Importância da avaliação e padronização analgésica em serviços de emergência

Abstract

RESUMOObjetivos: Conhecer a medicação antiálgica utilizada em pacientes que sofreram acidentes de transporte, o padrão analgésico e pontuar a intensidade da dor. Métodos:Estudo descritivo, exploratório e longitudinal com abordagem quantitativa, que abrangeu 100 pacientes envolvidos em acidentes de transporte admitidos para tratamento em hospital referência para trauma. Resultados:A dor foi identificada em 90,0% dos pacientes, sendo as de forte e média intensidade as mais frequentes; não se encontrou prescrição antiálgica em 48% dos casos. Maior uso medicamentoso foi encontrado em vítimas com lesões em membros e nos sete casos em que a dor foi totalmente aliviada, 5 (66,7%) foram utilizados opióides. Conclusão: A dor é um fenômeno comum associado ao trauma com sub-tratamento e sub-avaliação em nosso meio, e o uso de opióides para dores reconhecidamente muito intensas ainda é um recurso pouco utilizado na emergência, mesmo em pacientes hemodinamicamente estáveis e com Escala de Coma de Gasglow=15. Descritores: Dor; Ferimentos e lesões; Analgesia; Serviços médicos de emergência; Avaliação. ABSTRACT Objectives:To describe the types of analgesic medication used by patients who had automobile accidents and to identify standardization of analgesic medication and measurement of pain intensity. Methods: This was a descriptive longitudinal quantitative study with 100 patients who had automobile accidents from a trauma designated hospital. Results: The majority of patients (90.0%) reported having pain. High and moderate levels of pain intensity were the most commonly reported by the patients. There was no prescription of analgesic medication for 48% of the patients. Patients with limb lesions received more analgesic medication than those with other types of lesions. Among 7 patients who had complete pain relief, 5 of them (66.7%) received opioid medication. Conclusions: Pain is a common symptom associated with inadequate evaluation and management. The use of opioid medication to relief high intensity pain in trauma patients in emergency services is not a common practice even for those patients who are hemodynamically stable and having a score of 15 on the Glasgow Coma Scale. Key Words: Pain, Wounds and Lesions; Analgesia; Medical Emergency Services; Evaluation. RESUMENObjetivos: Conocer los medicamentos antiálgicos utilizados en pacientes que sufrieron accidentes de transporte, conocer el estándar analgésico y dar puntajes a la intensidad del dolor. Métodos: Estudio descriptivo, exploratorio y longitudinal con abordaje cuantitativo, que comprendió 100 pacientes que sufrieron accidentes de transporte y fueron admitidos para tratamiento en un hospital de referencia para tratamiento de traumas. Resultados: El dolor fue identificado en 90,0% de los pacientes, siendo los dolores más frecuentes los de fuerte y media intensidad; no se encontró prescripción antiálgica en 48% de los casos. El mayor uso medicamentoso fue encontrado en víctimas con lesiones en miembros y entre los siete casos en que el dolor fue totalmente aliviado, ...

Nursing diagnoses in trauma victims with fatal outcomes in the emergency scenario

“…An interesting finding of this study refers to the protective factors identified, related here to survival. The high positive correlation found between the protective factors ND 21 -impaired comfort and ND 25 -acute pain, can be explained by the high frequency of patients reporting feeling uncomfortable because of acute pain post-trauma, a fact that was only possible to identify in hemodynamically stable and conscious patients (4) .…”

“…The literature highlights the problem of underevaluation and under-treatment of acute pain in the emergency department, which in our environment is approximately 70.0% (4) . Another important aspect that merits consideration in this study concerns the multivariate analysis (statistical model adopted) which focuses on comprehending the scenario as a whole and not just the strength of one or another variable (15) .…”

“…However, the need to individualize the care is a reality experienced by all the professionals who participate in these consultations, due to their different forms of presentation, severity and complexity and accordingly the use of nursing diagnoses seemed an interesting and useful route for acting in the emergency scenario (4) . In pursuing of this route and after an extensive literature review on the theme, a knowledge gap was identified in the area of nursing diagnoses related to fatal victims resulting from trauma in our environment and in the international scenario, which seems a paradox due to the importance of the nurse in this care.…”

“…Studying the causes and the consequences of a disease is essential in order to establish a diagnosis and to contribute to the adoption of preventive, control, care and education measures (4) . In this sense, knowing the incidence of the nursing diagnoses with these victims and those most frequent in fatal victims is consistent with the national profile of morbidity and mortality and provides support for the performance with greater security and the stimulation for this study (5) .…”

Caracterização sociodemográfica e clínica de estrangeiros/ imigrantes adultos internados em um hospital

“…19 Another important result for this discussion is the fact that more than 50% of the foreign patients have undergone surgical procedures during hospitalization, which frequently signals pain, which reinforces the use of analgesics and anti-inflammatories. In both emergency and surgery, volume replacement is necessary to maintain the patient's hemostasis, justifying the use of English/Portuguese J Nurs UFPE on line., Recife, 11 (12) solutions for infusion such as saline sodium chloride 0.9%.…”