Ressuscitação cardiopulmonar: análise do atendimento pré-hospitalar na cidade de Ribeirão Preto de 2011 a 2013
AGRADECIMENTOS À Deus, pela minha vida e me dando força nos momentos difíceis. A minha amada mãe Fátima Benassi, que viveu todas conquistas comigo, me apoiando sempre em tudo. A minha orientadora e amiga Prfa Dra Maria Celia Barcelos Dalri, profissional admirável, sempre incentivadora e grande amiga. A Profa Dra Renata Karina Reis, que compartilhou sua sabedoria e nos trouxe sempre uma palavra amiga. A Profa Silvia Rita Marin da Silva Canini, por toda ajuda, fazendo grande diferença em
... ferença em detalhes, que passam despercebidos. A Prfa Regilene Molina Zacareli Cyrillo, sempre dispostas a esclarecer todas as dúvidas. A Profa Miyeko Hayashida, por sua sabedoria em nos fazer compreender melhor a estatística. A minha linda família e amigos, meus grandes incentivadores e sempre compreendendo meus momentos de ausência. A equipe do SAMU Regional de Ribeirão Preto-SP, por permitir o desenvolvimento desse trabalho. A equipe do Arquivo Central da Prefeitura de Ribeirão Preto, por me acolher nessa longa coleta de dados. A Prfa DRa Caroline Guilherme, por sua grande ajuda e disposição nos momentos mais trabalhosos. Á Escola de Enfermagem de Ribeirão Preto -USP, por proporcionar mais uma vez essa conquista. A todas pessoas que contribuíram direta e indiretamente na construção deste trabalho, muito obrigada. ABSTRACT MUNDIN, T. B. Cardiopulmonary resuscitation: analyses of pre-hospital care in the city of Ribeirão Preto from 2011 to 2013. 90 f. Thesis (master's degree in nursing) -Ribeirão Preto School of Nursing , USP, Ribeirão Preto, 2015. A cardiorespiratory arrest (CRA) in pre-hospital care is the third cause of death in the United States of America (USA) and the ischemic cardiac diseases are considered the main sudden death causes in Europe. In the western world, including Brazil, the acute myocardial infarction is responsible for a big part of these deaths. Evaluating the quality of the assistance provided to people who suffered CRA in pre-hospital care, can have an influence in these patients' survivals. The purpose of this study was to analyze the data in the nursing assistance systematization records (NASR) of the emergency medical services (SAMU) in Ribeirão Preto regarding those people who suffered CRA in pre-hospital care. This is a retrospective analytical study of documentary analysis of the NASR from January 2011 to December 2013 in which caring for people over 18 years old and CRA of clinical origin were included. A statistical analysis was performed on the SPSS 17.0 summer version show where the chi-square and Fisher's exact test were applied. Values with p<0,005 were considered significant. Among the records of people who suffered CRA, 439 (100%) were analyzed, being 54,2% males with an average of 64 years old. Most people who suffered CRA were over 61 years old. Heart diseases were the most prevalent comorbidities. The initial rhythm was the asystole in 28% of the cases and the adrenalin in 31% being the most administered medicine. The medical cares performed by SAMU were categorized in: residence 47,8%, health units 43,5% being 33,5% morning period, the greater commitment of ambulances. People suffered more CRA on Mondays, Wednesdays and Fridays whereas females suffered most CRA on Sundays and males on Fridays and winter 26%, was the season of the year that most of those cases happened. To check the variation between the categorical variables such as gender, age range, commitment of ambulance, days of the week with the place where the CRA happened the chi-square and Fisher's exact test were applied in which there was not a significant statistic difference (p>0.005). Regardless the gender, being over 61 years old was related to the CRA event, (p = 0,002) comparing to other age ranges. Among categorical variables gender, age range, commitment of ambulance, days of the week, weekends and week related to denouement (death and survival) of the CRA event, there was not a significant statistic difference (p>0,005). Place where it happened comparing to the denouement there was a statistic difference (p=0,001) people who suffered CRA in the health units, 160(76,9%) survived comparing to residences' survivals 34(16,3%). In conclusion, an investment in the education system by putting into execution resuscitation science and practical abilities trainings regarding CRA -not only to health professionals but also to people who are untrained -is recommended.