Mobile Emergency Care Service Research Articles

Factors associated with external causes in elderly attended by the mobile emergency care service.

To analyze the prevalence and factors associated with external causes in elderly people attended by the mobile emergency care service. Cross-sectional study with 1,972 pre-hospital care records of elderly victims of external causes from 2019 to 2020. A descriptive and bivariate analysis was performed, with a significance level of 5% (p<0.05). The prevalence of external causes in elderly people attended by the mobile emergency service was 12.2%. Falling was the most frequent occurrence. The associations of the occurrence of falls with age from 90 years old (OR=29.31; p<0.001) and female gender (OR=5.38; p<0.001) stood out, as well as the suspicion of ingestion of alcoholic beverages with occurrence of violence (OR=4.17; p<0.001) and traffic accidents (OR=1.97; p<0.001). The study showed factors associated with injuries due to external causes in theelderly and may support the formulation of coping strategies for this problem.

[Implementation of procedures by the Mobile Emergency Care Service (SAMU 192) in Brazil: performance, benchmarking, and challenges].

The scope of this article is to describe and analyze the production of approved procedures carried out by regulation centers and mobile resources of SAMU 192 between 2015 and 2019, according to frequency, population-based indicators, and daily productivity, to establish a performance indicator. It consisted of an observational and descriptive census study, with production data drawn from the Outpatient Information System, and population data from the Brazilian Institute of Geography and Statistics and information from the Ministry of Health. The 116.8 million procedures analyzed resulted from a 28.5% increase in the period, while the population covered and mobile resources grew by 9.7% and 14.4%, respectively. Every 1,000 inhabitants covered generated 109.8 calls, resulting in 24.0 mobile resource dispatches per year. Basic support units performed 3.3 consultations, and 0.5 transfers daily, while advanced support performed 2.7 consultations and 0.9 transfers. The production of procedures exceeded the increase in the population covered, with variations between states, high incidence in populated areas, a strong presence of basic support and an increase in transfers, although national productivity was seen to be lower than international productivity.

Factors associated with external causes in elderly attended by the mobile emergency care service

RESUMO Objetivo: Analisar a prevalência e fatores associados a causas externas em idosos atendidos pelo serviço de atendimento móvel de urgência. Método: Estudo transversal com 1.972 fichas de atendimento pré-hospitalar de idosos vítimas de causas externas no período de 2019 a 2020. Realizou-se análise descritiva e bivariada, com nível de significância de 5% (p&lt;0,05). Resultados: A prevalência de causas externas em idosos atendidos pelo serviço móvel de urgência foi de 12,2%. A queda foi a ocorrência mais frequente. Destacaram-se as associações da ocorrência de queda com a idade a partir de 90 anos (OR=29,31; p&lt;0,001) e o sexo feminino (OR=5,38; p&lt;0,001), bem como da suspeita de ingestão de bebida alcoólica com a ocorrência de violência (OR=4,17; p&lt;0,001) e acidentes de trânsito (OR=1,97; p&lt;0,001). Conclusão: O estudo evidenciou fatores associados aos agravos por causas externas em idosos e poderá subsidiar formulação de estratégias de enfrentamento a essa problemática.

Sleep quality assessment in emergency health professionals

Objective To assess emergency service professionals’ sleep quality and its association with the level of fatigue and quality of life. Methods A descriptive, cross-sectional and correlational study, carried out in the units of the Mobile Emergency Care Service (SAMU) and in the Emergency Care Unit (ECU), in 2021, with 108 participants. To assess sleep quality, the Pittsburgh Sleep Quality Index, Brazilian version (PSQI-BR), was used; to assess fatigue, the Chalder Fatigue Scale was used, together with the Need for Recovery Scale (NFR); and to assess quality of life, the World Health Organization Quality of Life Brief Version (WHOQOL-bref) was used, and the instruments used were adapted to Portuguese in previous studies. Association tests were applied for statistical analysis, using Pearson’s chi-square test, Mann-Whitney U test or Kruskal Wallis and Spearman’s correlation. P-values &lt;0.05 were considered significant. Results It was identified that 72.2% of participants had poor sleep quality and 75.9% were fatigued. A significant association was observed between sleep quality and fatigue, the need for recovery and quality of life. Conclusion It was identified that health professionals working in emergency services have poor sleep quality and life, and high levels of fatigue and need for recovery, which can directly impact their personal and professional activities.

Outcomes after Clinical and Traumatic Out-of-Hospital Cardiac Arrest.

Data on out-of-hospital cardiac arrest are still scarce, very varied, and indicate a poor prognosis for traumatic events. To describe the out-of-hospital/in-hospital survival, survival time, and neurological conditions of those treated by advanced life support units and submitted to cardiopulmonary resuscitation and compare the results of clinical and traumatic cardiac arrests. This is a cohort study carried out in three stages; in the first two, data were collected from the Mobile Emergency Care Service forms and medical records; then, the Brain Performance Category Scale was applied in the third stage. The sample consisted of resuscitated victims aged ≥18 years. Fisher's and log-rank tests were used to compare the causes, considering a significance level of 5%. 852 patients were analyzed; 20.66% were hospitalized, 4.23% survived until transfer or discharge, and 58.33% had a favorable outcome one year after arrest. There was an association between pre/in-hospital survival and the nature of the occurrence (p=0.026), but there was no difference between the survival curves (p=0.6). Survival of hospitalization after out-of-hospital cardiac arrest was low; however, most who survived to be discharged achieved a favorable outcome after one year. The survival time of those hospitalized after clinical and traumatic events were similar, but pre-hospital survival was higher among trauma patients.

Organizational climate among healthcare personnel and satisfaction of users assisted by the Mobile Emergency Care Service (SAMU) in the context of COVID-19, Piura, 2021

Objective: To determine the relationship between the organizational climate among healthcare personnel and the satisfaction of users assisted by the Mobile Emergency Care Service (SAMU) in the context of COVID-19, Piura. Materials and methods: A Likert-scale survey was administered to 80 healthcare workers to assess the organizational climate and 110 SAMU users to assess their satisfaction level and whether they met the selection criteria. The survey hadone section addressed to SAMU workers and another one to SAMU users. Results: Out of all healthcare personnel, 51.3 % were men with an average age of 32.65 ± 6.8 % years, and there were moreregistered nurses (32.50 %) than doctors (31.30 %). Out of all users, 54.5 % were men with an average age of 58.78 ± 20.97 years, 57.3 % had no comorbidities and 84.5 % used the service once. The organizational climate and its dimensions showed healthy outcomes (96.58 ± 3.21). Most SAMU users (51.60 %) were satisfied (57/110) while 38.20 % (42/110) were moderately satisfied and 10.20 % (11/110) showed dissatisfaction. The main hypothesis concerning the relationship between the organizational climateand the satisfaction of SAMU users (p &lt; 0.005) was confirmed. Moreover, there was a relationship between the five dimensions and the satisfaction of users. Conclusions: There is a relationship between the organizational climate among SAMU healthcare workers and the satisfaction of SAMU users in Piura. The organizational climate and its dimensions, compared to the instrument developed by MINSA, showed healthy outcomes. Most patients were satisfied with the care received and the most frequent comorbidities were hypertension and type 2 diabetes mellitus.

Regulatory aspects and measures of the Emergency Care Network: a game of disputes between the public and private interests

The study analyzes regulatory aspects and measures as social production in the Emergency Care Network (RUE) of two health regions. This is a multiple case study of qualitative character, performed via 61 interviews with public administrators, users, and health services managers. The analysis had as theoretical reference the Theory of Social Production. We identified professional, lay, clientelistic, and governmental regulatory measures, in the systemic aspects, of the services and of access. The main results point to regulatory flows produced by movements of various social actors, with emphasis on the action of representatives of hospital service providers, especially private ones, characterizing the proposal of another regime: market regulation. We emphasize the limits and powers of arrangements, such as hospital and the Mobile Emergency Care Service (SAMU) regulation centers, the internal hospital regulation centers, and the use of WhatsApp. Health regulation in RUE consists of complex, contradictory, and conflicting social processes, whose flows are produced at the limit between the public and private interests.

Temporal analysis of pediatric age in a regional Mobile Emergency Care Service

Temporal analysis of pediatric age in a regional Mobile Emergency Care Service

Reflection of vaccination against COVID-19 in pre-hospital care in northeastern cities

The Mobile Emergency Care Service (SAMU), a mobile pre-hospital component, aims to comfort the patient in urgent or emergency situations. In December 2019, researchers isolated a new type of coronavirus (SARS-CoV-2) that causes COVID-19. In 2020, attention was focused on the development of stages of scientific studies with vaccine candidates against the virus. In January 2021, the emergency use of the vaccine was authorized in the country. Research indicates an encouraging immunizing potential, especially in the prevention of serious clinical conditions. The objective of the research was to establish the influence of vaccination against COVID-19 on the profile of pre-hospital SAMU care in cities in the Northeast. This is a cross-sectional observational analytical study. Samples from secondary data from SAMU daily occurrence reports in the years 2020 and 2021 were analyzed. Of the 819,635 calls analyzed, about half were registered in 2021 and the calls related to COVID-19 added up to 12.5% ​​of the total number of victims met. For the years studied, the Maceió service recorded a reduction in the number of incoming calls, unlike Recife; both services had a reduction in the number of medical orientations. It is concluded that the pandemic changed the profile of services provided by SAMU and that vaccination, in Maceió, reduced the number of monthly calls, the number of calls and the number of calls with respiratory complaints. In this way, immunization appears as a pillar for the prevention of serious clinical conditions and less need for emergency services.

Assessment of the Impact of the Implementation of a Pre-Hospital Ambulance System on Acute Myocardial Infarction Mortality in a Developing Country.

The effective management of patients with acute myocardial infarction (AMI) is time-dependent. To assess the impacts of the implementation of prehospital care on admission rates and mortality associated with AMI. Retrospective, ecological study, which assessed data from the Brazilian Universal Health System, from all 853 municipalities of Minas Gerais, from 2008 to 2016. Excessive skewness of general and in-hospital mortality rates was smoothed using the empirical Bayes method. This study assessed the relationship between Mobile Emergency Care Service (SAMU) in each municipality and the following 3 outcomes: mortality rate due to AMI, AMI in-hospital mortality, and AMI hospitalization rate, using the Poisson hierarchical model. Rates were corrected by age structure and detrended by seasonality and temporal influences. A confidence interval of 95% was adopted. AMI mortality rates decreased throughout the study, on average 2% per year, with seasonal variation. AMI in-hospital mortality also showed a decreasing trend, from 13.81% in 2008 to 11.43% in 2016. SAMU implementation was associated with decreased AMI mortality (odds ratio [OR] = 0.967, 95% confidence interval [CI] 0.936 to 0.998) and AMI in-hospital mortality (OR = 0.914, 95% CI 0.845 to 0.986), with no relation with hospitalizations (OR = 1.003, 95% CI 0.927 to 1.083). SAMU implementation was associated with a modest but significant decrease in AMI in-hospital mortality. This finding reinforces the key role of prehospital care in AMI care and the need for investments on this service to improve clinical outcomes in low- and middle-income countries.

[Performance of the mobile emergency care service from the perspective of managers and professionals: case study in a region of the state of São Paulo, Brazil].

This article aims to analyze the perspective of managers and professionals about the performance of the Mobile Emergency Care Service (SAMU) in the Grande ABC region. This is a qualitative case study based on the formulation of a theoretical-logical model of intervention and semi-structured interviews. The Theoretical-Logical Model translated the dimensions of SAMU analysis: regulation, care and management. The regulation process was understood as a strategic space where the judgment of the patient's need and the ambulance dispatch time have the potential to influence the outcomes of the cases transported. In health care, the main themes that emerged were investment in the qualification of the team and in telemedicine with the perspective of improving the quality of care and making the diagnosis more accurate. In management, challenges such as integrating SAMU with tertiary centers, improving the information system, and monitoring and evaluation were highlighted aiming to qualify the regulatory processes by aligning them with the objectives proposed in the health policy. The set of data analyzed reinforces the capacity of the SAMU in emergency care in the region; however, the intervention needs to overcome important challenges in order to improve the prognosis of the cases transported.

Mental health of nursing professionals during the COVID-19 pandemic: a cross-sectional study.

ABSTRACTOBJECTIVE To identify the prevalence of and factors associated with: (1) major depressive episodes; (2) minor psychiatric disorders (MPDs); and (3) suicidal ideation among nursing professionals from a municipality in southern Brazil.METHODS Using a cross-sectional design, we recruited 890 nursing professionals linked to 50 Primary Care units, 2 walk-in clinics, 2 hospital services, 1 emergency room service, 1 mobile emergency care service, and 1 teleconsultation service, in addition to the municipal epidemiological surveillance service and the vacancy regulation center between June and July 2020. We used the Patient Health Questionnaire-9 and the Self-Reporting Questionnaire to evaluate the studied outcomes. Associations between the outcomes and variables related to sociodemographic profile, work, health conditions, and daily life were explored using Poisson regression models with robust variance estimators.RESULTS The observed prevalence of depression, MPDs, and suicidal ideation were 36.6%, 44%, and 7.4%, respectively. MPDs were associated with the assessment of support received by the service as ‘regular’ (PR: 1.48; 95% CI: 1.19–1.85) or ‘poor’ (PR: 1.54; 95% CI: 1.23–1.94), with a reported moderate (PR: 1.63; 95% CI: 1.29–2.07), or heavy (PR: 2.54; 95% CI: 2.05–3.15) workload, and with suspected COVID-19 infection (PR: 1.44; 95% CI: 1.25–1.66). Major depressive episodes were associated with a reported lack of personal protective equipment (PR: 1.20; 95% CI: 1.01–1.42), whereas suicidal ideation was inversely related to per capita income > 3 minimum monthly wages (PR: 0.28; 95% CI: 0.11–0.68), and positively related to the use of psychotropic drugs (PR: 3.14; 95% CI: 1.87–5.26).CONCLUSION Our results suggest that nursing professionals’ working conditions are associated with their mental health status. The need to improve working conditions through adequate dimensioning, support and proper biosafety measures is only heightened in the context of the COVID-19 pandemic.

Team climate and job satisfaction in a Mobile Emergency Care Service.

to identify the team climate and job satisfaction in a Mobile Emergency Care Service (SAMU). this is a quantitative, exploratory-descriptive study. The sample corresponded to 95 workers, allocated in 40 teams of a SAMU in the Metropolitan Region of the city of São Paulo. We applied three instruments: sociodemographic/labor characterization; Team Climate Inventory; and Job Satisfaction Scale-S20/23, validated for Brazil. Descriptive statistics were used for data analysis. the total score of team climate was high both among workers (194.5 points; SD = 21) and among teams (197.7 points; SD = 18.4). Satisfaction had a mean total score of 4.5 (SD = 0.4), for workers, and 4.6 points (SD = 0.6), for teams. As for the climate, "Team participation" and "Support for new ideas" obtained agreement percentages >70% in all propositions. Regarding job satisfaction, there was a percentage of concordance >80% in the three dimensions. the findings show a positive perception of workers about team climate and job satisfaction, supporting SAMU management in promoting a favorable environment for professional practice.

Network professional interaction in the care of patients with stroke.

to understand the professional interaction in the Emergency Care Network in the care of patients with acute ischemic stroke in the city of Salvador/Bahia. the Grounded Theory methodological framework, Straussian strand, and the health networks theoretical framework were used. An in-depth interview was used, between October 2019 and October 2020, with 75 professionals from the Mobile Emergency Care Service, Emergency Care Units and reference hospital. 5 categories and 24 subcategories point to shared goals among professionals, but they show elements of fragmentation of connections between services, such as the absence of a single language and conduct, obstacles to professional relationships and lack of knowledge of the other's role. to improve network relationships and care of patients with stroke, there is a need for well-established connecting elements, such as flows and protocols, supported by continuing education actions.

Mobile pre-hospital care reorganization during the COVID-19 pandemic: experience report.

To describe the reorganization of Belo Horizonte's Mobile Emergency Care Service during the new coronavirus pandemic using the Plan Do-Check-Act quality tool. Descriptive study, of the experience report type, on the reorganization of care in a mobile pre-hospital care service during the new coronavirus pandemic, from March to July 2020. The Plan-Do-Check-Act quality tool was applied for the process. Preparation of care protocol, meetings, training, addition of ambulances, hiring of professionals, and other actions were carried out, with subsequent evaluation and monitoring. When failures or new needs were identified, actions and changes were implemented while keeping monitoring and evaluation during the work routine. The reorganization of the service through the construction of a protocol and using the Plan-Do-Check-Act as a management tool was essential to promote safe care for professionals and patients.

A enfermagem e o perfil dos atendimentos realizados pelo SAMU em uma cidade do sudoeste goiano

The aim was to identify the profile of the assistance provided by the Mobile Emergency Care Service in a municipality in Goiás and highlight the role of nurses in this profile. This is a quantitative, exploratory, descriptive and retrospective study with a documentary approach, carried out between July and December 2021. Data collection was carried out through the attendance records and the application of two forms containing general and specific variables of the patients. five nurses and a coordinator who make up the sample of this study, meeting the inclusion and exclusion criteria. Data were tabulated and categorized using an Excel® spreadsheet and descriptive analysis was obtained by calculating mean, median, standard deviation and percentages. The results on the calls showed a high demand for calls with a greater number of calls of a clinical nature and attended by the Basic Support Unit. The main outcome of the consultations was the local Emergency Care Unit. That the professionals have specialization in the area, have been working in the service for an average of 3 years and provide assistance in cases and provide administrative support. It was noticed the importance of a network of emergency care and the roles of nurses before, during and after care.

Serviço de Atendimento Móvel de Urgência: Golden time desempenhado nos atendimentos obstétricos

The objective was to analyze the Golden team performed by the mobile emergency care service (SAMU 192) in obstetric care. This is a documentary, descriptive, retrospective study with a quantitative approach. Information was obtained from registration forms of obstetric occurrences attended by the SAMU 192. Data were analyzed using the Statistical Package for the Social Sciences software, in which absolute and relative frequencies, means, medians, amplitudes and test were used. T-Student. The SAMU 192 reached an average of 29.1 minutes in the Golden time, the general and clinical characteristics of the attended pregnant women reveal that their health status was stable. The main destination was the hospital in the city, many of the consultations did not include the condition of entry of pregnant women to the reference service. The Golden time achieved reflects the excellent performance directed to the so-called obstetricians.

A Rede de Atenção às Urgências e Emergências em cena: contingências e produção de cuidado

ABSTRACT This study aims to analyze the possible transformations in health care management and production processes, in the context of practice, based on the Emergency and Urgent Health Care Network (RUE) policy. The research has a qualitative character and is characterized as a case study. Interviews were conducted with 16 health service managers in four municipalities of different population sizes. The material was analyzed with reference to the context of the Public Policy Cycle Approach practice. It is observed that the RUE is not recognized as a public policy, although some of its elements are identified, such as the implementation of Emergency Care Units, protocols, risk classification, new care technologies, regulatory arrangements, and lines of care. Looking at the ‘RUE on scene’ mainly points to three issues: the relationship between primary care and emergency doors in meeting spontaneous demand; the medical regulation of Mobile Emergency Care Service (SAMU), as a promoter of access and quality; and the (dis)continuity in health care. There is evidence of live movements and productions induced by the policy that qualify health care in urgent and emergency situations. However, inequities are maintained or produced, and the need for articulation between network components, although evoked, translates into fragile and non-regular connections.

Assistência do enfermeiro na parada cardiorrespiratória no Serviço de Atendimento Móvel de Urgência (SAMU)

Introdução: A parada cardiorrespiratória é responsável por uma elevada taxa de morbimortalidade, mesmo em situações de atendimento ideal. Sua definição consiste na interrupção das atividades respiratória e circulatória efetiva, sua intervenção consiste em aplicar uma série de procedimentos emergenciais, a fim de restabelecer a oxigenação e a circulação. Objetivos: Analisar a assistência do enfermeiro durante uma parada cardiorrespiratória no Serviço de Atendimento Móvel de Urgência. Métodos: Refere-se a uma revisão integrativa da literatura do tipo exploratória com abordagem quantitativa, considerando os materiais disponíveis nas bases de dados BVS e LILACS. Resultados: De acordo com as pesquisas foram geradas duas divisões para apresentação das evidências e discussão da temática. Na primeira, são apresentados: Assistência do profissional enfermeiro no atendimento a vítima em PCR no Serviço de Atendimento Móvel em Urgente. Na segunda divisão apresenta: Fatores determinantes na sobrevida imediata após manobras de ressuscitação cardiopulmonar na Parada cardíaca extra-hospitalar. Conclusão: Foram observados que ainda existe uma escassez de conhecimento sobre o protocolo diante a uma PCR por parte do profissional enfermeiro, voltada para a importância das manobras de RCP com eficiência, visto que o enfermeiro na maioria é o primeiro a chegar no local.

Trauma em idosos socorridos pelo serviço de atendimento móvel de urgência

Resumo Objetivo: Descrever as ocorrências e os mecanismos de trauma em idosos socorridos pelo Serviço de Atendimento Móvel de Urgência. Métodos: Estudo transversal, realizado com registros de atendimento de trauma em idosos, em cidade de porte médio, com população estimada de 600 mil habitantes. Foram analisadas as variáveis: faixa etária, sexo, ano, mecanismo de trauma, região geográfica do atendimento e óbito. Os dados foram analisados por meio de frequências absolutas e relativas e, quando apropriado, por médias e desvio padrão. [...]