Abstract
Rev Bras Ter Intensiva. 2022;34(4):426-432
DOI 10.5935/0103-507X.20220278-en
To characterize the knowledge and perceived attitudes toward pharmacologic interventions for light sedation in mechanically ventilated patients and to understand the current gaps comparing current practice with the recommendations of the Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the Intensive Care Unit.
This was a cross-sectional cohort study based on the application of an electronic questionnaire focused on sedation practices.
A total of 303 critical care physicians provided responses to the survey. Most respondents reported routine use of a structured sedation scale (281; 92.6%). Almost half of the respondents reported performing daily interruptions of sedation (147; 48.4%), and the same percentage of participants (48.0%) agreed that patients are often over sedated. During the COVID-19 pandemic, participants reported that patients had a higher chance of receiving midazolam compared to before the pandemic (178; 58.8% versus 106; 34.0%; p = 0.05), and heavy sedation was more common during the COVID-19 pandemic (241; 79.4% versus 148; 49.0%; p = 0.01).
This survey provides valuable data on the perceived attitudes of Brazilian intensive care physicians regarding sedation. Although daily interruption of sedation was a well-known concept and sedation scales were often used by the respondents, insufficient effort was put into frequent monitoring, use of protocols and systematic implementation of sedation strategies. Despite the perception of the benefits linked with light sedation, there is a need to identify improvement targets to propose educational strategies to improve current practices.
Abstract
Rev Bras Ter Intensiva. 2010;22(2):153-158
DOI 10.1590/S0103-507X2010000200009
BACKGROUND: The main causes of cardiopulmonary arrest are endemic, and require constant medical improvement on cardiopulmonary resuscitation techniques. Training and continued education are essential to skilled management of cardiopulmonary resuscitation. OBJECTIVE: This study aimed to evaluate the physicians' theoretical knowledge on diagnosis and treatment of cardiopulmonary arrest. METHODS: This was a cross-sectional descriptive research conducted in a general hospital in Roraima, Brazil. The study population consisted of physicians who worked in the emergency department and intensive care units. The data were collected using a questionnaire addressing the subject. RESULTS: Forty four physicians answered the questionnaire. The mean score was 50% right answers. Most (88.5%) respondents committed "fatal errors". Half of the sample was never trained in advanced life support skills. No correlation was found between the number of right answers and attendance to advanced life support training courses. An inverse correlation was found between performance and age, but no statistically significant correlation was seen regarding performance and time from medical graduation. CONCLUSION: The physicians' theoretical knowledge on this field is worrisome. The results point to the importance of professional advanced life support training in order to assure quality standards for cardiac arrest management in this general hospital.
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Case reports (56) Child (53) Coronavirus infections (34) COVID-19 (46) Critical care (115) Critical illness (54) Extracorporeal membrane oxygenation (26) Infant, newborn (27) Intensive care (72) Intensive care units (256) Intensive care units, pediatric (31) mechanical ventilation (38) Mortality (76) Physical therapy modalities (28) Prognosis (61) Respiration, artificial (119) Respiratory insufficiency (26) risk factors (34) SARS-CoV-2 (28) Sepsis (98)