Abordagem da sedação, da analgesia e do delirium em Portugal: inquérito nacional e estudo de prevalência

Paulino, Carolina; Costa, Vasco; Neves, Aida; Santos, Anabela Costa; Teixeira, Carla; Coimbra, Isabel; Fernandes, Paula Odete; Bernardo, Ricardo; Póvoa, Pedro; Granja, Cristina

doi:10.5935/0103-507x.20220020-pt

RBTI

2022

DOI: 10.5935/0103-507x.20220020-pt

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Abordagem da sedação, da analgesia e do delirium em Portugal: inquérito nacional e estudo de prevalência

Carolina Paulino¹,

Vasco Costa²,

Aida Neves³

et al.

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2024

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Cited by 3 publications

References 39 publications

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Interprofessional Education for Delirium Management: a Quality Improvement Project

Schimböck,

Hanisch,

Günther

et al. 2024

Delirium Communications

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Background Implementation of delirium management in hospitals is a complex process, often challenging and requiring interprofessional and interdisciplinary communication and collaboration. This project aimed to assess whether a delirium-specific interprofessional education (IPE) course would empower clinicians to conduct quality improvement projects in their hospital. Method Quality-improvement project in a university-affiliated hospital. Clinicians (physicians, nurses, and therapists) attended a 2-day IPE course for delirium management certified by the German Society of Intensive Care Medicine. Participants developed projects for quality improvement and presented results in a meeting eight weeks later. Results In total, 16 clinicians (eight nurses, six therapists, two physicians) from six wards participated. Participants organised themselves into five project groups. Eight weeks after attending the training, four out of five groups presented projects with successful and ongoing implementation, such as establishing a hospital delirium expert panel, delirium flyers for relatives, an informational one-pager for clinicians across the hospital, and a teaching concept for training of therapists. Implementing the 4AT delirium assessment in electronic patient charts took longer, extending beyond the 8-week timeframe. Overall, clinicians were satisfied with the IPE course and reported they felt more competent to care for delirious patients. Conclusions The delirium IPE course motivated and enabled participating clinicians to develop and perform delirium-specific quality-improvement projects in their hospital. Further research is needed to evaluate the sustainability of these projects and to estimate the effect of influencing factors within the context of the culture and setting.

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Interprofessional Education for Delirium Management: a Quality Improvement Project

Schimböck,

Hanisch,

Günther

et al. 2024

Delirium Communications

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Percepções e práticas sobre sedação superficial em pacientes sob ventilação mecânica: um inquérito sobre as atitudes de médicos intensivistas brasileiros

Souza-Dantas¹,

Tanaka²,

Serafim³

et al. 2022

Revista Brasileira De Terapia Intensiva

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Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report

Ribeiro,

Pombo,

Lages

et al. 2023

Cureus

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The retroclavicular approach to the infraclavicular region (RAPTIR) is a recently described locoregional technique for upper limb analgesia that offers advantages over the classic infraclavicular block. RAPTIR is considered an effective and easy-to-perform block associated with few complications and better patient comfort. We present a case of a critically ill patient with thoracic and upper limb trauma. Despite multimodal analgesia, the patient developed delirium and experienced suboptimal pain control. An ultrasound-guided continuous RAPTIR block was performed, resulting in improved pain scores and delirium control. Twenty-four hours post block, the patient presented with dyspnea and chest pain, leading to the diagnosis of hemothorax. Chest computed tomography angiography revealed no vascular damage. The perineural catheter was removed 48 hours after its placement and the patient had a satisfactory recovery without long-term complications. The RAPTIR requires the needle to pass underneath the clavicle’s acoustic shadow, putting the structures beneath the clavicle at risk of injury. Cadaver studies have raised concerns about potential vascular complications of the RAPTIR in a noncompressible location. This case highlights, for the first time, a rare but serious complication of the RAPTIR, demonstrating the potential risks of passing the needle through a blind spot.

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Abordagem da sedação, da analgesia e do delirium em Portugal: inquérito nacional e estudo de prevalência

Cited by 3 publications

References 39 publications

Interprofessional Education for Delirium Management: a Quality Improvement Project

Interprofessional Education for Delirium Management: a Quality Improvement Project

Percepções e práticas sobre sedação superficial em pacientes sob ventilação mecânica: um inquérito sobre as atitudes de médicos intensivistas brasileiros

Hemothorax After Retroclavicular Approach to the Infraclavicular Region in a Critically Ill Patient: A Case Report

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