treatment. These guidelines will be subject to evolving knowledge and experience of COVID-19. As countries are at different stages of the pandemic, there may some international variation in practice.


Assuntos
Infecções por Coronavirus/complicações , Parada Cardíaca/etiologia , Parada Cardíaca/terapia , Pneumonia Viral/complicações , Betacoronavirus , Reanimação Cardiopulmonar/normas , Europa (Continente) , Humanos , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Medição de Risco , Sociedades Médicas
16.
Arq Bras Cardiol ; 114(5): 805-816, 2020 05 11.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32401847

RESUMO

In face of the pandemic of the novel coronavirus disease 2019 (COVID-19), the management of patients with cardiovascular risk factors and/or disease is challenging. The cardiovascular complications evidenced in patients with COVID-19 derive from several mechanisms, ranging from direct viral injury to complications secondary to the inflammatory and thrombotic responses to the infection. The proper care of patients with COVID-19 requires special attention to the cardiovascular system aimed at better outcomes.


Assuntos
Betacoronavirus , Doenças Cardiovasculares/virologia , Infecções por Coronavirus/complicações , Pessoal de Saúde , Pneumonia Viral/complicações , Reanimação Cardiopulmonar/normas , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Fenômenos Fisiológicos Cardiovasculares , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Pessoal de Saúde/normas , Coração/fisiopatologia , Humanos , Pandemias , Assistência ao Paciente/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Fatores de Risco , Disfunção Ventricular/etiologia
17.
Tunis Med ; 98(2): 116-122, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32395800

RESUMO

BACKGROUND:   Nurses play a key role in cardiac arrest management, especially those assigned to cardiac intensive care units, where they are often actively involved in cardiopulmonary resuscitation. AIM: To evaluate the effect of simulation training in in continuing professional development of nurses in this setting. METHODS: A comparative study using paired samples (where the candidate was his own control with repeated measures before and after intervention), was conducted among nurses working in the cardiology and cardiovascular surgery division of our institution. The primary endpoint was the change in skills judged on the basis of competency score of 20 assessed before and after simulation training. RESULTS: 32 nurses participated in the training session. Despite a median job seniority of 8.5 years [4.0 - 12.5], only 44% of nurses had already participated in a simulation session. Although most of the candidates (84%) had previously performed chest compressions, only 34% had delivered an electrical defibrillation during their exercise. We showed a significant increase in overall scores from 8.0 [5.0 - 9.8] to 17.5 [17.0 - 19.0] after the simulation training session (p<0.0001). All the criteria judged in the evaluation grid (basic life support, manual electrical defibrillation) were significantly improved and the most positive effect was observed in the manual defibrillation where the prior experience of the participants was limited. CONCLUSIONS: Simulation learning had a major positive impact on the development of nurses' skills in terms of cardiopulmonary resuscitation.


Assuntos
Cardiologia/educação , Reanimação Cardiopulmonar/educação , Procedimentos Cirúrgicos Cardiovasculares/educação , Procedimentos Cirúrgicos Cardiovasculares/enfermagem , Educação Continuada em Enfermagem/métodos , Treinamento por Simulação , Reanimação Cardiopulmonar/normas , Estudos de Casos e Controles , Competência Clínica , Avaliação Educacional , Humanos , Aprendizagem , Pesquisa em Avaliação de Enfermagem , Treinamento por Simulação/métodos , Treinamento por Simulação/normas
18.
PLoS One ; 15(5): e0232984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32396569

RESUMO

BACKGROUND: Cardiac arrest is rare in pregnancy, and up-to date competence can be difficult to assess and maintain. The objective of this study was to develop and validate a questionnaire to assess healthcare personnel experiences, self-assessed competence and perception of role and resposibility related to cardiac arrest and cardio-pulmonary resuscitation (CPR) in pregnancy. METHODS: The study had a cross-sectional design, developing and validating a questionnaire: the Competence in cardiac arrest and CPR in pregnancy (ComCA-P). Development and validation of the ComCA-P was conducted in three stages: 1) Literature review and expert group panel inputs, 2) a pilot study and 3) a cross-sectional questionnaire study. In stage one, the ComCA-P was developed over several iterations between the researchers, including inputs from an expert group panel consisting of highly competent professionals (n = 11). In stage two, the questionnaire was piloted in a group of healthcare personnel with relevant competence (n = 16). The ComCA-P was then used in a baseline study including healthcare personnel potentially involved in CPR in pregnancy (n = 527) in six hospital wards. Based on these data, internal consistency, intra-class correlations, and confirmatory factor analysis were utilized to validate the questionnaire. RESULTS: The expert group and pilot study participants evaluated the appropriateness, relevance and accuracy to be high. Formulation of the items was considered appropriate, with no difficulties identified related to content- or face validity. Cronbach's alpha was 0.8 on the thematic area self-assessment, and 0.73 on the theoretical knowledge area of the ComCA-P. On both the self-assessed competence items and the teoretical knowledge items, Kaiser-Meyer-Olkin was 0.8. Moreover, the Bertletts' test of sphericity was greater than the critical value for chi-square, and significant (p < .0001). CONCLUSIONS: Findings indicate that the ComCA-P is a valid questionnaire that can be used to assess healthcare personnel competence in cardiac arrest and resuscitation in pregnancy.


Assuntos
Reanimação Cardiopulmonar/normas , Competência Clínica , Parada Cardíaca/complicações , Parada Cardíaca/terapia , Complicações Cardiovasculares na Gravidez/terapia , Reanimação Cardiopulmonar/métodos , Cesárea , Estudos Transversais , Prova Pericial , Análise Fatorial , Estudos de Viabilidade , Feminino , Pessoal de Saúde , Humanos , Projetos Piloto , Gravidez , Reprodutibilidade dos Testes , Inquéritos e Questionários
19.
Resuscitation ; 151: 145-147, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32371027

RESUMO

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.


Assuntos
Reanimação Cardiopulmonar/normas , Infecções por Coronavirus/terapia , Parada Cardíaca/terapia , Pandemias/estatística & dados numéricos , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Comitês Consultivos , Reanimação Cardiopulmonar/tendências , Consenso , Infecções por Coronavirus/epidemiologia , Estado Terminal/terapia , Desfibriladores/estatística & dados numéricos , Feminino , Saúde Global , Humanos , Internacionalidade , Masculino , Determinação de Necessidades de Cuidados de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Análise de Sobrevida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA