Perfil clínico e atuação fisioterapêutica em pacientes atendidos na emergência pediátrica de um hospital público de Goiás

Abstract

Nos últimos anos, tem-se ampliado a atuação fisioterapêutica no setor de urgência e emergência, visando reduzir complicações e tempo de internação hospitalar. Os objetivos deste estudo foram traçar o perfil dos pacientes admitidos na sala de reanimação do Serviço de Referência em Urgência Pediátrica (SERUPE) do Hospital das Clínicas da Universidade Federal de Goiás (HC/UFG) e descrever a atuação fisioterapêutica nesse setor. Trata-se de um estudo observacional, prospectivo, realizado entre fevereiro e junho de 2012, para o qual foram acompanhados todos os pacientes admitidos na sala de reanimação do SERUPE. Foram avaliados 47 pacientes, 53,2% (n=25) do sexo masculino, idade média de 5,2±4,1 anos e 74,5% (n=35) apresentavam doenças prévias. A queixa principal mais frequente foi dispneia em 26,1% (n=29) dos casos e as hipóteses diagnósticas mais identificadas foram doenças respiratórias em 69,4% (n=43). Do total de pacientes, 76,6% (n=36) necessitaram de oxigenoterapia, 21,3% (n=10), de assistência ventilatória e 31,9% (n=15) tiveram acompanhamento fisioterapêutico, 86,7% (n=13) com abordagem respiratória e motora. O tempo médio de permanência na sala de reanimação foi de 1,9±1,5 dias; subsequentemente, 63,8% (n=30) dos pacientes foram internados em enfermaria. Portanto, verifica-se que, no setor de emergência, existe uma grande demanda de pacientes com desordens respiratórias que podem se beneficiar com a presença de um fisioterapeuta.

Oxigenoterapia inalatória em idosos internados em um hospital público

“…The most commonly used devices are nasal cannulas, followed by tracheostomy masks and facial masks. These results are partly similar to other studies, 18,26 in which a prevalence of the use of nasal cannulas predominated, followed by Venturi and facial masks. Venturi masks were only used in 1.9% of the sample, a result that differs from the studies cited.…”

“…17 Among the population studied, physiotherapy was a widely used form of treatment, and therefore the physiotherapist was essential for the monitoring and evolution of the elderly through this type of (27,3) 32 (72,7) therapy. 18,19 Physiotherapy treatment, in addition to its motor and respiratory evaluation and intervention functions also involves the continuous monitoring of vital signs and parameters of oxygen therapy, as well as bronchial hygiene and pulmonary re-expansion techniques, contributing to more comprehensive and effective care for the patient undergoing oxygen therapy. 18 The specialties of the most frequent hospitalizations of the elderly were internal medicine, pulmonology, cardiology, and surgical clinical.…”

“…18,19 Physiotherapy treatment, in addition to its motor and respiratory evaluation and intervention functions also involves the continuous monitoring of vital signs and parameters of oxygen therapy, as well as bronchial hygiene and pulmonary re-expansion techniques, contributing to more comprehensive and effective care for the patient undergoing oxygen therapy. 18 The specialties of the most frequent hospitalizations of the elderly were internal medicine, pulmonology, cardiology, and surgical clinical. These specialties manage various common diseases of aging such as pneumonia, chronic obstructive pulmonary disease (COPD), cardiovascular diseases such as heart failure (HF) and cerebrovascular accidents or strokes (CVA), in addition to fractures.…”

“…2,12,13 These situations often feature OIT as a therapeutic resource, used as needed by the patient. 4,18,20 In terms of evolution, approximately 15% of the elderly persons hospitalized and treated with OIT were discharged for treatment at home, which indicates the need for monitoring and longterm care, not only of the patient but also the the environment in which he or she lives, the household conditions and the care to which the patient has access. 21,22 The median duration of hospitalization was 17 days.…”

“…Venturi masks were only used in 1.9% of the sample, a result that differs from the studies cited. 18,26 This result can be attributed to the different contexts in which research into this subject has been carried out. These results can be attributed to the flows required for each type of device, as in an internal medicine environment the elderly are already clinically stable, so the supply they require is, in the vast majority of cases, the type of low oxygen flows offered by nasal cannulas.…”