Recebido em: 17/04/2015 -Aprovado em: 25/08/2015 -Disponibilizado em: 30/10/2015 RESUMO: Esta pesquisa surgiu da vivência em um Hospital de referência em Trauma, onde foi observado um grande número de pacientes com diagnóstico de traumatismo cranioencefálico e que, ao passarem um tempo demasiado longo hospitalizados, evoluíam para a traqueostomia e, em consequência, pôde-se observar seu processo de desmame e decanulação que, no âmbito do Hospital Metropolitano é realizada de forma diferenciada. Foi estudada a relação entre o tempo de desmame e decanulação da traqueostomia e o tempo de hospitalização, a presença de complicações póstraqueostomia e o protocolo de desmame de traqueostomia adotado pelo hospital. Objetivamos analisar a relação entre o tempo de hospitalização dos pacientes vítimas de traumatismo cranioencefálico e que realizaram traqueostomia e a realização do protocolo de desmame do hospital, bem como observar a incidência das complicações que podem ocorrer. Os objetivos foram alcançados mediante realização de coleta de dados em prontuários de pacientes hospitalizados no HMUE no ano de 2012. Observou-se a correlação no tempo de desmame e decanulação de traqueostomia no tempo de alta hospitalar e no tempo de hospitalização do paciente vítima de Trauma Cranioencefálico. A não padronização no processo do cuidado com a traqueostomia causa um grande desentendimento entre vários profissionais na hora de lidar com esse tipo de situação. Palavras-Chave: Trauma Craniano.Traqueostomia.Desmame.Fisioterapia.Decanulação ABSTRACT: This research arose from the experience in a Hospital's Trauma, where a large number of patients with traumatic brain injury was observed and that by spending too long a time hospitalized, progressed to tracheostomy, and consequently, we could observe your processor of decannulation that, in the Hospital Metropolitano is performed differently. We studied the relationship between the time of weaning and decannulation of tracheostomy and
The insertion of the physiotherapist in urgency and emergency units in a multidisciplinary team can support the care and treatment of patients who come to this type of service. The objective wasto identify the clinical and epidemiological profile of patients seen by physiotherapists in the emergency service of a referral hospital in trauma and burn high and medium complexity during the 90 days period and check the work of physiotherapists in this service.Observational, retrospective study with descriptive statistics which analyzed medical records of patients seen by physiotherapists in the Emergency Room of the Emergency Hospital Metropolitano and Emergency. The sample was composed of 175 patients records, most males 82.29% (144), aged 19-29 years (28.57%), coming from Belém-PA 65.14% (70), submitted to conservative medical treatment 65.14% (114). Traumatic brain injury was the most prevalent type of trauma 65.71% (115). The body region most affected by the trauma was the head 74.86% (131) and the most common mechanism of injury was the motorcycle accident 32.57% (57). The red risk rating was the most observed 62.3% (109). The respiratory therapy procedures were performed more mechanical ventilation control 88% (154) and endotracheal suctioning 60.57% (106). The fate of most of the patients were in the ICU 68.5% (120). Thus the operation of physical therapy in the emergency care sector aims to ameliorate the clinical signs and symptoms, including breathing in order to optimize the clinical treatment through behaviors such as mechanical ventilation control, tracheal suctioning , mechanical ventilation assembly, intra-hospital transport , respiratory therapy techniques. It is necessary to carry out studies to assess the impacts of these activities.
Color vision tests use estimative of threshold color discrimination or number of correct responses to evaluate performance in chromatic discrimination tasks. Both approaches have advantages and disadvantages. In the present investigation, we compared the number of errors during color discrimination task in normal trichromats and participants with color vision deficiency (CVD) using pseudoisochromatic stimuli at fixed saturation levels. We recruited 28 normal trichromats and eight participants with CVD. Cambridge Color Test was used to categorize their color vision phenotype, and those with a phenotype suggestive of color vision deficiency had their L- and M-opsin genes genotyped. Pseudoisochromatic stimuli were shown with target chromaticity in 20 vectors radiating from the background chromaticity and saturation of 0.06, 0.04, 0.03, 0.02, 0.01, and 0.005 u’v' units. Each stimulus condition appeared in four trials. The number of errors for each stimulus condition was considered an indicator of the participant's performance. At high chromatic saturation, there were fewer errors from both phenotypes. The errors of the normal trichromats had no systematic variation for high saturated stimuli, but below 0.02 u’v' units, there was a discrete prevalence of tritan errors. For participants with CVD, the errors happened mainly in red-green chromatic vectors. A three-way ANOVA showed that all factors (color vision phenotype, stimulus saturation, and chromatic vector) had statistically significant effects on the number of errors and that stimulus saturation was the most important main effect. ROC analysis indicated that the performance of the fixed saturation levels to identify CVD was better between 0.02 and 0.06 u’v’ units reaching 100%, while saturation of 0.01 and 0.005 u’v’ units decreased the accuracy of the screening of the test. We concluded that the color discrimination task using high saturated stimuli separated normal trichromats and participants with red-green color vision deficiencies with high performance, which can be considered a promising method for new color vision tests based in frequency of errors.
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