A família do portador de sofrimento psíquico e os serviços de saúde mental: Estudo de caso

This qualitative research, case study type, aimed at presenting the understanding of psychic sufferers in search for mental health services during emergency situation, partial hospitalization or in ambulatory services. 12 family members were interviewed. They reported difficulties in the attendance in the emergency room when the patient is in crisis, as well as doctors considering merely the present symptomatology and undervaluing their own knowledge of the sickening process. The day-care hospital is conceived as a place to provide care, occupation and should teach as a school. The ambulatory service represents for the family the possibility of the patient being responsible for their attendance to the consultations and for the correct use of the medication.

Automedicação em oftalmologia

Purpose: To analyze the conditions, consequences and risks of self-medication in patients attended in ophthalmology emergency room at Hospital das Clínicas de Botucatu (UNESP). Methods: Sixty patients who had used any form of self-medication were studied according: age, sex, professional activity, mainly complain, visual acuity (best-corrected vision), who administrated the self-medication (friends/parents, pharmacy clerk, advertisement, or the person himself), sort of medication or product used (eyedrops/ointments/contact lenses), cost (R$), time expenditure to medical attention, ocular complications, risk of visual loss and final diagnose. Results: The majority of patients with self-medication were male (72%). The mean age was 40,9 years (7-77 years). Patients usually used eyedrops that they had at home and delayed 3 days to the first medical evaluation. The most frequently kind of topical eyedrop used was vasoconstrictor (17%). However, many patients even knew what kind of medication they had dropped in their eyes (21%). The great majority of the patients (68%) were exposed to the risk of visual loss. According to our results, self-medication may cause visual complications in 12% of patients, in which, 42% was related to the contact lenses fit without ophthalmologic assistance. Conclusion: The majory of the patients used medication that they had in home. The topical vasoconstrictor was the most frequently used drug, however, they did not know which medication were dropping in their eyes (21%).

Drug dependence, mental impairment and education

This study aimed to evaluate the mental conditions of cocaine-dependent individuals and school commitment/attachment. We evaluated 50 patients referred to the psychiatry emergency room due to mental disorders from chemical dependence. After clinical diagnosis, clinical interview, Hospital Anxiety and Depression Scale, Hamilton Scale for Depression and Brief Psychiatric Rating Scale were applied. The Spearman and Mann-Whitney nonparametric tests, as well as the t-Student test were utilized for statistical analysis.. The accepted significance value was 0.05. All subjects had used cocaine or crack and other substances. Only 13 (26%) did not drop out of school (group 1). Regarding the other 37 (74%), irregular class attendance , successive failures and definitive school drop out rates (group 2) were verified. These subjects presented an early substance use when compared with those which did not drop out of school (p=0.0001). Patients with an early substance use presented higher school dropout rates than those with a later initiation to substance use. Psychopathological phenomena were frequent in both groups.

Identificação das variáveis associadas à mortalidade de pacientes internados em unidade de terapia intensiva adulto

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação dos efeitos de diferentes manobras de fisioterapia respitatória no desfecho de pacientes ventilados mecanicamente

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A interface entre uma Unidade de internação infantil em Pronto Socorro de Hospital Universitário, com o Sistema de Saúde local e regional

Pós-graduação em Pediatria - FMB

A morte em situações de urgência e emergência: a dimensão cuidadora dos profissionais de enfermagem

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Avaliação e capacitação da equipe de enfermagem para o atendimento da parada cardiorrespiratória em uma unidade de terapia intensiva de um pronto socorro

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Comportamentos e situações de risco e de segurança para acidente com material biológico durante estágio curricular de enfermagem

Pós-graduação em Educação - FFC

Perfil epidemiológico de acidentes com material biológico entre estudantes de medicina em um pronto-socorro cirúrgico

OBJECTIVE: To evaluate the accidents with biological material among medical students interning in a trauma emergency room and identify key related situations, attributed causes and prevention. METHODS: we conducted a study with a quantitative approach. Data were collected through a questionnaire applied via internet, with closed, multiple-choice questions regarding accidents with biological material. The sample comprised 100 students. RESULTS: thirty-two had accidents with biological material. Higher-risk activities were local anesthesia (39.47%), suture (18.42%) and needle recapping (15.79%). The main routes of exposure to biological material were the eyes or mucosa, with 34%, and syringe needle puncture, with 45%. After contamination, only 52% reported the accident to the responsible department. CONCLUSION: The main causes of accidents and routes of exposure found may be attributed to several factors, such as lack of training and failure to use personal protective equipment. Educational and preventive actions are extremely important to reduce the incidence of accidents with biological materials and improve the conduct of post-exposure. It is important to understand the main causes attributed and situations related, so as general and effective measures can be applied.

Avaliação dos parâmetros gasométricos dos traumatizados durante o atendimento pré-hospitalar móvel

OBJECTIVE: To evaluate gasometric differences of severe trauma patients requiring intubation in prehospital care. METHODS: Patients requiring airway management were submitted to collection of arterial blood samples at the beginning of pre-hospital care and at arrival at the Emergency Room. We analyzed: Glasgow Coma Scale, respiratory rate, arterial pH, arterial partial pressure of CO2 (PaCO2), arterial partial pressure of O2 (PaO2), base excess (BE), hemoglobin O2 saturation (SpO2) and the relation of PaO2 and inspired O2 (PaO2/FiO2). RESULTS: There was statistical significance of the mean differences between the data collected at the site of the accident and at the entrance of the ER as for respiratory rate (p = 0.0181), Glasgow Coma Scale (p = 0.0084), PaO2 (p <0.0001) and SpO2 (p = 0.0018). CONCLUSION: tracheal intubation changes the parameters PaO2 and SpO2. There was no difference in metabolic parameters (pH, bicarbonate and base excess). In the analysis of blood gas parameters between survivors and non-survivors there was statistical difference between PaO2, hemoglobin oxygen saturation and base excess.

Orientações de alta: cartões padronizados ajudam na compreensão dos pacientes do pronto socorro?

OBJECTIVE: To determine whether the addition of discharge standard illustrated cards improves understanding of patients in the emergency room. METHODS: We conducted a prospective, randomized, interventional study with 228 patients discharged from the emergency department. All patients were interviewed and tested for the level of understanding of discharge instructions. Some of them received the intervention, with the standard cards, and another did not, constituting the control group. RESULTS: The average of followed discharge guidelines of the group that received the cards was higher than the control group, with statistical significance (p=0.009). When segregated by age, the group between 16 and 35 years of both sexes had the best average of followed guidelines, statistically, than the average of the control group (p=0.01). The difference between the mean orientations between the control group and the card for patients undergoing procedures was statistically significant (p=0.02); as for the stratification according to the number of procedures, the significance increases when that is equal to 1 (p=0.001) and decreased the more procedures were carried out. CONCLUSION: The introduction of discharge standard orientation cards was associated with improvement in the understanding of patients. Without replacing the verbal directions, which establishes dialogue and doctor-patient bonding, cards appear as auxiliary elements, facilitating understanding and care guidelines.

Caracterização da demanda do pronto socorro do Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP

The demand for health services can be understood as an application needs the user has. The inability to use the outpatient services and limited supply of these make it possible for users to browse sites that focus attention on a greater possibility of entry doors, in which first-aid centers and hospital emergency match this profile, distorting the flow of patients in the network through an inverse demand of the movement hierarchy. Added to this, the burden of care in these services results in overcrowding and poor quality of care. Evaluate the demand of the visits occurred in the Emergency Room of the Hospital of the Medical School of Botucatu / UNESP (PS - HC - FMB / UNESP) during June-July 2010. A transversal, descriptive and retrospective. For data collection sheet was used in the proposed Service unit and the data it was filled out the form with the necessary items for the search. Made an exploratory analysis and frequency distributions for categorical variables of the form. Females predominated (56%) and aged 61 years or older with 30%. 96.5% were owned by DRS VI, and 62.5% of Botucatu. The attendance by the physician on duty and corresponded to 57.7% among the 23 medical specialties, Gastric (7.0%), Cardiology (4.5%), Medical (4.4%), urology (4.2%) and Pulmonology (4.1%) were the ones that stood out. The medical procedures performed that stood out were X-ray (46.4%) and electrocardiogram (ECG) (42.3%) and in most specialty care occurred, only the daily consultation with the patient. It was possible to characterize, so the demand for PS - HC - FMB / UNESP for the period June- July 2010, The predominance of the elderly shows that come along with aging diseases and addictions, causing a greater need for health services. Moreover, this study showed that the high number of visits is related to both the daily demands that the tertiary hospital has the same transformation... (Complete abstract click electronic access below)

Gerenciamento dos resíduos de serviços de saúde do pronto socorro de um hospital escola na cidade de Botucatu

Health Care Waste (HCW) represents 1%, and it has presently gained a lot of importance. Adequate management is one of the great challenges to be faced by health care centers. It has gained distinction and been widely discussed by members of the sectors involved with sanitation, public health and environmental issues due to waste physical, chemical biological characteristics, which pose potential risk to the environment and public health. The present study aims at evaluating HCW internal management by following all its phases, determining indicators, classifying and quantifying, establishing production rates (kg /patient/day) for the sector and designing materials to disseminate appropriate HCW disposal in the Emergency Room of the UNESP University Hospital in the city of Botucatu according to the guidelines presently in force. : From June to October 2011, the waste flow was observed from its production to final disposal. Four weight measurements were performed on four consecutive days in the month of August by using a properly calibrated (in grams) digital scale at the times scheduled for collection of the produced waste. Hence, the daily and monthly amounts were estimated according to their classification. All the waste packaged in the bags in garbage cans in the Emergency Room for a 24-hour period was considered to be a sample. Separation was not adequately performed in that sector, and waste from Group A was mixed with that from Group D. The amount of infectious waste produced in the sector corresponded to 87.80 %, common waste to 10.93 % and recyclable waste to 1.27%. The mean daily HCW production was of 123.300 kg/day, and the total monthly production was of 3,822 kg/month, which was distributed as follows: Group A 3,355,750 kg/month; Group D 417,570 kg/month and recyclables 48,670 kg/month. The production rate corresponded to 0.47 kg/patient/day, thus showing... (Complete abstract click electronic access below)

Análise dos acidentes automobilísticos atendidos no Hospital das Clínicas no ano de 2010, Botucatu

As a result of the 20th-century industrial development, and particularly after World War II, cars have become an important consumer good, and this has led to a large number of circulating vehicles. To this day, the number of cars has increased exponentially worldwide, which results in a high number of traffic accidents (TAs) every day. TAs are responsible for 1.2 million deaths worldwide each year, and in Brazil, they are considered to be a public health problem, considering that its traffic is regarded as one of the worst and most dangerous in the world. In addition to temporary or permanent physical disabilities that bring great harm to individuals, accidents also cause psychological disorders, such as the post-traumatic stress disorder. Hence, considering the importance of TAs in the country and their outcomes, this study aimed at investigating the epidemiological aspects of car accidents occurring in 2010 who were assisted in the emergency room of a university hospital in São Paulo state. By means of records made by the nursing team and medical records analysis, it was possible to extract a stratified sample of 88 cases involving adults and eight cases involving children. The sample was analyzed by the SAS software for Windows, version 9.2. As regards the accidents involving adults, there was a predominance of males (67%), with an approximate 2:1 ratio in relation to females. The victims’ most frequent age range was 20-29 years (39%), and they were mostly single (56%). The month showing the largest number of occurrences was July, with 17%, and the weekday was Sunday, with 25%. Showing 32%, the time period when most accidents occurred was from 06:00 o’clock p.m. to 11:59 p.m. As regards vehicles types involved, motorcycles were in first place, with 47% of cases, and the most common accident type was crashing between vehicles, with 43%... (Complete abstract click electronic access below)