Objective: To identify in the literature the complications related to physiological changes of the patient, the multidisciplinary team and the use of equipment during the intrahospital transport of critically ill patients. Methods: Integrative review of literature, through a search in the databases of PubMED, MEDLINE, and LILACS. Results: We encountered 20 articles, all written in the English language. Studies have shown that changes in arterial pressure and heart rate are most common during transport. Of the adverse events related to problems with the team, the lack of knowledge of the professional and failure of communication stood out, apart from those derived from equipment used. Conclusion: Transporting the critically ill patient safely requires improving communication between teams, standardizing the actions and equipment used by means of protocols, and identifying opportunities to obtain excellence in service during transport. RESUMOObjetivo: Identificar na literatura as complicações relacionadas às alterações fisiológicas do paciente, à equipe multidisciplinar e ao uso de equipamentos durante o transporte intra-hospitalar de pacientes críticos. Métodos: Revisão integrativa da literatura, com busca nas bases de dados PUBMED, MEDLINE, e LILACS. Resultados: Foram encontrados 20 artigos, todos escritos na língua inglesa. Os estudos mostraram que as alterações na pressão arterial e na frequência cardíaca são as mais comuns durante o transporte. Dos eventos adversos relacionados a problemas com a equipe, destacaram-se, a falta de conhecimento do profissional e a falha de comunicação, além dos provenientes dos equipamentos utilizados. Conclusão: Transportar o paciente crítico de maneira segura significa melhorar a comunicação entre as equipes, padronizar as ações e equipamentos utilizados por meio de protocolos e identificar intercorrências para obter excelência no atendimento durante o transporte. Descritores: Transporte de pacientes; Transferência de pacientes; Cuidados críticos; Pacientes internados; Sintomas clínicos RESUMEN Objetivo: Identificar en la literatura las complicaciones relacionadas a las alteraciones fisiológicas del paciente, al equipo multidisciplinario y al uso de equipamientos durante el transporte intrahospitalario de pacientes críticos. Métodos: Revisión integrativa de la literatura, con búsqueda en las bases de datos PUBMED, MEDLINE, y LILACS. Resultados: Fueron encontrados 20 artículos, todos escritos en el idioma inglés. Los estudios mostraron que las alteraciones en la presión arterial y en la frecuencia cardíaca son las más comunes durante el transporte. De los eventos adversos relacionados a problemas con el equipo, se destacaron, la falta de conocimiento del profesional y la falla en la comunicación, además de los provenientes de los equipamientos utilizados. Conclusión: Transportar al paciente crítico de manera segura significa mejorar la comunicación entre los equipos, patronizar las acciones y equipamientos utilizados por medio de protocolos e identificar complicaciones...
Objectives: To identify and describe the profile of potential transthyretin cardiac amyloidosis (ATTR-CM) cases in the Brazilian public health system (SUS), using a predictive machine learning (ML) model. Methods: This was a retrospective descriptive database study that aimed to estimate the frequency of potential ATTR-CM cases in the Brazilian public health system using a supervised ML model, from January 2015 to December 2021. To build the model, a list of ICD-10 codes and procedures potentially related with ATTR-CM was created based on literature review and validated by experts. Results: From 2015 to 2021, the ML model classified 262 hereditary ATTR-CM (hATTR-CM) and 1,581 wild-type ATTR-CM (wtATTR-CM) potential cases. Overall, the median age of hATTR-CM and wtATTR-CM patients was 66.8 and 59.9 years, respectively. The ICD-10 codes most presented as hATTR-CM and wtATTR-CM were related to heart failure and arrythmias. Regarding the therapeutic itinerary, 13% and 5% of hATTR-CM and wtATTR-CM received treatment with tafamidis meglumine, respectively, while 0% and 29% of hATTR-CM and wtATTR-CM were referred to heart transplant. Conclusion: Our findings may be useful to support the development of health guidelines and policies to improve diagnosis, treatment, and to cover unmet medical needs of patients with ATTR-CM in Brazil.
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