Condutas de enfermagem diante da ocorrência de alarmes ventilatórios em pacientes críticos

• Autor(a) principal: Nepomuceno, Raquel de Mendonça
• Data de Publicação: 2007
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11302
• topic: Nursing; Intensive care; Mechanical ventilation; Alarm; Enfermagem; Cuidados intensivos; Ventilação mecânica; Alarme; Enfermagem de tratamento intensivo; Respiração artificial (Enfermagem); Respiração artificial Equipamentos e acessórios; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

This study is about mechanical ventilation, specifically the nursing procedures ahead of the ventilatory alarms actions. The research issue was: what are the nursing procedures observed ahead of the ventilatory alarms actions during the nursing care in patient undergoing invasive mechanical ventilation? Two objective was suggested: a) to identify the type and the frequency of each alarm event during the nursing care with patient in intensive care; b) to present the nursing procedures executed face to the ventilatory alarms action. This work explained itself by concerning the safety of the critical patient undergoing mechanical ventilation and monitoring the alarms system offered by the nursing stuff. Investigating about ventilatory alarms there was a major gap in the national and international literature concerning of nursing procedures. The theoretical review analyzed the understanding about mechanical ventilation, which elucidate the significance of the correct alarm control in ventilators warning occurrence as barotrauma, volutrauma and hypoxia. One was about the ventilarory alarms, with its description, the influence for the patient and the procedures in the correction of its causes. The type of the research was descriptive, observational. It was developed in intensive care units and in a private post operative hospital in Rio de Janeiro. Assessing datas reached 120 hours of direct observation. It was an observatory study applied in a check list modality, which related the type of active alarms, the accomplished nursing care and the nursing procedures. The population was 33 nurses, which 91% were female. The mean age was 32.4 years old (± 5.69). There were an average of 8.15 years (± 5.08) relating to intensive care experience. Results: 48% of the nurses have attended an intensive care course. The alarms occurred in 35 patient, which 54% were female. The mean age was 82 years old (± 10.92). There were an average of 23 days (± 26.12) relating to the days that they were undergoing of mechanical ventilation. 60% were deep sedated patients, 20% were light or moderate sedated patients and 20% were non sedated patient. 45 alarms event were led to calls for nurses. The high arterial pressure (42.2%) alarm was assumed, followed by those alarms: low current pressure/volume (31.1%), high respiratory frequency (15.5%) and high current volume (11.1%). The alarms was inflamed in more frequency over those cares: respiratory functions (46.6%), change the decubitus position (22.2%) and shower over bed (17.7%). It was observed 45 procedures. It predominated the following procedures: to go off (44.4%), disregard (22.2%) e to aspirate TOT/TQT (11.1%). In conclusion the alarms event was considered normal during the nursing procedures by the risks in 77.7% of the cases. The prevalent procedures assumed ahead of the high pressure alarm (34.4%). In 66.4% of the cases the procedures were not considered safe to the patient. The objective is to encourage the training programs for nurses, focusing on ventilatory alarms monitoring and its control as an important element of monitoring in intensive care aiming to qualify the assistance ventilation performed by nursing.