Mobile Emergency Care Service Research Articles

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. [...]

A ergonomia no ambiente de trabalho dos enfermeiros do samu: uma visão da enfermagem

A ergonomia é considerada uma das principais estratégias na prevenção de algumas doenças laborais, e é utilizada com o objetivo de identificar situações desfavoráveis durante a realização de atividades nos ambientes de trabalho, a fim de reduzir os riscos sem prejuízo do desempenho profissional. Nesse contexto, o Serviço de Atendimento Móvel de Urgência constantemente expõe os seus trabalhadores de enfermagem a essas circunstâncias, devido às especificidades dos serviços de assistência direta ao paciente fora do ambiente hospitalar, visando à manutenção da vida em situação de urgência e emergência antes da chegada a uma instituição de atendimento especializado. O objetivo deste estudo foi avaliar artigos científicos da área de saúde que abordam as condições de trabalho no SAMU e refletir acerca das melhorias no posto de trabalho do profissional de enfermagem no SAMU. Trata-se de uma revisão bibliográfica realizada nas bases de dados científicos Medline, Lilacs, Scielo e BVS. Para seleção dos artigos foram utilizados, os descritores: Ergonomia física, Enfermagem, SAMU e Atendimento Pré-hospitalar. Os resultados demonstraram que os trabalhadores de enfermagem estão expostos a inúmeros riscos ocupacionais causados por fatores químicos, físicos, mecânicos, biológicos, ergonômicos e psicossociais, é importante que os mesmos sejam informados e treinados para evitar problemas de saúde, e métodos de controle devem ser instituídos para prevenir acidentes. Em vista disso, conclui-se que este estudo é relevante para a literatura no tocante ao incentivo do conhecimento teórico-prático acerca da ergonomia no ambiente hospitalar.

Nursing APHMÓVEL: mobile application to register the nursing process in prehospital emergency care.

to develop an application for a mobile device for the registration of the Nursing Process by nurses of the Mobile Emergency Care Service. applied research with technology development based on software engineering and Apple's Human Interface Guidelines. It had the support of an application developer and a designer. The proposal was built in four steps (scope definition, planning, prototype creation and development). the application "Nursing APHMóvel" allows to record the steps of the Nursing Process, such as history, nursing diagnoses, outcomes and interventions with the possibility of storing the data and/or file in printable format. The technological innovation has location features, scales with automatic sum of items, touchscreen, and offline operation. it was possible to develop the application with the potential for computerized documentation of the Nursing Process by nurses working in the Mobile Emergency Care Service.

Prevalence and associated factors with musculoskeletal pain in professionals of the Mobile Emergency Care Service

ABSTRACT BACKGROUND AND OBJECTIVES: The professionals who work in pre-hospital care are exposed to unhealthy environments, which can represent risk factors for the development of musculoskeletal disorders. Thus, the objective of this study was to observe the prevalence of musculoskeletal pain in professionals of the Mobile Emergency Care Service (SAMU) and identify its associated factors. METHODS: Cross-sectional study, carried out at three SAMU bases in Pernambuco. Ninety five professionals were evaluated, of both sexes and age range between 21-58 years old, being (n=36: ambulance drivers, n=38: nursing technicians, n=15: nurses and n=6: physicians). For the musculoskeletal pain evaluation, the Nordic Questionnaire of Musculoskeletal Symptoms was used. To quantify the intensity of pain, the visual analogue scale was used. RESULTS: Musculoskeletal pain was reported by 71.6% (n=68) of the rescuers; of these, only 18% (n=17) mentioned that they already had these pains before their SAMU labor activity. Nursing technicians were the professionals most affected by the musculoskeletal pain (89.5%), followed by nurses (73.3%), ambulance drivers (55.6%) and the physicians (50%). The lumbar spine (53.5%), knees (32.6%) and cervical spine (30.5%) were the body regions most affected by pain and the female sex was associated with musculoskeletal pain presence (p=0.024). CONCLUSION: High musculoskeletal pain prevalence was observed among professionals of SAMU, especially in the nursing professionals. In addition, the female sex was shown to be a factor associated with musculoskeletal pain presence in this group of professionals.

Psychiatric emergency service in Federal District: interdisciplinarity, pioneering spirit and innovation

This study aims to discuss the care for people in psychic crises conducted by the team of the Mental Health Center of the Mobile Emergency Care Service of the Federal District - Brazil (NUSAM/SAMU/DF/BRAZIL), describing the dynamics of care, since the regulation from cases to follow-up. Qualitative, exploratory, descriptive study, with data collected through data collection in the information system of the Health Department of the Federal District (SES/DF), participant observation activities and interviews, over a period of three months, with professionals from NUSAM/SAMU/DF. The qualitative analysis consisted of Bardin's content analysis. NUSAM/SAMU/DF showed its ability to offer care in a humanized and resolving way to urgencies and emergencies of a psychosocial nature, considering the resources it has. The service's pioneering spirit regarding the prehospital approach to people in psychic crises is highlighted, characterized by the singularized, humanized and resolutive service.

Caracterização das ocorrências do serviço de Atendimento Móvel de Urgência – SAMU

Esse artigo buscou caracterizar as ocorrências do Serviço de Atendimento Móvel de Urgência e Emergência por meio da pesquisa quantitativa, realizada com dados arquivados no Sistema de Informação do serviço. A amostragem selecionada correspondeu a quantidade de ocorrências atendidas nos meses de setembro à dezembro de 2019, e de janeiro à abril de 2020. A quantidade total de atendimentos no período de 2020 (6.158) foi bem próxima ao apresentado em 2019 (6.160). A média geral de atendimentos em 2019 e 2020 foi de 1.540 ocorrências. Em 2019 a USA apresentou a média de 258 atendimentos, da USB 1.197 e a motolância 45. A prevalência de atendimentos em 2020 realizados pela USB obteve a média 1.271, a USA 228 e a motolância 40. As ocorrências clínicas foram prevalentes em relação as outras naturezas. Porém, ressalta- se a incidência significativa dos serviços prestados às vítimas de acidente de trânsito, às vítimas de queda e aos pacientes internados que necessitaram de transferência inter-hospitalar.

OPTIMIZATION MODEL FOR THE INSTALLATION OF SAMU BASES: APPLICATION IN NATAL-RN

Purpose – The objective of this study was the application of a mathematical model aiming to designate neighborhoods to install new Mobile Emergency Care Service (SAMU) bases to minimize the distance traveled by ambulances in the city of Natal / RN.Design/methodology/approach –The data were grouped in order to obtain parameters, such as: call district, time, day of the week, number of accidents. After data collection and processing, a matrix of neighborhood-to-neighborhood distances in the city of Natal based on Google Maps was created. A model was created to minimize the distance traveled by ambulances with the aid of the AIMMS program.Findings – The application of the model allowed for the simulation of scenarios with the installation of 3 to 8 fixed bases. There was a significant reduction in the distance traveled by the ambulances, which reached 48%, after the installation of eight bases. In other words, there was a reduction of 6,560 kilometers traveled per month by ambulances.  Research, Practical & Social implications – The reduction in the total distance covered by the ambulances has practical and social implications, since it provides an increase in the number of ambulances available to serve the population and directly reflects in the reduction in the average response time of the service. Originality/value – The article contributes to the debate on efficiency in Brazilian medical emergency services by proposing engineering and management solutions for monitoring critical indicators such as response time.Keywords - Emergency medical service. Health care. Model simulation

Serviço de Atendimento Móvel de Urgência: caracterização dos agravos clínicos

O objetivo do trabalho foi caracterizar os agravos clínicos atendidos por um Serviço de Atendimento Móvel de Urgência e os fatores associados com os destinos dos atendimentos realizados. Foi realizado levantamento documental retrospectivo nos boletins de atendimento prestados pelo Serviço de Atendimento Móvel de Urgência, de um município do sul do Brasil, no período de novembro de 2015 a maio de 2016. Para a coleta de dados utilizou-se roteiro estruturado, que contemplavam as informações dos boletins. A análise de regressão de Poisson foi utilizada para avaliar o risco dos agravos clínicos nos destinos dos atendimentos. Foram realizados 1.748 atendimentos para agravos clínicos. Os agravos neurológicos foram os mais atendidos. Pacientes com agravos clínicos tem 731% maior risco de permanecer no local após atendimento. O maior risco de permanecer no local após atendimento de agravos clínicos, indica que apesar de ser um serviço destinado a atenção das urgências e emergências, por muitas vezes, é acionado pelo fato de disponibilizar médicos e medicamentos, demonstrando que a população desconhece a real função desse serviço.

Riscos ocupacionais inerentes aos profissionais do serviço de atendimento móvel de urgência

Objetivo: identificar os riscos ocupacionais inerentes aos profissionais do serviço de atendimento móvel de urgência. Método: estudo descritivo transversal, coletado em março e abril/2019, com profissionais do serviço de atendimento móvel de urgência, em uma capital do Nordeste, com uso de questionário com perguntas fechadas, análise dos dados estatísticos descritivos e qui-quadrado com uso do software Statistical Package for the Social Sciences e com respeito aos princípios éticos da Resolução 466/2012. Resultados: 91 profissionais atuantes, com predomínio do sexo masculino 59 (64,8%), 43 (47,3%) na faixa etária entre 45 a 60 anos, 31 (34,1%) ensino médio completo, 37 (40,7%) técnicos em enfermagem, 56 (61,5%) mais de dez anos de atuação. 91 (100%) apontaram a colisão automobilística e o sangue como os mais frequentes, o risco de fumaça de veículos com 89 (97,8%), ruído de sirene 83 (91,2%), levantamento de peso e o estresse, ambos com 86 (94,5%). Conclusão: predomínio do sexo masculino, adultos, com mais de oito anos de formação, técnicos em enfermagem, com longa data de exercício profissional e alta prevalência de riscos ocupacionais em diferentes categorias, com destaque para risco de colisão automobilística e agressões físicas, contaminação por sangue, ruídos de sirene, fumaças de veículos, levantamento de pesos, estresse situação e agressões verbais.

Assistência ao binômio mãe e lactante com covid-19: um relato de experiência

Objetivo: relatar a experiência de atendimento de uma equipe de Serviços de Atendimento Móvel de Urgência (SAMU) ao binômio mãe e lactente com Covid-19. Metodologia: Trata-se de um relato de experiência. Resultados e Discussões: o atendimento se deu em três momentos, executando-se uma triagem prévia e após uma anamnese detalhada foi constatado que no ato de amamentar a mãe não estava utilizando a máscara de proteção individual. A criança de 3 meses foi transportada para a unidade de atendimento mais próximo onde realizou teste para Covid-19, sendo positivo, contudo, não pode ser constatado a transmissão via leite materno, uma vez que as orientações de proteção e higiene não foram seguidas. Conclusão: fica clara a fundante necessidade de realizar a educação popular em saúde. Ressalta-se ainda a necessidade de atualização constante da equipe multiprofissional que presta atendimento de urgência e em especial aos pacientes com suspeita ou confirmados da Covid-19.

Development and Psychometric Testing of a Tool Measuring Nurses’ Competence for Disaster Response

IntroductionThere is a growing awareness among governments, communities, and health care agencies of the need to evaluate roles and competencies in disaster nursing. A validated instrument was developed to evaluate nurses’ competencies for disaster response. MethodsA psychometric evaluation study was developed in 2 stages: 1) content and face validity, and 2) verification of feasibility and reliability with test-retest. Competencies were extracted from the Framework of Disaster Nursing Competencies published by the International Council of Nurses. The participants included 8 experts in emergencies and disasters who were nurses with a PhD and had more than 2 years of experience with education or clinical practice in emergencies or disasters, and 326 nurses from a mobile emergency care service in southern Brazil. The data analysis used a content validity index and intraclass correlation coefficients. The psychometric properties of the instrument included reliability assessed with Cronbach alpha, feasibility and test-retest reliability assessed with t tests and intraclass correlation coefficients, and factor analysis. ResultsThe overall evaluation of the instrument yielded an intraclass correlation coefficient of 0.92 (SD = 0.04), and the mean content validity index was acceptable at 0.88 (SD = 0.12). Out of 51 items, 41 were validated and organized in 3 domains according to factor analysis: 1) care of the community; 2) care of the individual and family; and 3) psychological support and care of vulnerable populations. The instrument demonstrated good internal consistency (Cronbach α = 0.96) and adequate test-retest reliability (intraclass correlation coefficient >0.7). DiscussionThe Nurses’ Disaster Response Competencies Assessment Questionnaire showed good internal consistency, adequate reproducibility, and appropriate feasibility for use to evaluate nurses’ competencies for disaster response.

Golden time: Analysis of the response time of the Mobile Urgency Care Service (Samu)

Background and Objectives: To analyze the golden time developed by the Mobile Emergency Care Service (Samu) in Floriano, Piauí, Brazil. There are few productions that primarily emphasize the service’s response time (golden hour), crucial for students and professionals in the field, whose knowledge on the issue can lead to saving lives. Methods: This is a descriptive, documentary, and quantitative study that analyzed emergency care records for the year 2018. It is based on the survey of the variables of the golden time stages, their nature, and the duration of events, analyzed by descriptive and inferential statistics. This study met all ethical principles based on the approval opinion of the ethics committee (No. 96443518.4.0000.5660). Results: The most frequent golden time performed by Samu was 15 to 30 minutes, in 58.5% of the cases. Adult clinical urgencies and emergencies were the most common types of events (35.50%). Conclusion: The most frequent service provided by Floriano’s Samu was clinical urgencies and emergencies in adults, with a response time of 15 to 30 minutes.

Mobile emergency care service for pregnant adolescents: A population-based study.

The mobile emergency care service (MECS) has been used worldwide as an effective means to improve access to care for vulnerable individuals. Obstetric emergencies endanger the life of both woman and fetus. Many studies indicate that complications increase in prevalence and magnitude in adolescent pregnant women, which may contribute towards an increased risk of adverse maternal/neonatal events.[1-4] The present study aimed to investigate obstetric complications in adolescents that were attended by MECS.

Serviço de Atendimento Móvel de Urgência: perfil dos atendimentos de crianças e adolescentes

Objetivo: identificar o perfil de atendimentos do Serviço de Atendimento Móvel de Urgências, a crianças e adolescentes no noroeste do Paraná. Metodologia: desenvolveu-se estudo transversal de caráter quantitativo, no noroeste do Estado do Paraná. A amostra foi composta por todos os registros da equipe de atendimento do Serviço de Atendimento Móvel de Urgências. A coleta de dados ocorreu no primeiro semestre de 2017, foram extraídos dados dos atendimentos a pacientes com idade entre 0 e 19 anos. A análise dos fatores associados foi realizada por meio do cálculo da razão de chances. Resultados: Analisou-se 1483 atendimentos, dos quais 62,2% eram adolescentes, seguido do grupo etário de lactentes e crianças, ambos representando 14,1%. Os chamados versaram sobre transferências, problemas respiratórios, acidentes domésticos em sua grande maioria, e o local mais frequente dos chamamentos foram os domicílios. Conclusão: é necessário o fortalecimento das instituições de ensino e de saúde, para que estejam preparados para receber esta clientela, bem como a importância da difusão do funcionamento do Serviço de Atendimento Móvel de Urgências, para que este não seja utilizado apenas como um serviço de transferência.

As dificuldades vivenciadas pelos profissionais de enfermagem no atendimento pré-hospitalar

Introdução: O Serviço de Atendimento Móvel de Urgência (SAMU) é responsável por oferecer um atendimento precoce a vítima após ter ocorrido algum agravo a sua saúde, proporcionando um atendimento adequado e de qualidade no local em que o usuário se encontra e o transporte precoce ao local mais adequado à resolução do problema de saúde até os serviços de saúde fixos, hierarquizado e integrado ao Sistema Único de Saúde (SUS). Existem inúmeras situação que podem atrapalhar o atendimento, como locais imprevisíveis, materiais e recursos humanos limitados e apropriados para garantir a assistência de saúde a vítima, podendo afetar diretamente a qualidade do atendimento prestado.  Objetivo: Compreender as dificuldades vivenciadas pela enfermagem no atendimento pré-hospitalar. Métodos: Estudo qualitativo, não experimental, exploratório descritivo transversal realizado através entrevista semiestruturada gravada com os profissionais de enfermagem do SAMU de Araçatuba-SP. Resultados: Participaram do estudo 16 profissionais de enfermagem do SAMU, a maioria do sexo feminino, com idade média de 38 anos, metade dos participantes eram enfermeiros e outra metade técnicos de enfermagem do serviço. Os discursos foram submetidos à Análise de Conteúdo de Bardin, emergindo nas categorias: Desconhecimento populacional da função do SAMU; Dificuldades com a Central de Regulação; Estratégias de melhorias para o serviço. Conclusão O estudo permitiu a reflexão dos profissionais acerca da atuação no serviço, instigando as reflexões apresentando possíveis estratégias para melhoria da realidade.

Occupational stress of nurses from the Mobile Emergency Care Service.

To evaluate stress, and to associate it with sociodemographic and clinical aspects of nurses from the Mobile Emergency Care Service. This is an observational, cross-sectional and quantitative study conducted with 123 nurses, who answered a questionnaire to assess sociodemographic and clinical variables, and the Job Stress Scale, which evaluates stress in the workplace. The results indicated that most of them were women, 20 to 40 years old, married, without another employment bond and with specialization course. They had low control and low demand at work and performed a passive work. Women reported passive work and high stress levels, while men were equally divided in active and passive work with low stress levels. Passive work is harmful to health and it is related to lack of autonomy, decision-making, and social support. It may lead to reduced ability to solve problems faced in daily work routine.

TRANSFER OF PRE-HOSPITAL CARE AND ITS POTENTIAL RISKS FOR PATIENT SAFETY

ABSTRACT Objective: to identify potential risks to patient safety during the transfer of pre-hospital care. Method: a descriptive-exploratory study, with a qualitative approach. Data collection occurred between April and June 2018, with non-participant observation and semi-structured interview, in a Mobile Emergency Care Service in the Southern Brazil. Twenty-eight professionals were interviewed, including nursing technicians/auxiliaries, nurses and physicians, and 135 hours of care were observed. The data were submitted to thematic analysis. Results: two interrelated categories emerged a) Stakeholders in patient and team safety; and b) The (inter) personal/professional dimension of the transfer of care. The study's findings showed that, in addition to the inherent vulnerabilities to traffic and urban violence, patients are exposed to circumstances that include potential risks related to falling on stretchers, medication errors and clinical judgment. The vertical communication by hierarchies, influenced by personal and emotional factors of each professional, generated implications for the continuity of care. Conclusion: given the potential risks to patient safety at the time of transfers of pre-hospital care, one should invest in effective communication strategies, as well as in forms of interpersonal relationships and links between services in the emergency network.

QUALITY OF LIFE OF NURSES FROM THE MOBILE EMERGENCY CARE SERVICE

ABSTRACT Objective: to evaluate the quality of life of nurses from the Mobile Emergency Care Service of the Federal District (Brazil) and to identify the domains that influenced this assessment. Method: an observational, descriptive, cross-sectional and quantitative study, with data obtained from 123 nurses who answered a questionnaire developed and structured in order to know sociodemographic and clinical variables and with the application of the World Health Organization Quality of Life Instrument Bref, to assess the quality of life. The data were submitted to descriptive statistics and inferential statics. Results: most of the nurses were women, aged between 20 and 40 years old, married, with a specialization degree and without any employment relation with another institution. Most (72.36%) considered their quality of life good or very good and were satisfied or very satisfied with their health (65.03%). The environment domain was the worst evaluated. A significant correlation was observed between the social relations (p=0.049) and environment (p=0.035) domains when correlated with the gender variable. The women rated their social relations and environment better than the men. Conclusion: the knowledge produced by this investigation may support the design of strategies that enable reducing the difficulties related to the life and work of nurses of the Mobile Emergency Care Service. Actions in this direction may contribute to the improvement of health, well-being and quality of life of the professionals and will have positive effects on the quality of health care provided to the population.

RISK PERCEPTION AMONG WORKERS WITH PREVIOUS OCCUPATIONAL ACCIDENTS IN PRE-HOSPITAL SETTINGS

ABSTRACT Objective: to identify the risk perception of workers with previous occupational accidents in Mobile Emergency Care Services. Method: this quantitative and analytical study with a cross-sectional design was conducted with 265 professionals working in pre-hospital settings from 57 cities in the state of Rio Grande do Sul, Brazil. An online questionnaire addressed sociodemographic characteristics, previous occupational accidents and the workers’ occupational risk perceptions rated on a five-point Likert scale. The analysis included descriptive statistics, mean, standard deviation, median, and associations were verified using the Mann-Whitney test; the level of significance was established at p<0.05. Results: the occupational risks the workers more frequently reported were: exposure to blood (4.43); exposure to contaminated secretion/excretion (4.36); contact and handling of hygienization products (4.28); exposure to bacteria (4.25); lifting and transporting heavy loads (4.25); and exposure to viruses (4.23). A significant association was found between the risk perception of workers with previous occupational accidents and chemical (p=0.001), physical (p=0.006), ergonomic or psychological (p=0.000) risks, and accidents (p=0.000). Conclusion: association between the risk perception of workers who had previously experienced occupational accidents was significant, suggesting that workers may not identify or trivialize risks before they experience an accident. Therefore, actions are needed to encourage changes in behavior so that workers identify risks and prevent occupational accidents, such as adopting personal and collective protective equipment and improving the work conditions in pre-hospital settings.

Leadership and job satisfaction in the Mobile Emergency Care Service context.

Objective:to evaluate the correlation between the practice of Coaching Leadership performed by nursing coordinators and job satisfaction, in the self-perception of coordinators and the perception of nursing technicians of the Mobile Emergency Care Service.Method:a descriptive, correlational study that used the Questionnaire on Self-Perception of the Nurse in the Exercise of Leadership to measure the self-perception of leadership of the eleven nursing coordinators and the Questionnaire on Nursing Technician Perception in the Exercise of Leadership to verify the perception of 155 nurse technicians. The Job Satisfaction Questionnaire assessed job satisfaction in both categories. Correlations among instrument domains were determined using the Spearman test (p<0.05) and the association was analyzed.Results:the Coaching Leadership exercise correlated with job satisfaction (p-value=0.001), both in the self-perception of nursing coordinators, with high correlation (Spearman coefficient - (0.835), and in the perception of nursing technicians, with moderate association (Spearman coefficient - 0.678).Conclusion:coaching Leadership showed a positive correlation with job satisfaction, marked by mutual trust, continuous interaction between nurse and nursing technicians, and the pursuit of professional and personal development.