Impacto do Protocolo Unificado de Manejo do AVC em uma Unidade de Pronto-Atendimento (UPA) do Sistema Único de Saúde na realização de trombólises

Autor: Cunha, Thaís Saraiva Leão
Přispěvatelé: Carvalho, Fernanda Martins Maia, Rodrigues Sobrinho, Carlos Roberto Martins, Martins, Sheila Cristina Ouriques
Jazyk: portugalština
Rok vydání: 2021
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da UNIFOR
Universidade de Fortaleza (UNIFOR)
instacron:UNIFOR
Popis: Made available in DSpace on 2022-06-23T00:17:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-05-17 Introduction: Time is a crucial factor in the treatment of stroke. Between the time of onset of symptoms and the admission to a referral center, delays in prehospital environments are responsible for most of the failure to administer reperfusion therapy. The prehospital emergency network of the Brazilian Unified Health Care System (SUS) includes both mobile emergency care services (EMS) and 24-hour emergency care facilities (UPA). The latter are often the first medical contact for stroke patients; from there patients are transported to the referral center by EMS vehicle or private means. Objective: To implement a new stroke protocol (PUMA) at a UPA, evaluate its impact on the number of thrombolyses performed, document the delay at each prehospital step, and assess the ability of the LAPSS and FAST-ED scales used in the PUMA to identify stroke patients and predict large-vein occlusion, respectively. Methods: Retrospective cohort of 252 UPA patients with suspected stroke within the treatment window divided into a pre-PUMA group and a post-PUMA group, covering the period from January 2016 to September 2019. PUMA strategies included stroke triage, changes in the flow of suspected stroke patients, and prenotification of the referral center. Results: In the post-PUMA group the absolute number of thrombolyses increased by 437%, and the total prehospital time fell from 203 min to 143 min (p=0.019). The most delayed step was waiting at the UPA for an EMS vehicle to take the patient to the referral center, despite the observed decrease from 116 min to 76 min (p
Databáze: OpenAIRE
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