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Management of bleeding in trauma victims by Portuguese nurses in prehospital setting

2022Journal article Open access
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dc.contributor.authorMota, Mauro
dc.contributor.authorReis Santos, Margarida
dc.contributor.authorSantos, Eduardo JF
dc.contributor.authorFigueiredo, Andrea
dc.contributor.authorMelo, Filipe
dc.contributor.authorAlbuquerque, Sara
dc.contributor.authorCunha, Madalena
dc.date.accessioned2022-10-25T14:52:46Z
dc.date.available2022-10-25T14:52:46Z
dc.date.issued2022
dc.description.abstractIntroduction: External bleeding is the leading preventable cause of death from traumatic injuries. Implementation of guidelines for its control have been associated with a significant reduction in mortality. The objectives of this study were to provide a characterisation of trauma patients with external bleeding and to compare the outcomes from specific autonomous interventions applied by nurses in prehospital care.Methods: A non-randomised prospective study was conducted in the Immediate Life Support Ambulances in Portugal, from 1 March 2019 to 30 April 2020. Patients were divided into two groups according to whether external bleeding was controlled or not on their arrival at the emergency room.Results: A total of 189 patients were included in this study (73.0% men; mean age of 53.6 years). Among these patients, 140 (74.1%) had their external bleeding controlled by prehospital nurse’s intervention. The average time of assistance at the incident site was 31.5 min. Patients with uncontrolled bleeding had a higher average rescue time (30.8 ±15.2 vs 33.7 ±13.0). Cryotherapy was administered to 15.9% of all patients and 93.3% of these patients arrived at the emergency room with controlled bleeding (p=0.01).Discussion: Despite the substantial reduction in the number of patients who keep bleeding after prehospital care, it was observed that one fifth of patients have external bleeding on arrival at the emergency room. Cryotherapy has been shown to be effective in controlling external bleeding. Failure to use haemostatic agents may explain the ineffective control of more complex external bleeding.Contribution to Emergency Nursing Practice: The current literature on management of bleeding in trauma patients is scarce and contradictory, especially in terms of interventions provided by AUTHORSMAURO AL MOTA PhD, RN1,2,3,4,5MARGARIDA REIS SANTOS PhD, RN6,7EDUARDO JF SANTOS PhD, RN2,3ANDREA FIGUEIREDO MSN, RN5FILIPE MELO MSN, RN5,8,9SARA ALBUQUERQUE MSc, MD10MADALENA CUNHA PhD, RN2,31. Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal2. Health School of the Polytechnic Institute of Viseu, Portugal3. Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Portugal4. Hospital Nossa Senhora da Assunção, Local Health Unit of Guarda, Seia, Portugal5. INEM – National Institute of Medical Emergency. Portugal6. Nursing School of Porto, Porto, Portugal7. CINTESIS – Center for Health Technology and Services Research, University of Porto, Porto, Portugal8. Hospital de Faro. University Hospital Center of Algarve. Faro, Portugal9. ABC – Algarve Biomedical Centre. Faro, Portugal10. Group of Health Centers – Greater Porto VII – Gaia, USF Nova Salus, Gaia, PortugalRESEARCH ARTICLESManagement of bleeding in trauma victims by Portuguese nurses in prehospital setting rehospital teams led by a registered nurse. In addition, interventions vary from country to country.This article increases awareness of autonomous interventions implemented by prehospital nurses to manage external bleeding.Key implications for emergency nursing practice identified in this study suggest greater fluid therapy appears harmful while cryotherapy achieved the best results (control of the bleeding on emergency room arrival). This may contribute to the review of institutional algorithms and training in this area.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationMota, M.A., Santos, M.R., Santos, E.J., Figueiredo, A., Melo, F., Albuquerque, S., Cunha, M. (2022). Management of bleeding in trauma victims by Portuguese nurses in prehospital setting Australian Journal of Advanced Nursing, 39(2), 4-11pt_PT
dc.identifier.doi10.37464/2020.392.505pt_PT
dc.identifier.issn1447-4328
dc.identifier.urihttp://hdl.handle.net/10400.26/42052
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAustralian Nursing and Midwifery Federation (ANMF)pt_PT
dc.relation.publisherversionhttps://www.ajan.com.au/index.php/AJAN/article/view/505pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectTraumapt_PT
dc.subjectPatient Care Teampt_PT
dc.subjectPrehospital Carept_PT
dc.subjectNursingpt_PT
dc.titleManagement of bleeding in trauma victims by Portuguese nurses in prehospital settingpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue2pt_PT
oaire.citation.titleAustralian Journal of Advanced Nursingpt_PT
oaire.citation.volume39pt_PT
person.familyNameReis Santos
person.givenNameMargarida
person.identifier.ciencia-id9813-185A-AC20
person.identifier.orcid0000-0002-7948-9317
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication9ae620cf-8b78-4888-9a0f-5d11168cb36d
relation.isAuthorOfPublication.latestForDiscovery9ae620cf-8b78-4888-9a0f-5d11168cb36d

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