Implementação de um modelo de triagem cirúrgica para casos urgentes em um hospital terciário.

Coelho, Monique Antônia; Lourenção, Pedro Luiz Toledo de Arruda; Weber, Silke Anna Theresa; Ortolan, Érika Veruska Paiva

doi:10.1590/0100-6991e-20192211

Cited by 6 publications

(7 citation statements)

References 9 publications

(5 reference statements)

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“…The validity of the TACS classification system was evaluated in a tertiary public hospital of a developing country, and data showed that TACS rating improves time for surgeries classified as yellow (ideal time to surgery within 6 h) [38].…”

Section: Summary Of Evidence and Discussionmentioning

confidence: 99%

The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

et al. 2021

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Background Since the COVID-19 pandemic has occurred, nations showed their unpreparedness to deal with a mass casualty incident of this proportion and severity, which resulted in a tremendous number of deaths even among healthcare workers. The World Society of Emergency Surgery conceived this position paper with the purpose of providing evidence-based recommendations for the management of emergency surgical patients under COVID-19 pandemic for the safety of the patient and healthcare workers. Method A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) through the MEDLINE (PubMed), Embase and SCOPUS databases. Synthesis of evidence, statements and recommendations were developed in accordance with the GRADE methodology. Results Given the limitation of the evidence, the current document represents an effort to join selected high-quality articles and experts’ opinion. Conclusions The aim of this position paper is to provide an exhaustive guidelines to perform emergency surgery in a safe and protected environment for surgical patients and for healthcare workers under COVID-19 and to offer the best management of COVID-19 patients needing for an emergency surgical treatment. We recommend screening for COVID-19 infection at the emergency department all acute surgical patients who are waiting for hospital admission and urgent surgery. The screening work-up provides a RT-PCR nasopharyngeal swab test and a baseline (non-contrast) chest CT or a chest X-ray or a lungs US, depending on skills and availability. If the COVID-19 screening is not completed we recommend keeping the patient in isolation until RT-PCR swab test result is not available, and to manage him/she such as an overt COVID patient. The management of COVID-19 surgical patients is multidisciplinary. If an immediate surgical procedure is mandatory, whether laparoscopic or via open approach, we recommend doing every effort to protect the operating room staff for the safety of the patient.

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Section: Summary Of Evidence and Discussionmentioning

confidence: 99%

The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

et al. 2021

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“…The territorial distribution of transplants can be analyzed in Figures 2, 3 These values may be linked to the risk of life and/or risk of loss of the donated organ, thus requiring the surgical procedure to occur quickly compared to the elective procedure. It is worth mentioning that the expected period between removal of the body and transplantation must take up to 48 hours, and depending on the individual's clinical condition, it requires less time than expected (Coelho et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

Epidemiological analysis of kidney transplants in Brazil comparative analysis between 2012 and 2022

Marães,

Sousa,

Cavalcante

et al. 2024

Cad. Pedagógico

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Kidney transplantation is a replacement therapy option for patients with end-stage renal failure, where a healthy kidney from a living or deceased donor is transplanted into these patients who are usually on some type of dialysis. Understanding the number of transplants and their territorial characteristics is one of the major challenges in the Unified Health System (SUS) for the implementation of new reference centers and public campaigns aimed at individuals with chronic kidney disease and potential donors. . The present study aims to compare the number of hospitalizations for kidney transplants in Brazil between 2012 and 2022, and describe a possible territorial disparity involving the procedure. Descriptive study of kidney transplants in Brazil over the last 10 years, using data available on the websites of the SUS Information Technology Department (Data-SUS) and the Brazilian Association of Organ Transplants (ABTO), with analysis data frequency lysis and geoprocessing. It is observed that from 2012 to 2019 there was a progressive increase in the number of kidney transplants, however, subsequent years showed a considerable reduction compared to 2012. In general, the largest number of donors are deceased and the region The Southeast has the greatest history of transplants in Brazil. The years 2020 to 2022 show a progressive reduction in the number of kidney transplants performed, suggesting that the pandemic may have compromised the performance of these procedures, as well as the availability of organ donors. Furthermore, it is possible to understand that awareness about organ donation is a determining factor in changing indicators, especially inter-living donations.

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“…A retrospective study in a tertiary hospital which implemented TACS classification in daily routine for 4 surgical specialties with high demand for emergencies demonstrated that the TACS classification significantly improved the timing of surgery in the yellow class and during the night [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported the advantages of the implementation of TACS in clinical practice, mostly in terms of reduced time from admission to the management of surgical patients in the emergency setting [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Simone¹,

Coccolini²,

Saverio³

et al. 2023

World J Emerg Surg

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Background Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion The new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a “safe” timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients. Graphical Abstract

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Implementação de um modelo de triagem cirúrgica para casos urgentes em um hospital terciário.

Cited by 6 publications

References 9 publications

The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

The management of surgical patients in the emergency setting during COVID-19 pandemic: the WSES position paper

Epidemiological analysis of kidney transplants in Brazil comparative analysis between 2012 and 2022

The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

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