Evaluation of care for traffic accidents victims made by on duty emergency physicians and surgeons in the emergency room

Abstract

Objective: to evaluate the care for victims of traffic accidents by on call emergency physicians and/or surgeons in the emergency room. Methods: we conducted a retrospective, descriptive and exploratory study on the care for traffic accidents victims in the urban area of Maringá-PR, between July 2013 and July 2014 in reference hospitals. We assessed demographics and vocational training through a questionnaire sent to the attending physicians. Results: of the 688 records evaluated, 99% of patients had a prehospital Revised Trauma Score of 12. Statistical analysis showed that in the cases conducted by the emergency physicians (n=187), the recording of the Glasgow Coma Scale and the performance of surgical procedures were less common, whereas the recording of blood pressure values was performed in greater numbers when compared with cases led by surgeons (n=501). There was a statistically significant relationship (p<0.01) between the length of hospital stay and surgical specialty, with a greater chance (crude OR=28) in the period from one to six hours for the group treated by emergency doctors. Most physicians participating in the study were young, with emergency room time of up to one to two years, and with ATLS training. Among those who had attended the ATLS course, 60% did so in the last four years. Surgeons performed 73% of hospital treatments. Conclusion: in the care of traffic victims with minor injuries, the Glasgow Coma Scale, the blood pressure levels, the type of treatment in the emergency room and hospital stay had different approaches between emergency physicians and surgeons.

Clinical validation of nursing diagnosis “00085 Impaired Physical Mobility” in multiple traumas victims

“…The prevalence of male was identified, agreeing with the literature ( 1 , 25 - 27 ) , which shows greater involvement of men aged between 20 and 40 years. The greatest vulnerability is associated with socio-cultural and economic factors, which can be related to individual behavior and personality, such as hyperactivity, impulsiveness and aggressiveness, lack of prudence and maturity in transit, non use of safety devices such as seat belt or helmet, driving under the influence of alcohol or drugs, performing more dangerous activities, and inattention ( 2 ) .…”

“…The main mechanism of trauma was the traffic accident, especially those caused by motorcycles, followed by the falls and injuries caused by weapons and aggression, predominantly affecting the musculoskeletal, integumentary, and nervous systems, supporting the findings of other studies ( 25 - 27 , 30 - 34 ) .…”

“…It is also noteworthy the occurrence of the surgical approach as the main form of treatment for correction or fixation of fractures, relief of intracranial pressure, drainage of hematomas, identification or correction of internal injuries, which, in association with the prevalence of blunt traumas, corroborate the findings ( 1 , 5 , 25 - 27 , 33 - 34 ) .…”

“…Approximately 80.0% of the sample was economically active, resulting in an important economic impact due to lost productive years, premature death, or years lived with disabilities. The expenditures with health care of this population are around U$300 billion/year and mean recovery time of 12 to 24 months ( 27 ) .…”

Diretrizes de atendimento inicial ao paciente queimado do Hospital Universitário de Maringá

“…Por fim, as de terceiro grau (espessura total) acometem toda a derme, atingem tecidos subcutâneos, com destruição total de terminações nervosas, e na maioria das vezes é indolor e causada principalmente por inalação de gazes quentes, eletricidade, fraturas e traumas (Brasil, 2012;Marques et al, 2016;Sociedade Brasileira de Cirurgia Plástica, 2008).…”