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1.
Rev Med Suisse ; 16(681): 307-309, 2020 Feb 12.
Artigo em Francês | MEDLINE | ID: mdl-32049451

RESUMO

Switzerland has a high rate of legal measures of constraint by international standard. Beside the incorporation of legal, medical and economic elements, the physician may be asked on what it means to be a care giver and to be free, because his decision could private his patient of a fundamental human right. The deprivation of freedom for purposes of assistance is helpful in some clinical situations but remains a controversial issue. We have to do our due diligence when assessing the patient, notably his capacity of discernment, and discuss with him and his relatives other treatments without legal constraint. The advance directives and the joint plan of crisis should be tools to increase patients' autonomy and to decrease the coercive measures.


Assuntos
Coerção , Tomada de Decisões , Hospitais Psiquiátricos , Direitos do Paciente/legislação & jurisprudência , Diretivas Antecipadas , Humanos , Transferência de Pacientes/legislação & jurisprudência , Médicos/psicologia , Suíça
3.
Anaesthesia ; 75(2): 234-246, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31788789

RESUMO

The location of care for many brain-injured patients has changed since 2012 following the development of major trauma centres. Advances in management of ischaemic stroke have led to the urgent transfer of many more patients. The basis of care has remained largely unchanged, however, with emphasis on maintaining adequate cerebral perfusion as the key to preventing secondary injury. Organisational aspects and training for transfers are highlighted, and we have included an expanded section on paediatric transfers. We have also provided a table with suggested blood pressure parameters for the common types of brain injury but acknowledge that there is little evidence for many of our recommendations. These guidelines remain a mix of evidence-based and consensus-based statements. We have received assistance from many organisations representing clinicians who care for these patients, and we believe our views represent the best of current thinking and opinion. We encourage departments to review their own practice using our suggestions for audit and quality improvement.


Assuntos
Lesões Encefálicas/terapia , Transferência de Pacientes/métodos , Acidente Vascular Cerebral/terapia , Transporte de Pacientes/métodos , Anestesiologia , Anestesistas , Cuidados Críticos , Humanos , Sociedades Médicas
5.
J Surg Res ; 246: 457-463, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31706537

RESUMO

BACKGROUND: Readmissions after colorectal operations adversely impact patient recovery and are associated with about $300 million in additional health care expenditure in the United States alone. The present study aimed to characterize nonelective, short-term readmissions of colorectal surgery patients who underwent colostomy. METHODS: The Nationwide Readmissions Database was used to identify patients who received a colostomy from 2010 to 2015. Patients were stratified by discharge-to-readmission interval: immediate (within 7 d) and delayed (7-30 d). Nonparametric trend analysis and multivariable regression were performed to identify predictors of immediate and delayed readmission. RESULTS: Of an estimated 376,693 operations requiring colostomies during the study, in-hospital survival was 92.3%, with higher rates after elective compared with nonelective operations (96.5 versus 90.8%, P < 0.001). Overall, 15.3% patients undergoing elective and nonelective colostomy creation returned to the hospital within 30 d, with 41.6% of these readmissions occurring by the first week of discharge (immediate). Readmission rates and proportion of immediate and delayed groups did not significantly change over the 6-year study period. Nonhome discharge increased the odds of immediate (AOR 1.25, 95% CI 1.17-1.34) and delayed readmission (AOR 1.44, 95% CI 1.35-1.54). Annually, immediate and delayed rehospitalizations after colostomy creation were responsible for $64 and 82 million in excess costs, respectively. CONCLUSIONS: Colostomy creation is associated with a steady and high rate of rehospitalization. Nonhome discharge, in addition to several patient comorbidities, is associated with higher odds of readmission. Programs aimed at reduction of immediate readmission are warranted.


Assuntos
Colostomia/efeitos adversos , Readmissão do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Transferência de Pacientes/estatística & dados numéricos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia
6.
World Neurosurg ; 133: e76-e83, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31521757

RESUMO

OBJECTIVE: Spine fractures, including associated spinal cord injury, account for 3%-6% of all skeletal fractures annually in the United States. Patients who undergo interhospital transfer after injury may have a greater likelihood of nonroutine disposition, longer hospital stay, and higher cost. We evaluated the effects of patient transfer on functional outcomes after spine trauma. METHODS: Patients were treated after acute traumatic spine injury at a rehabilitation hospital in 2011-2017. Compared patients were those directly admitted to the tertiary hospital or transferred from a community hospital. RESULTS: A total of 188 patients (mean age 46.1 ± 18.6 years, 77.1% men) were evaluated, including 130 (69.1%) directly admitted and 58 (30.9%) transferred patients. The most common levels of injury were at C5 (19.1%) and C6 (12.2%), and most injuries were American Spinal Injury Association injury severity score grade D (33.2%) or grade A (32.1%). No statistical difference in age, injury pattern, timing from injury to surgery, or rehabilitation length of stay was seen between admitted and transferred patients. A significant improvement in ambulation distances was seen at discharge for directly admitted compared with transferred patients (447.7 ± 724.9 vs. 159.9 ± 359.5 feet; P = 0.005). However, no significant difference primary outcomes, namely American Spinal Injury Association injury severity score distribution (P = 0.2) or Functional Independence Measures (Δ30.9 ± 15.9 vs. 30.1 ± 17.1; P = 0.7), were seen between admitted and transferred patients at time of rehabilitation discharge. CONCLUSIONS: Interhospital transfer status did not diminish time to rehabilitation after injury or reduce functional recovery, suggesting early surgical treatment in community settings may have merit prior to transfer.


Assuntos
Transferência de Pacientes , Traumatismos da Coluna Vertebral/reabilitação , Atividades Cotidianas , Adulto , Idoso , Continuidade da Assistência ao Paciente , Feminino , Hospitais Comunitários , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/reabilitação , Traumatismos da Medula Espinal/cirurgia , Traumatismos da Coluna Vertebral/complicações , Traumatismos da Coluna Vertebral/cirurgia , Centros de Atenção Terciária , Centros de Traumatologia , Índices de Gravidade do Trauma , Resultado do Tratamento , Adulto Jovem
7.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 33-40, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31079068

RESUMO

OBJECTIVE: To compare the risk of mortality and morbidity between outborn and propensity score-matched inborn extremely preterm neonates. SETTING: Multiple neonatal intensive care units (NICU) across the USA. PATIENTS: Singleton neonates born at 22-29 weeks' gestation with no major anomalies who were admitted to a NICU and discharged between 2000 and 2014. Outborn neonates were restricted to those who transferred into a NICU on the day of birth. METHODS: The association between inborn-outborn status and the time-to-event outcomes of in-hospital mortality and necrotising enterocolitis (NEC) were assessed using Cox proportional hazards regression. Logistic regression was used to assess the remaining secondary outcomes: retinopathy of prematurity requiring treatment (tROP), chronic lung disease (CLD), periventricular leucomalacia (PVL) and severe intraventricular haemorrhage (IVH). Since outborn status was not random, we used 1:1 propensity score matching to reduce the imbalance in illness severity. RESULTS: There were 59 942 neonates (7991 outborn) included in the study. Outborn neonates had poorer survival than inborns and higher rates of NEC, severe IVH, tROP and PVL. Inborn-outborn disparities in mortality were reduced over the study period. When analysing the matched cohort (6524 matched pairs), outborns were less likely to die in-hospital compared with inborns (HR 0.84, 95% CI 0.77 to 0.91). However, outborns experienced higher rates of NEC (HR 1.14, 95% CI 1.04 to 1.25), severe IVH (OR 1.52, 95% CI 1.38 to 1.68), tROP (OR 1.45, 95% CI 1.25 to 1.69) and CLD (OR 1.12, 95% CI 1.01 to 1.24). CONCLUSION: Additional research is needed to understand the contributors to increased morbidity for outborn extremely preterm neonates and identify interventions that mitigate this risk.


Assuntos
Lactente Extremamente Prematuro , Unidades de Terapia Intensiva Neonatal , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Hemorragia Cerebral Intraventricular/epidemiologia , Conjuntos de Dados como Assunto , Enterocolite Necrosante/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Recém-Nascido , Leucomalácia Periventricular/epidemiologia , Lesão Pulmonar/epidemiologia , Masculino , Análise por Pareamento , Transferência de Pacientes , Retinopatia da Prematuridade/epidemiologia , Estados Unidos/epidemiologia
8.
J Surg Res ; 245: 593-599, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31499365

RESUMO

BACKGROUND: After traumatic arrest, resuscitative thoracotomy is lifesaving in appropriately selected patients, yet data are limited regarding hospital course after intensive care unit (ICU) admission. The objective of this study was to describe the natural history of resuscitative thoracotomy survivors admitted to the ICU. MATERIALS AND METHODS: We conducted a retrospective review (January 1, 2012-June 30, 2017) of all adult trauma patients who underwent resuscitative thoracotomy after traumatic arrest at two adult level 1 trauma centers. Data evaluated include demographics, injury characteristics, hospital course, and outcome. RESULTS: Over 66 mo, there were 52,624 trauma activations. Two hundred ninety-eight patients underwent resuscitative thoracotomy and 96 (32%) survived to ICU admission. At ICU admission, mean age was 35.8 ± 14.5 y, 79 (82%) were male, 36 (38%) sustained blunt trauma, and the mean injury severity score was 32.3 ± 13.7. Eight blunt and 20 penetrating patients (22% and 34% of ICU admissions, respectively) survived to discharge. 67% of deaths in the ICU occurred within the first 24 h, whereas 90% of those alive at day 21 survived to discharge. For the 28 survivors, mean ICU length of stay was 24.1 ± 17.9 d and mean hospital length of stay was 43.9 ± 32.1 d. Survivors averaged 1.9 ± 1.5 complications. Twenty-four patients (86% of hospital survivors) went home or to a rehabilitation center. CONCLUSIONS: After resuscitative thoracotomy and subsequent ICU admission, 29% of patients survived to hospital discharge. Complications and a long hospital stay should be expected, but the functional outcome for survivors is not as bleak as previously reported.


Assuntos
Parada Cardíaca/cirurgia , Complicações Pós-Operatórias/epidemiologia , Ressuscitação/efeitos adversos , Toracotomia/efeitos adversos , Ferimentos não Penetrantes/complicações , Ferimentos Penetrantes/complicações , Adulto , Feminino , Parada Cardíaca/etiologia , Parada Cardíaca/mortalidade , Mortalidade Hospitalar , Humanos , Escala de Gravidade do Ferimento , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Alta do Paciente/estatística & dados numéricos , Transferência de Pacientes/estatística & dados numéricos , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Centros de Reabilitação/estatística & dados numéricos , Ressuscitação/métodos , Estudos Retrospectivos , Centros de Traumatologia/estatística & dados numéricos , Resultado do Tratamento , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/cirurgia , Adulto Jovem
11.
Fortschr Neurol Psychiatr ; 87(11): 608-615, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756739

RESUMO

Disruptions in psychiatric care delivery during the transition from adolescence to adulthood frequently lead - particularly in the case of severe mental illness - to a considerable treatment delay and an especially high rate of treatment dropout with a high risk of early chronification. The joint Task Force Transition, of the German Society of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (DGKJP) and the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN), therefore analyzed general, sector-specific and disorder-specific gaps in the German psychiatric care system which obstruct a successful transition to the adult psychiatric care system. The article summarizes the results of the Task Force, outlines the aims and challenges of transition-psychiatric treatment models, and addresses their structural and professional prerequisites. The requirements and recommendations derived from this are transferred to psychiatric planning, health and research policy as well as education, training and professional development in order to optimally shape the transition from adolescent-centered to adult-oriented psychiatric care in the future.


Assuntos
Transtornos Mentais/terapia , Transferência de Pacientes , Psiquiatria , Adolescente , Adulto , Criança , Alemanha , Humanos
12.
Fortschr Neurol Psychiatr ; 87(11): 619-623, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756740

RESUMO

The structure of psychiatric outpatient clinics with multi-professional treatment teams provides a suitable frame for a successful transition from child to adult treatment settings. At present, however, the management of transition, especially for severely mentally ill adolescents, is unsatisfactory. In order to optimize conditions of transition, the following measures are proposed:▪ use of structured transfer sheets▪ round table conferences▪ shared trainings of child and adult psychiatrists▪ development of specific consultation hours for adolescents in transition; financial funding has to be established by health insurances.


Assuntos
Instituições de Assistência Ambulatorial , Pacientes Ambulatoriais , Transferência de Pacientes , Psiquiatria , Adolescente , Adulto , Criança , Humanos , Seguro Saúde
13.
Fortschr Neurol Psychiatr ; 87(11): 616-618, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756744

RESUMO

The transition from private practice child and adolescent psychiatric care in to the following psychiatric care of adults bears many changes and problems for young people with psychiatric disorders. This article informs about structural difficulties and demands improvements regarding the handover.


Assuntos
Transtornos Mentais/terapia , Transferência de Pacientes , Prática Privada , Psiquiatria , Adolescente , Adulto , Criança , Humanos , Psicoterapia
14.
Fortschr Neurol Psychiatr ; 87(11): 629-633, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31756745

RESUMO

Adolescence is a particularly vulnerable age for the first manifestation of psychoses due to the brain maturation process and especially with additional stress factors and these have negative psychosocial consequences for the affected persons and their relatives. The disadvantages of an early onset of the disease can be partially compensated for by high-quality early diagnosis and early treatment, taking into account transitional medical approaches. In order to promote a successful transition of adolescent patients with psychoses, there are practical recommendations for the establishment of community-based, flexible and follow-up early diagnosis and treatment networks in which employees work together across diagnosis, age, discipline, and setting, enabling a structured, comprehensive, patient-oriented and flexible successful transition.


Assuntos
Diagnóstico Precoce , Transferência de Pacientes , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/terapia , Adolescente , Adulto , Criança , Humanos
15.
Am Surg ; 85(9): 1010-1012, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638515

RESUMO

Many trauma patients present to nontrauma centers with emergency conditions. The Emergency Medical Treatment and Active Labor Act dictates that nontrauma centers attempt stabilization and provide appropriate transfer. Our goal was to determine whether there was a survival benefit in transferring hypotensive patients. The Tampa General Hospital trauma registry database was queried for adult trauma transfers from January 2012 to April 2018 including the first recorded systolic blood pressure (SBP) and other pertinent data. A manual chart review in hypotensive (SBP < 90) patients determined blood pressure at the time of transfer. Of the 3038 patients, 40 patients were hypotensive on arrival, with 40% (16) mortality. Eight of nine (88%) patients with SBP <70 on arrival, 3 of 11 (27%) with SBP 70 to 79, and 5 of 20 (25%) with SBP 80 to 89 died. The only survivor in the <70 group was normotensive at transport. Patients in these groups who were hypotensive at the time of transport died (4/4, 100%). Our data show no benefit in transferring patients with refractory hypotension at the time of transport; although the numbers are small, an SBP <70 should be considered prohibitive to transfer.


Assuntos
Hipotensão/etiologia , Hipotensão/terapia , Transferência de Pacientes , Centros de Traumatologia , Ferimentos e Lesões/complicações , Ferimentos e Lesões/terapia , Adulto , Florida , Humanos , Sistema de Registros , Estudos Retrospectivos , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/fisiopatologia
16.
Am Surg ; 85(9): 1033-1039, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31638520

RESUMO

Regionalization of complex surgical care has increased interhospital transfers to quaternary centers within large health-care systems. Risk-based patient selection is imperative to improve resource allocation without compromising care. This study aimed to develop predictive models for identifying low-risk patients for transfer to a fully integrated satellite hepatopancreatobiliary (HPB) service in the northeast region of the health-care system. HPB transfers to the quaternary center over 15 months from hospitals in proximity to the satellite HPB center. A predictive tool was developed based on simple pretransfer variables and outcomes for 30-day major complications (Clavien grade ≥ 3), readmission, and mortality. Thresholds for "low risk" were set at different SDs below mean for each model. Predictive models were developed from 51 eligible northeast region patient transfers for major complications (Brier score 0.1948, receiver operator characteristic (ROC) 0.7123, P = 0.0009), readmission (Brier score 0.0615, ROC 0.7368, P = 0.0020), and mortality (Brier score 0.0943, ROC 0.7989, P = 0.0023). Thresholds set from 2 SD below the mean for all models identified 2 as "low risk." Adjusting the threshold for the serious complication model to only 1 SD below the mean increased the "low-risk" cohort to five patients. These models demonstrate an easy-to-use tool to assist surgeons in identifying low-risk patients for diversion to a fully integrated satellite center. Improved interhospital transfers within a region could begin a transition from centers of excellence toward health-care systems of excellence.


Assuntos
Doenças Biliares/cirurgia , Hepatopatias/cirurgia , Modelos Logísticos , Pancreatopatias/cirurgia , Transferência de Pacientes , Medição de Risco/estatística & dados numéricos , Tomada de Decisão Clínica , Cuidados Críticos , Feminino , Mortalidade Hospitalar , Planejamento Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina , Readmissão do Paciente , Complicações Pós-Operatórias , Medição de Risco/métodos
17.
Medicine (Baltimore) ; 98(43): e17715, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651903

RESUMO

A few studies have compared patients who were directly admitted with patients who were transferred to a tertiary facility for an appendectomy. However, there have been no reports of an association between the time to transfer and outcome in patients who underwent an appendectomy. As the only tertiary military hospital in South Korea, we occasionally encountered patients who were delayed for transfer due to the military environment. We hypothesize that patients with a longer time to transfer have a worse outcome. This study aimed to evaluate the relationship between the time to transfer and the outcome of patients who underwent an appendectomy.Patients who underwent appendectomy in the tertiary military hospital in South Korea from May 2015 to April 2017 were analyzed retrospectively. The groups were divided by the time for the transfer. Four hours was used as the cut-off point to divide the early and delayed transfer groups. Time from symptom onset to hospitalization, time from diagnosis to surgery, and time from hospitalization to surgery were also analyzed to assess the effect of time for the transfer.A total of 449 patients were analyzed: 293 with direct admission, 110 with early transfer, and 46 with delayed transfer. The time required for transfer was more critical for delaying appendectomy than the time from hospital admission to surgery. There was no difference in outcomes among the groups. When patients were compared according to the perforation, no differences were found in time from hospitalization to surgery, time from diagnosis to surgery, and presence of transfer. Multivariate analysis showed that a greater than 72 hours delay from symptom onset to hospitalization was associated with perforation (odds ratio = 12.61; 95% confidence interval: 3.84-41.40; P < .001).Even if a long transfer time is necessary, an appendectomy can be performed safely if patients were administered antibiotics immediately after diagnosis.


Assuntos
Apendicite/cirurgia , Hospitais Militares , Transferência de Pacientes/estatística & dados numéricos , Tempo para o Tratamento , Apendicectomia , Progressão da Doença , Feminino , Humanos , Masculino , República da Coreia , Estudos Retrospectivos , Centros de Atenção Terciária , Resultado do Tratamento , Adulto Jovem
18.
Hosp Pract (1995) ; 47(5): 249-253, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31652402

RESUMO

Objectives: To investigate whether direct oral anticoagulant (DOAC) therapy at acute hospitals is continued after transfer to subacute or chronic hospitals and geriatric health services facilities in Japan.Methods: Acute hospitals routinely transfer patients to nearby subacute or chronic hospitals and geriatric health services facilities after acute stroke treatment. To elucidate the status of antithrombotic therapy, particularly DOAC therapy, we conducted a questionnaire survey of chief physicians at 33 subacute or chronic hospitals and geriatric health services facilities in the vicinity of Kawasaki City.Results: Responses were received from 23 hospitals and geriatric health services facilities (5 convalescent and rehabilitation hospitals, 5 chronic hospitals, 13 geriatric health services facilities). The number of convalescent hospitals responding, 'no problem with DOAC administration' before transfer to subacute or chronic hospitals and geriatric health services facilities increased from 4 (80%) at the introduction of DOACs to 5 (100%) presently. The number of chronic hospitals and geriatric health services facilities also increased from 1 (20%) to 3 (60%) and 4 (30.8%) to 5 (38.5%), respectively, albeit not significantly. The number of convalescent hospitals, chronic hospitals, and geriatric health services facilities requesting pre-transfer change of oral anticoagulants decreased from 20% to 0%, 60% to 40%, and 69.2% to 61.5%, respectively. All convalescent hospitals continued DOAC therapy after transfer. However, only 40.0% of chronic hospitals and 46.2% of geriatric health services facilities used DOACs in the present period. Warfarin was used instead at 3 (60%) chronic hospitals and 7 (53.8%) geriatric health services facilities and antiplatelet drugs were used at 1 hospital/facility each (20% and 7.7%, respectively). Nine (39.1%) hospitals and facilities cited high DOAC costs for the switch.Conclusions: Convalescent hospitals have incorporated DOAC use and readily accept patients receiving DOACs at transferring hospitals. Conversely, many chronic hospitals and geriatric health services facilities eventually switch from DOACs to warfarin or antiplatelet drugs due to cost. Efforts to resolve these barriers to continued administration of DOACs between acute hospitals and subacute or chronic hospitals and geriatric health services facilities in Japan are needed as soon as possible.


Assuntos
Anticoagulantes/administração & dosagem , Continuidade da Assistência ao Paciente , Serviços de Saúde para Idosos , Hospitais , Administração Oral , Humanos , Japão , Transferência de Pacientes , Inquéritos e Questionários
19.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 31(9): 1158-1159, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31657344

RESUMO

OBJECTIVE: In daily medical work, most of the critically ill patients who cannot move by themselves are pulled and lifted by manpower, often relying on the cooperation of many doctors and nurses, which not only increases the risk of transfer and patients' discomfort, but also causes certain skeletal and muscle damage to the porters. The emergency department of the First Hospital of Jiaxing City, Zhejiang Province designed a kind of patient transfer device, and obtained the National Utility Model Patent (ZL 2018 2 0579844.X). The transfer device is composed of upper frame, lower frame and base. The upper frame and the lower frame are rectangular and in a horizontal position. The upper frame can slide laterally through the circular tubes which are fixed on the lower frame. The lower part of the base is provided with four universal foot brake wheels. During the usage, the booster frame facilitates the transfer of patients by the rolling and two sliding tracks of the circular tube, which can make patients move smoothly and comfortably, and reduce the working intensity of the transporter. This device has good practical value.


Assuntos
Estado Terminal , Transferência de Pacientes/métodos , Serviço Hospitalar de Emergência , Humanos
20.
Transplant Proc ; 51(9): 3042-3043, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31627913

RESUMO

OBJECTIVE: The objective is to describe the donations made with extracorporeal membrane oxygenation as a method of preservation to meet the characteristics of the donors and the transplants obtained. METHODS: This was a retrospective descriptive study, using the donation registration data made at Virgen de las Nieves Hospital from 2010 to February 2018. RESULTS: A total of 11 transfers occurred: 2 to the province of Jaen (Jaen Hospital, 92 km from Virgen de las Nieves Hospital; San Agustín Hospital, Linares, 136 km), 1 to Santa Ana Hospital, Motril (68 km), 1 to Poniente Hospital, El Ejido, Almeria (137 km), and 7 trips within the city of Granada. From these donations, a total of 21 kidneys, 3 livers, 10 corneal transplants, 4 extractions of osteotendinous tissue, and 1 extraction of vascular tissue were obtained. CONCLUSION: Extracorporeal membrane oxygenation mobile teams can enable donation in controlled donation after circulatory death with normothermic preservation in hospitals without these resources, which increases the donor group and optimizes graft results.


Assuntos
Oxigenação por Membrana Extracorpórea , Transferência de Pacientes/métodos , Obtenção de Tecidos e Órgãos/métodos , Transplantes , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doadores de Tecidos/provisão & distribução
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