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1.
Texto & contexto enferm ; 29: e20180100, Jan.-Dec. 2020. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1059131

RESUMO

ABSTRACT Objective: to evaluate the quality of life of nurses from the Mobile Emergency Care Service of the Federal District (Brazil) and to identify the domains that influenced this assessment. Method: an observational, descriptive, cross-sectional and quantitative study, with data obtained from 123 nurses who answered a questionnaire developed and structured in order to know sociodemographic and clinical variables and with the application of the World Health Organization Quality of Life Instrument Bref, to assess the quality of life. The data were submitted to descriptive statistics and inferential statics. Results: most of the nurses were women, aged between 20 and 40 years old, married, with a specialization degree and without any employment relation with another institution. Most (72.36%) considered their quality of life good or very good and were satisfied or very satisfied with their health (65.03%). The environment domain was the worst evaluated. A significant correlation was observed between the social relations (p=0.049) and environment (p=0.035) domains when correlated with the gender variable. The women rated their social relations and environment better than the men. Conclusion: the knowledge produced by this investigation may support the design of strategies that enable reducing the difficulties related to the life and work of nurses of the Mobile Emergency Care Service. Actions in this direction may contribute to the improvement of health, well-being and quality of life of the professionals and will have positive effects on the quality of health care provided to the population.


RESUMEN Objetivo: evaluar la calidad de vida de los enfermeros del Servicio de Atención Móvil de Emergencias del Distrito Federal (Brasil) e identificar los dominios que influenciaron en esa evaluación. Método: estudio de observación, descriptivo, transversal y cuantitativo, en el que se obtuvieron datos de 123 enfermeros que respondieron a un cuestionario desarrollado y estructurado para descubrir variables sociodemográficas y clínicas y en el que se aplicó el instrumento World Health Organization Quality of Life Instrument Bref para evaluar la calidad de vida. Los datos se sometieron a estadística descriptiva y inferencial. Resultados: en su mayoría, los enfermeros eran mujeres de 20 a 40 años de edad, casadas, con un nivel académico de especialización y sin ningún vínculo de empleo con otras instituciones. La mayor parte (72,36%) consideraron que su calidad de vida era buena o muy buena y se mostraron satisfechas o muy satisfechas con su salud (65,03%). El dominio del medio ambiente fue el peor evaluado. Se observó una correlación significativa entre los dominios de las relaciones sociales (p=0,049) y del medio ambiente (p=0,035) al correlacionarlos con la variable del sexo. Las mujeres evaluaron mejor que los hombres sus relaciones sociales y el medio ambiente. Conclusión: los conocimientos obtenidos gracias a esta investigación podrán ayudar a delinear estrategias que permitan reducir las dificultades relacionadas con la vida y el trabajo de los enfermeros del Servicio de Atención Móvil de Emergencias. Implementar acciones en este sentido podrá contribuir a mejorar la salud, el bienestar y la calidad de vida de los profesionales y tendrá efectos positivos sobre la calidad de la atención a la salud que se presta a la población.


RESUMO Objetivo: avaliar a qualidade de vida de enfermeiros do Serviço de Atendimento Móvel de Urgência do Distrito Federal (Brasil) e identificar os domínios que influenciaram nessa avaliação. Método: estudo observacional, descritivo, transversal e quantitativo, com dados obtidos de 123 enfermeiros que responderam a um questionário desenvolvido e estruturado para conhecer variáveis sociodemográficas e clínicas e com aplicação do World Health Organization Quality of Life Instrument Bref, para avaliar a qualidade de vida. Os dados foram submetidos à estatística descritiva e inferencial. Resultados: os enfermeiros eram em sua maioria mulheres, entre 20 a 40 anos, casadas, com nível acadêmico de especialização e sem vínculo empregatício com outra instituição. A maior parte (72,36%) considerou sua qualidade de vida boa ou muito boa e estava satisfeita ou muito satisfeita com a saúde (65,03%). O domínio meio ambiente foi o pior avaliado. Observou-se correlação significativa entre os domínios relações sociais (p=0,049) e meio ambiente (p=0,035) quando correlacionados à variável sexo. As mulheres avaliaram melhor suas relações sociais e o meio ambiente em relação aos homens. Conclusão: o conhecimento produzido por essa investigação poderá subsidiar o delineamento de estratégias que permitam diminuir as dificuldades relacionadas à vida e ao trabalho de enfermeiros do Serviço de Atendimento Móvel de Urgência. Ações nesse sentido poderão contribuir para a melhoria da saúde, do bem-estar e da qualidade de vida dos profissionais e terão efeitos positivos sobre a qualidade da assistência à saúde prestada à população.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Enfermagem , Serviços Médicos de Emergência , Qualidade de Vida , Organização Mundial da Saúde , Sistema Único de Saúde , Observação , Serviços de Atendimento , Serviços Médicos de Emergência , Enfermeiras e Enfermeiros
2.
Rev. bioét. derecho ; (50): 189-203, nov. 2020.
Artigo em Espanhol | IBECS | ID: ibc-191353

RESUMO

La actual pandemia por la COVID-19 está ocasionado serias amenazas para la salud pública a nivel mundial, especialmente para los grupos de población más vulnerables. Los casos más graves de la enfermedad han sido primeramente atendidos por los profesionales de urgencias y emergencias, los cuales han tenido que tomar decisiones en contextos altamente complejos donde la priorización en la asignación de los recursos sanitarios disponibles les ha generado situaciones éticamente conflictivas. El objetivo del presente artículo es analizar la importancia de implantar la PDA en los servicios de urgencias y emergencias como herramienta de consulta en la resolución de los problemas éticos surgidos durante la pandemia por COVID-19, concretamente, en la atención al paciente crónico complejo o con enfermedad crónica avanzada


The events of the present CoVID-19 pandemic are causing serious threats to Public Health worldwide, specifically at the most vulnerable population groups. Emergency professionals have served as the first responders for the most serious cases of this disease. At the same time, they have made decisions in highly complex contexts where the prioritization of allocated care resources has generated ethically conflictive situations. The aim of this article is to analyze the importance of implementing the ACP as a tool in the emergency services to solve ethical problems that have arisen during the COVID-19 pandemic, particularly in the care of complex chronic patients or those with advanced chronic disease


L'actual pandèmia per la COVID-19 està ocasionat serioses amenaces a la salut pública a nivell mundial, especialment als grups de població més vulnerables. Els casos més greus de la malaltia han estat primerament atesos pels professionals d'urgències I emergències, els quals han hagut de prendre decisions en contextos altament complexos on la priorització en l'assignació dels recursos sanitaris disponibles els ha generat situacions èticament conflictives. L'objectiu d'aquest article va ser analitzar la importància d'implantar la PDA en els serveis d'urgències I emergències com a eina de consulta a la resolució dels problemes ètics sorgits durant la pandèmia per COVID-19, concretament, en l'atenció al pacient crònic complex o amb malaltia crònica avançada


Assuntos
Humanos , Prioridades em Saúde/ética , Prioridades em Saúde/organização & administração , Planejamento de Assistência ao Paciente , Tomada de Decisões/ética , Conflito de Interesses , Serviços Médicos de Emergência/ética , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Doença Crônica
3.
Artigo em Alemão | MEDLINE | ID: mdl-33053587

RESUMO

Seriously injured patients represent only a small group of patients in the emergency medical service with 0.5% (ground based) to 5% (HEMS), but they are associated with a high mortality rate. Among people younger than 45, trauma is the most common cause of death, mostly as a result of severe traumatic brain injury (TBI) and/or extreme hemorrhage. As the outcome of severe TBI prehospitally can only be influenced to a very limited extent, a majority of preventable deaths in prehospital setting are caused by "critical" bleeding. The "critical" bleeding is defined by its life-threatening dimension. Anticoagulation medication can have a reinforcing effect. Adequate prehospital therapy strategies exist for external bleeding. In contrast, internal bleeding regularly evades a causal prehospital care, so that in such cases, transport prioritization and rapid definitive surgical intervention remain the only option. In the civilian environment the tested and evaluated "ABCDE" scheme must be preceded by the (for "critical bleeding") in order to react time-critically to compressible external bleeding, possibly even prior to airway management. These findings have found their way into the current version of the S3 guideline on treatment of multi system trauma by the German Society for Trauma Surgery (DGU). According to this "severely bleeding injuries that can impair vital functions should be treated with priority". Thus, this publication focuses on prehospital bleeding control.


Assuntos
Lesões Encefálicas Traumáticas , Serviços Médicos de Emergência , Traumatismo Múltiplo , Manuseio das Vias Aéreas , Hemorragia/terapia , Humanos
4.
Cir. Esp. (Ed. impr.) ; 98(8): 433-441, oct. 2020. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-188970

RESUMO

La infección por el nuevo coronavirus SARS-CoV-2 (enfermedad por coronavirus 2019 [COVID-19]) ha determinado la necesidad de la reorganización de muchos centros hospitalarios en el mundo. España, como uno de los epicentros de la enfermedad, ha debido asumir cambios en la práctica totalidad de su territorio. Sin embargo, y desde el inicio de la pandemia, en todos los centros que atienden urgencias quirúrgicas ha sido necesario el mantenimiento de su cobertura, aunque igualmente ha sido inevitable introducir directrices especiales de ajuste al nuevo escenario que permitan el mantenimiento de la excelencia en la calidad asistencial. Este documento desarrolla una serie de indicaciones generales para la cirugía de urgencias y la atención al politraumatizado desarrolladas desde la literatura disponible y consensuadas por un subgrupo de profesionales desde el grupo general Cirugía-AEC-COVID-19. Estas medidas van encaminadas a contemplar un riguroso control de la exposición en pacientes y profesionales, a tener en cuenta las implicaciones de la pandemia sobre diferentes escenarios perioperatorios relacionados con la urgencia y a una adaptación ajustada a la situación del centro en relación con la atención a pacientes infectados


New coronavirus SARS-CoV-2 infection (coronavirus disease 2019 [COVID-19]) has determined the necessity of reorganization in many centers all over the world. Spain, as an epicenter of the disease, has been forced to assume health policy changes in all the territory. However, and from the beginning of the pandemic, every center attending surgical urgencies had to guarantee the continuous coverage adopting correct measures to maintain the excellence of quality of care. This document resumes general guidelines for emergency surgery and trauma care, obtained from the available bibliography and evaluated by a subgroup of professionals designated from the general group of investigators Cirugía-AEC-COVID-19 from the Spanish Association of Surgeons, directed to minimize professional exposure, to contemplate pandemic implications over different urgent perioperative scenarios and to adjust decision making to the occupational pressure caused by COVID-19 patients


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Serviços Médicos de Emergência/organização & administração , Equipamentos de Proteção/normas , Gestão da Segurança , Procedimentos Cirúrgicos Operatórios/normas , Traumatismo Múltiplo/cirurgia , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle
5.
Ann Emerg Med ; 76(4): 413-426, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33012377

RESUMO

STUDY OBJECTIVE: Emergency medical services (EMS) may serve as a key source of real-time data about the evolving health of coronavirus disease 2019 (COVID-19)-affected populations, especially in low- and middle-income countries with less rapid and reliable vital statistics registration systems. Although official COVID-19 statistics in Mexico report almost exclusively inhospital mortality events, excess out-of-hospital mortality has been identified in other countries, including 1 EMS study in Italy that showed a 58% increase. Additionally, EMS and hospital reports from several countries have suggested that silent hypoxemia-low Spo2 in the absence of dyspnea-is associated with COVID-19. It is unclear, however, how these phenomena can be generalized to low- and middle-income countries. We assess how EMS data can be used in a sentinel capacity in Tijuana, a city on the Mexico-United States border with earlier exposure to COVID-19 than many low- and middle-income country settings. METHODS: In this observational study, we calculated numbers of weekly out-of-hospital deaths and respiratory cases handled by EMS in Tijuana, and estimated the difference between peak epidemic rates and expected trends based on data from 2014 to 2019. Results were compared with official COVID-19 statistics, stratified by neighborhood socioeconomic status, and examined for changing demographic or clinical features, including mean Spo2. RESULTS: An estimated 194.7 excess out-of-hospital deaths (95% confidence interval 135.5 to 253.9 deaths) occurred during the peak window (April 14 to May 11), representing an increase of 145% (95% CI 70% to 338%) compared with expected levels. During the same window, only 5 COVID-19-related out-of-hospital deaths were reported in official statistics. This corresponded with an increase in respiratory cases of 236.5% (95% CI 100.7% to 940.0%) and a decrease in mean Spo2 to 77.7% from 90.2% at baseline. The highest out-of-hospital death rates were observed in low-socioeconomic-status areas, although respiratory cases were more concentrated in high-socioeconomic-status areas. CONCLUSION: EMS systems may play an important sentinel role in monitoring excess out-of-hospital mortality and other trends during the COVID-19 crisis in low- and middle-income countries. Using EMS data, we observed increases in out-of-hospital deaths in Tijuana that were nearly 3-fold greater than increases reported in EMS data in Italy. Increased testing in out-of-hospital settings may be required to determine whether excess mortality is being driven by COVID-19 infection, health system saturation, or patient avoidance of health care. We also found evidence of worsening rates of hypoxemia among respiratory patients treated by EMS, suggesting a possible increase in silent hypoxemia, which should be met with increased detection and clinical management efforts. Finally, we observed social disparities in out-of-hospital death that warrant monitoring and amelioration.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Serviços Médicos de Emergência/estatística & dados numéricos , Hipóxia/virologia , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , Registros Eletrônicos de Saúde , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pandemias , Vigilância em Saúde Pública , Classe Social , Adulto Jovem
6.
Rev Assoc Med Bras (1992) ; 66(9): 1187-1189, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027443

RESUMO

OBJECTIVE: Social distancing during the COVID-19 pandemic has been associated with a decrease in the search for medical care. High-risk patients have avoided hospital environments fearing infection. We hypothesize that there was also a decrease in the search for medical care related to gastrointestinal emergencies. The aim of this study is to evaluate the frequency of consultations for severe gastrointestinal emergencies during and before the months of the pandemic. METHODS: This was a transversal study. The inclusion criteria were cases of consultation in the emergency department for gastrointestinal diseases that required hospitalization, from January to April, from 2015 to 2020. The pediatric population (under age 12) was excluded. RESULTS: A total of 2,457 cases of cases was included. The number of emergency hospitalizations for gastrointestinal cases decreased during the first four months of 2020: 108, 112, 82, and 77, respectively. Comparing April of 2020 with previous years, there was a lower than expected number of cases during the social distancing period (P=0.002). CONCLUSION: This study reports a pronounced decrease in consultations for severe gastrointestinal emergencies during the pandemic. Governments and society should be aware that health crises do not halt the natural occurrence of noninfectious diseases; otherwise, an increase in mortality from these morbidities may arise.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Serviços Médicos de Emergência , Pandemias , Pneumonia Viral , Emergências , Humanos
7.
West J Emerg Med ; 21(5): 1095-1101, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32970560

RESUMO

The unprecedented COVID-19 pandemic has resulted in rapidly evolving best practices for transmission reduction, diagnosis, and treatment. A regular influx of new information has upended traditionally static hospital protocols, adding additional stress and potential for error to an already overextended system. To help equip frontline emergency clinicians with up-to-date protocols throughout the evolving COVID-19 crisis, our team set out to create a dynamic digital tool that centralized and standardized resources from a broad range of platforms across our hospital. Using a design thinking approach, we rapidly built, tested, and deployed a solution using simple, out-of-the-box web technology that enables clinicians to access the specific information they seek within moments. This platform has been rapidly adopted throughout the emergency department, with up to 70% of clinicians using the digital tool on any given shift and 78.6% of users reporting that they "agree" or "strongly agree" that the platform has affected their management of COVID-19 patients. The tool has also proven easily adaptable, with multiple protocols being updated nearly 20 times over two months without issue. This paper describes our development process, challenges, and results to enable other institutions to replicate this process to ensure consistent, high-quality care for patients as the COVID-19 pandemic continues its unpredictable course.


Assuntos
Betacoronavirus , Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/terapia , Sistemas de Apoio a Decisões Clínicas , Serviços Médicos de Emergência/métodos , Pneumonia Viral/terapia , Atitude do Pessoal de Saúde , Protocolos Clínicos , Árvores de Decisões , Eficiência , Emergências , Humanos , Internet , Pandemias , Padrões de Prática em Enfermagem/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Desenvolvimento de Programas , São Francisco
8.
Emerg Med Clin North Am ; 38(4): 795-805, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32981618

RESUMO

Successful emergency transfusions require early recognition and activation of resources to minimize treatment delays. The initial goals should focus on replacement of blood in a balanced fashion. There is an ongoing debate regarding the best approach to transfusions, with some advocating for resuscitation with a fixed ratio of blood products and others preferring to use viscoelastic assays to guide transfusions. Whole-blood transfusion also is a debated strategy. Despite these different approaches, it generally is accepted that transfusions should be started early and crystalloid infusions limited. As hemodynamic stability is restored, endpoints of resuscitation should be used to guide the resuscitation.


Assuntos
Transfusão de Sangue , Choque Hemorrágico/terapia , Antifibrinolíticos/uso terapêutico , Tipagem e Reações Cruzadas Sanguíneas , Cateterismo Venoso Central , Tomada de Decisão Clínica , Protocolos Clínicos , Estado Terminal , Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Humanos , Hipotensão , Infusões Intraósseas , Infusões Intravenosas , Ressuscitação , Tromboelastografia , Ácido Tranexâmico/uso terapêutico , Ferimentos e Lesões/terapia
9.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(8): 1003-1007, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32912418

RESUMO

OBJECTIVE: To provide a scientific basis for reducing the rate of invalid ambulance attendance and the establishment of grades dispatch system through a retrospective analysis of the invalid ambulance attendance in prehospital emergency care. METHODS: The data of the invalid ambulance attendance was collected in Huazhong University of Science and Technology Union Shenzhen Hospital (the only tertiary hospital of in Nanshan District) from 2014 to 2018, and the reasons of the invalid ambulance attendance, the time period during the invalid ambulance attendance occurred (every 3 hours was divided into one time period), and the reasons of ambulance calling were statistically analyzed. RESULTS: (1) The invalid ambulance attendance rates showed a fluctuating decrease trend year by year from 2014 to 2018, the rates were 31.22% (2 515/8 055), 26.94% (2 147/7 970), 29.80% (2 398/8 046), 25.69% (1 844/7 177) and 21.89% (1 686/7 703), respectively. The total invalid ambulance attendance rate was 27.19% (10 590/38 951) in the five years. (2) The top three reasons for the invalid ambulance attendance were cancelled calls, departure before the ambulance arrived, and going to hospital by themselves, accounting for 36.87%, 25.08%, and 17.03%, respectively. The constituent ratios of the causes of invalid ambulance attendance in each year were different with statistical significance (χ2 = 217.626, P < 0.001). (3) The top three time period of invalid ambulance attendance occurred at 21:00-23:59, 18:00-20:59 and 09:00-11:59, accounting for 16.86%, 14.95% and 13.54%, respectively. There was no statistical significance in the distribution of time period in each year (χ2 = 32.571, P = 0.252). (4) The top five reasons for ambulance calling of invalid ambulance attendance were fainting/syncope, trauma, alcoholism, traffic accident injuries, and brawls, accounting for 20.13%, 15.67%, 9.97%, 8.64%, and 6.45%, respectively, and there was statistically significant difference in the distribution of the reason for ambulance calls in each year (χ2 = 194.213, P < 0.001). CONCLUSIONS: The invalid ambulance attendance rate is high in Nanshan District of Shenzhen. Improving the professional level and triage ability of the dispatchers, improving the system construction of prehospital emergency care system and increasing social education are conducive to reduce invalid ambulance attendance rate.


Assuntos
Ambulâncias , Serviços Médicos de Emergência , Estudos Retrospectivos , Centros de Atenção Terciária , Triagem
11.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 507-512, 2020 May 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-32879098

RESUMO

OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS: Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.


Assuntos
Infecções por Coronavirus/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Hospitais Gerais/organização & administração , Pacientes Ambulatoriais , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Serviços Médicos de Emergência/organização & administração , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle
13.
BMC Neurol ; 20(1): 358, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972381

RESUMO

BACKGROUND: The novel coronavirus (COVID-19) global pandemic is associated with an increased incidence of acute ischemic stroke (AIS) secondary to large vessel occlusion (LVO). The treatment of these patients poses unique and significant challenges to health care providers requiring changes in existing protocols. CASE PRESENTATION: A 54-year-old COVID-19 positive patient developed sudden onset left hemiparesis secondary to an acute right middle cerebral artery occlusion (National Institutes of Health Stroke Scale (NIHSS) score = 11). Mechanical thrombectomy (MT) was performed under a new protocol specifically designed to maximize protective measures for the team involved in the care of the patient. Mechanical Thrombectomy was performed successfully under general anesthesia resulting in TICI 3 recanalization. With regards to time metrics, time from door to reperfusion was 60 mins. The 24-h NIHSS score decreased to 2. Patient was discharged after 19 days after improvement of her pulmonary status with modified Rankin Scale = 1. CONCLUSION: Patients infected by COVID-19 can develop LVO that is multifactorial in etiology. Mechanical thrombectomy in a COVID-19 confirmed patient presenting with AIS due to LVO is feasible with current mechanical thrombectomy devices. A change in stroke workflow and protocols is now necessary in order to deliver the appropriate life-saving therapy for COVID-19 positive patients while protecting medical providers.


Assuntos
Infecções por Coronavirus/complicações , Procedimentos Endovasculares/métodos , Infarto da Artéria Cerebral Média/cirurgia , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Trombectomia/métodos , Betacoronavirus , Isquemia Encefálica/complicações , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/cirurgia , Angiografia Cerebral , Angiografia por Tomografia Computadorizada , Serviços Médicos de Emergência , Feminino , Humanos , Infarto da Artéria Cerebral Média/complicações , Infarto da Artéria Cerebral Média/diagnóstico por imagem , Intubação Intratraqueal , Pessoa de Meia-Idade , Pandemias , Reperfusão , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/cirurgia , Tempo para o Tratamento , Resultado do Tratamento
14.
PLoS One ; 15(9): e0238491, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32936804

RESUMO

As the most visible face of health expertise to the general public, health agencies have played a central role in alerting the public to the emerging COVID-19 threat, providing guidance for protective action, motivating compliance with health directives, and combating misinformation. Social media platforms such as Twitter have been a critical tool in this process, providing a communication channel that allows both rapid dissemination of messages to the public at large and individual-level engagement. Message dissemination and amplification is a necessary precursor to reaching audiences, both online and off, as well as inspiring action. Therefore, it is valuable for organizational risk communication to identify strategies and practices that may lead to increased message passing among online users. In this research, we examine message features shown in prior disasters to increase or decrease message retransmission under imminent threat conditions to develop models of official risk communicators' messages shared online from February 1, 2020-April 30, 2020. We develop a lexicon of keywords associated with risk communication about the pandemic response, then use automated coding to identify message content and message structural features. We conduct chi-square analyses and negative binomial regression modeling to identify the strategies used by official risk communicators that respectively increase and decrease message retransmission. Findings show systematic changes in message strategies over time and identify key features that affect message passing, both positively and negatively. These results have the potential to aid in message design strategies as the pandemic continues, or in similar future events.


Assuntos
Betacoronavirus , Doenças Transmissíveis Emergentes , Comunicação , Infecções por Coronavirus , Disseminação de Informação/métodos , Pandemias , Pneumonia Viral , Mídias Sociais , Distribuição de Qui-Quadrado , Emergências , Serviços Médicos de Emergência/organização & administração , Órgãos Governamentais , Humanos , Internet , Meios de Comunicação de Massa , Modelos Estatísticos , Modelos Teóricos , Administração em Saúde Pública , Gestão da Segurança , Mídias Sociais/estatística & dados numéricos
17.
J Korean Med Sci ; 35(35): e324, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32893524

RESUMO

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic infection associated with high morbidity and mortality. The Korean city of Daegu endured the first large COVID-19 outbreak outside of China. Since the report of the first confirmed case in Daegu on February 18, 2020, a total of 6,880 patients have been reported until May 29, 2020. We experienced five patients with ischemic stroke and COVID-19 during this period in four tertiary hospitals in Daegu. The D-dimer levels were high in all three patients in whom D-dimer blood testing was performed. Multiple embolic infarctions were observed in three patients and suspected in one. The mean time from stroke symptom onset to emergency room arrival was 22 hours. As a result, acute treatment for ischemic stroke was delayed. The present case series report raises the possibility that the coronavirus responsible for COVID-19 causes or worsens stroke, perhaps by inducing inflammation. The control of COVID-19 is very important; however, early and proper management of stroke should not be neglected during the epidemic.


Assuntos
Infecções por Coronavirus/patologia , Citocinas/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Pneumonia Viral/patologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Serviços Médicos de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , República da Coreia/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Tromboembolia/patologia , Terapia Trombolítica/métodos , Tempo para o Tratamento
19.
Tex Med ; 116(7): 42-45, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32872701

RESUMO

The need for improved training on hemorrhage control in emergencies has been building for decades. Physicians say it's just as important to reach out to the community to promote hemorrhage control in the same way CPR and other life-saving methods are promoted.


Assuntos
Educação Médica Continuada , Serviços Médicos de Emergência/métodos , Medicina de Emergência/educação , Hemorragia/terapia , Médicos , Torniquetes , Hemorragia/prevenção & controle , Humanos
20.
Recurso na Internet em Inglês | LIS - Localizador de Informação em Saúde | ID: lis-47761

RESUMO

In January 2020, we published the findings of a two year in-depth inquiry into the ethical issues relating to research in global health emergencies. The inquiry was run by an international working group which gathered evidence and experience from many contributors across the globe. Better evidence about what helps or doesn’t help during an emergency is needed in order to improve the response to global health emergencies. Research conducted during an emergency itself plays a crucial role in obtaining this evidence, and helps support the immediate response, as well as learning for the future. The aim of the report is to identify ways in which research can be undertaken ethically during emergencies, in order to promote the contribution that ethically-conducted research can make to improving current and future emergency preparedness and response. We have made 24 recommendations to ‘duty bearers’ such as research funders, research organisations, governments, and researchers. These are summarised in our call for action. We suggest changes that would align their policies and practices more closely to three core values of fairness, equal respect, and helping reduce suffering. The report presents these values in the form of an ‘ethical compass’ to guide the conduct of the very wide range of people involved in research in global health emergencies.


Assuntos
Serviços Médicos de Emergência/ética , Prática Clínica Baseada em Evidências/ética , Sistemas de Saúde/organização & administração , Formulação de Políticas , Bioética
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