Objective:To evaluate the effects of physical methods of reducing body temperature (ice pack and warm compression) in critically ill patients with fever. Method: A randomized clinical trial involving 102 adult patients with tympanic temperature ≥ 38.3°C of an infectious focus, and randomized into three groups: Intervention I -ice pack associated with antipyretic; Intervention II -warm compress associated with antipyretic; and Control -antipyretic. Tympanic temperature was measured at 15 minute intervals for 3 hours. The effect of the interventions was evaluated through the Mann-Whitney test and Survival Analysis. "Effect size" calculation was carried out. Results: Patients in the intervention groups I and II presented greater reduction in body temperature. The group of patients receiving intervention I presented tympanic temperature below 38.3°C at 45 minutes of monitoring, while the value for control group was lower than 38.3°C starting at 60 minutes, and those who received intervention II had values lower than 38.3°C at 75 minutes of monitoring. Conclusion: No statistically significant difference was found between the interventions, but with the intervention group I patients showed greater reduction in tympanic temperature compared to the other groups.

RESUMOO Sistema de Triagem de Manchester (STM) é utilizado em serviços de urgência para determinar prioridade clínica de pacientes, otimizando o tempo de espera para atendimento médico. Estudos que mensurem diferentes tempos de espera para atendimento são escassos. Objetivo: avaliar tempos de espera para atendimento de pacientes em hospital público de urgência. Método: estudo descritivo realizado em hospital público de urgência brasileiro com população de 68.215 prontuários de pacientes atendidos em 2014. Os dados foram coletados por consulta em prontuário na base de dados eletrônica do hospital. Estatística descritiva foi usada para análise nos programas SPSS 21.0 e software R 3.2. 1. Resultados: o tempo médio de espera entre o registro na porta de entrada e a classificação de risco foi de 12:23 minutos. O tempo médio geral entre início e fim da triagem foi de 2:06 minutos. Apenas 32,3% dos pacientes classificados como laranja foram atendidos pelo médico em até 10 minutos após a classificação. A maioria (58,2%) dos pacientes classificados como amarelo foi atendida pelo médico em até 60 minutos após a classificação. No geral, os pacientes esperaram, em média, 52:03 minutos entre a chegada ao hospital e o atendimento médico. Conclusão: o enfermeiro está classificando o paciente no tempo recomendado pelo STM. A maioria dos pacientes classificados como laranja e 41,8% dos classificados como amarelo aguardaram por atendimento médico em tempo superior ao recomendado pelo STM, indicando a necessidade de estabelecer fluxos assistenciais para minimizar tempos de espera e adequá-los ao recomendado pelo STM. Palavras-chave: Enfermagem; Serviços Médicos de Emergência; Triagem.

Objective: to clinically validate the nursing diagnosis of Dysfunctional Ventilatory Weaning Response in adult patients admitted to Intensive Care Units. Method: a concurrent cohort performed with 93 patients admitted to Intensive Care Units. The incidence and incidence density of the diagnosis were estimated, its related factors were identified based on bivariate analysis and clinical indicators for determining its occurrence, according to the global and temporal presentation. Results: the overall incidence of the diagnosis was 44.09% and the incidence density was 14.49 occurrences for every 100 extubations/day. The factors related to the diagnosis were the following: age, clinical severity, fluid balance, oliguria, hemodialysis, edema in upper/lower limbs, anasarca, number of antibiotics, hypothermia, hyperthermia, amount of secretion, muscle retraction, anxiety score, heart rate, use of vasopressors and non-invasive ventilation after extubation. The clinical indicators most frequently identified for determining the diagnosis were the following: tachypnea, drop of saturation and tachycardia. Temporal progression in the severity of these manifestations was found. Conclusion: the Dysfunctional Ventilatory Weaning Response is a common finding in critically ill patients. Some components of the diagnosis of the NANDA-International (2018) version could be clinically validated. It is noteworthy that there are variables not yet described in the taxonomy, demonstrating the need to review this nursing diagnosis.