This paper presents the Mechanical Ventilator Milano (MVM), a novel intensive therapy mechanical ventilator designed for rapid, large-scale, low-cost production for the COVID-19 pandemic. Free of moving mechanical parts and requiring only a source of compressed oxygen and medical air to operate, the MVM is designed to support the long-term invasive ventilation often required for COVID-19 patients and operates in pressure-regulated ventilation modes, which minimize the risk of furthering lung trauma. The MVM was extensively tested against ISO standards in the laboratory using a breathing simulator, with good agreement between input and measured breathing parameters and performing correctly in response to fault conditions and stability tests. The MVM has obtained Emergency Use Authorization by U.S. Food and Drug Administration (FDA) for use in healthcare settings during the COVID-19 pandemic and Health Canada Medical Device Authorization for Importation or Sale, under Interim Order for Use in Relation to COVID-19. Following these certifications, mass production is ongoing and distribution is under way in several countries. The MVM was designed, tested, prepared for certification, and mass produced in the space of a few months by a unique collaboration of respiratory healthcare professionals and experimental physicists, working with industrial partners, and is an excellent ventilator candidate for this pandemic anywhere in the world.
Objective: to analyze, in the scientific literature, the knowledge available on the use of the prone position in pregnant women diagnosed with COVID-19 or other health conditions. Method: an integrative literature review developed through the following guiding question: What is the scientific knowledge available on the use of the prone position in pregnant women with COVID-19 or other health conditions? The search for studies was carried out in eight databases. Results: using the prone position in pregnant women with Acute Respiratory Distress syndrome allowed for improvements in lung compliance and oxygenation. It also allowed reducing uterine compression on the maternal large vessels, and a reduction in blood pressure was observed in pregnant women with pre-eclampsia. The prone position was also safe in the surgical management of pregnant patients. In addition, the following conditions stood out as disadvantages related to the prone position in pregnant women: possibility of aortocaval compression, causing severe hypotension, and inability to easily monitor fetal status or to perform emergency Cesarean sections. Conclusion: the prone position was considered safe, reliable and comfortable for its use in the clinical management of pregnant women, where specific care measures must be taken to avoid compression of gravid abdomen, as well as fetal monitoring is important to detect placental circulation impairment.
Objective: to unveil the experience of the elderly with social isolation in the pandemic of COVID-19. Methods: qualitative study, with 14 elderlies in social isolation. The content was recorded and processed using the software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires. Results: six classes were obtained, the first focused on spirituality and pre-pandemic pleasurable activities; the second was related to missing the extra-household routine and family life; the third, to the construction of a new routine; the fourth, to the strategies adopted for the prevention of COVID-19; the fifth, to the signs/symptoms experienced during the infection; and the sixth class, to the fear of dying. Conclusion: the experience of the elderly was permeated by the adaptation of routine, adoption of preventive measures and feelings of anguish in the face of uncertainties.
Objetivo: avaliar o impacto da Febre Chikungunya nas atividades de vida diária (AVDs) de pessoas idosas. Método: estudo exploratório realizado em 2019, em Redenção-CE/Brasil, com 248 idosos acompanhados por Centros de Saúde da Família. Os dados foram coletados com instrumento estruturado que continha variáveis demográficas, clínicas e com a Escala de Katz. A análise dos dados ocorreu a partir do teste qui-quadrado de Pearson. Resultados: houve predomínio de idosos do sexo feminino (73,79%) com média de idade de 71 anos e baixo grau de escolaridade (85,48%). Verificou-se associação estatisticamente significante entre disfunções de cunho articular e limitação para AVDs. A principal atividade básica desempenhada com limitações foi transferir-se (63,9%) e 23,7% dos idosos foram considerados parcialmente dependente e 53,8% totalmente dependentes nas atividades básicas. Todas as atividades instrumentais eram realizadas com limitações. Conclusão: constatou-se que a infecção pela Febre Chikungunya impactou negativamente a funcionalidade dos idosos. Assim, o planejamento do cuidado de enfermagem precisa ser pautado em práticas que atenuem os efeitos das sequelas da doença na qualidade de vida desses pacientes.
Objectives: to create and validate a serial album for Pressure Ulcer prevention in the hospital environment. Methods: a methodological study with the production of the serial album and validation by 22 judges and 22 patients. The content was based on the integrative review and the reports of the World Health Organization. It was considered a Content Validity Index equal to or greater than 80% in the items and the binomial test for the judges’ agreement. Results: the serial album entitled “Pressure Ulcer Prevention in the hospital environment” has 13 pages. In the content and layout validation, all items had an agreement above 80% among the participants. The overall Content Validity Index was 0.99 for the judges and 1.0 for the patients. Conclusions: the constructed and validated material presented itself as an adequate instrument to be used in health education activities.
Objective To evaluate the effectiveness of the Arco de Maguerez in teaching nursing students about the Bladder Catheter. Method Quasi-experimental study conducted at a public university in northeastern Brazil, with 29 students, in a single group, in the period of october 2018. Data were collected before and after using the Arco de Maguerez in educational intervention, using validated instruments, referring to knowledge and practice. IBM SPSS Statistics software version 24 was used for statistical analysis. The level of significance was set at 5% and the 95% confidence interval. Data analysis was performed using the McNemar and Mann-Whitney test. Results The median of correct answers for knowledge was 7, in the pre-test, and 9 in the post-test (p> 0.001). Regarding practice, in the pre-test the median of correct answers was 28 and, in the post-test, it went to 36, p> 0.001. The academics explained that the AM technology based on the problematization of a fictitious clinical case made learning about Bladder Catheterization Delay clear and feasible. Conclusion The Arco de Maguerez was effective in improving the knowledge and skill of nursing students regarding the Bladder Catheter.
O estudo objetivou classificar o grau de dependência de pacientes adultos admitidos no setor de emergência. Estudodescritivo, realizado em unidade de emergência de hospital de ensino da Região Norte do Estado do Ceará. A populaçãofoi composta por 783 pacientes admitidos na unidade no período de julho a agosto de 2017. Foi utilizado o instrumentode classificação de pacientes de Fugulin para determinar o nível de dependência para os cuidados de enfermagem. Foramefetivadas 2557 observações de enfermagem. A maior parte dos pacientes (37%) se enquadrou no nível de cuidado mínimo, seguido do intermediário (31,7%). Foi observado que a maioria dos pacientes é consciente (63,1%), não dependentede oxigenoterapia (89,7%) e possui sinais vitais avaliados em controle de rotina (91,7%). São ainda independentes para aalimentação (45,1%), apesar da dificuldade para movimentar os segmentos corpóreos (32,7%) e de estarem restritos aoleito (31,5%). O cuidado corporal (31,9%) e a eliminação (31,3%) eram autossuficientes e a terapêutica mais comum foiendovenosa contínua ou por sonda nasogástrica (45,1%). Foi possível classificar os pacientes atendidos em uma unidadede emergência de acordo com a complexidade assistencial.Palavras-Chave: Enfermagem; Cuidados de enfermagem; Classificação; Serviço Hospitalar de Emergência.ABSTRACTThe study aimed to classify the degree of dependence of adult patients admitted to the emergency department. Descriptive study, carried out in an emergency unit of a teaching hospital in the Northern Region of the State of Ceará. The population consisted of 783 patients admitted to the unit from July to August 2017. The Fugulin patient classification instrumentwas used to determine the level of dependence for nursing care. 2557 nursing observations were made. Most patients(37%) were enrolled in the minimum care level, followed by the intermediate (31.7%). It was observed that most patientsare conscious (63.1%), not dependent on oxygen therapy (89.7%) and have vital signs evaluated in routine control (91.7%).They are still independent for food (45.1%), despite the difficulty of moving the body segments (32.7%) and being restricted to the bed (31.5%). Body care (31.9%) and elimination (31.3%) were self-sufficient and the most common therapy wascontinuous intravenous or nasogastric tube (45.1%). It was possible to classify the patients treated in an emergency unitaccording to the assistance complexity.Keywords: Nursing; Nursing care; Ranking; Emergency Hospital Service
Objective: to assess the effect of aromatherapy on anxiety symptoms in women undergoing treatment for breast cancer. Method: a systematic review, carried out from the PEOT strategy: what are the effects of aromatherapy in reducing anxiety symptoms in women undergoing treatment for breast cancer? The research was conducted in six databases and in eight other data sources. Randomized clinical trials without date and language restrictions were included. Results: the sample consisted of seven studies. Aromatherapy was applied by inhalation (57.1%) and massage (42.8%), and was adopted alone or in conjunction with other interventions, demonstrating a reduction in anxiety symptoms in 71.4% of studies. The predominance of lavender, bergamot, frankincense and sandalwood essential oils is highlighted for their anxiolytic, relaxing, sedative, invigorating, antidepressant and muscle tension reducing effects. Conclusion: aromatherapy showed positive and significant results in reducing anxiety symptoms in women undergoing treatment for breast cancer.
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