Analysis of the profile of neurological emergencies and physiotherapeutic performance in the emergency room
DOI:
https://doi.org/10.33448/rsd-v13i4.45456Keywords:
Neurology; Emergency relief; Physical therapy department, hospital.Abstract
Neurological emergencies are among the main occurrences in an emergency room, highlighting the particularity of demonstrating the need for a longer period of stay in the emergency service, hospitalization rate, admissions to critical patient units, in this way Physiotherapy work together with the multidisciplinary team is essential in the care of these patients. The objective of the present study was to analyze the profile of neurological emergencies and physiotherapeutic performance, in order to discuss effective conduct in physiotherapeutic care in response to this demand in the emergency room sector. This is an observational study, lasting twelve months, where we analyzed age, sex, neurological diagnostic hypothesis and the physiotherapeutic treatment that was carried out. 1619 patients were treated in the emergency unit during this period, of which 192 patients presented a neurological emergency profile, representing a percentage of 11.85% in relation to the total. Regarding the pathologies found in adult patients, 4 were more prevalent, being: Ischemic Stroke (50%), Hemorrhagic Stroke (17.7%), Seizures (13%) and Traumatic Brain Injury (13%). The physiotherapeutic approaches observed in the study demonstrated a greater focus on behaviors related to the respiratory system, and a lower prevalence of action focused on the motor system and early mobilization, which is justified by the fact that priority occurs in situations of complications that promote risks of life and are commonly prevalent in this sector, directly interfering in behaviors aimed at early mobilization.
References
Al Harthi, H. A., Al Kashmiri, A., Zakaryia, L. M., Al-Lawati, J. A., Najem, O. M., Al-Lawati, I., Memon, G. R., & Elfaham, A. A. (2022). Clinical Profile of Stroke Patients Presenting to the Emergency Department of a Major Stroke Centre in Oman. Sultan Qaboos University medical journal, 22(1), 91–97. https://doi.org/10.18295/squmj.4.2021.062
Alyoubi, R. A., Aljaafari, D. T., Basheikh, M. A., Al-Yahyawi, N. Y., Bakry, M. A., BenHli, N. M., Sindi, G. J., Alhainiah, M. H., Alateeq, M. M., Nasser, J. A., & Al-Hayani, M. M. (2021). The etiology and risk factors of convulsive status epilepticus in pediatric patients of tertiary center in Saudi Arabia. Neurosciences (Riyadh, Saudi Arabia), 26(1), 26–30. https://doi.org/10.17712/nsj.2021.1.20200116
Boulanger, J. M., Lindsay, M. P., Gubitz, G., Smith, E. E., Stotts, G., Foley, N., Bhogal, S., Boyle, K., Braun, L., Goddard, T., Heran, M., Kanya-Forster, N., Lang, E., Lavoie, P., McClelland, M., O'Kelly, C., Pageau, P., Pettersen, J., Purvis, H., Shamy, M., … Butcher, K. (2018). Canadian Stroke Best Practice Recommendations for Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care, 6th Edition, Update 2018. International journal of stroke : official journal of the International Stroke Society, 13(9), 949–984. https://doi.org/10.1177/1747493018786616
Carteri, R. B. K., & Silva, R. A. da. (2021). Incidência hospitalar de traumatismo craniencefálico no Brasil: uma análise dos últimos 10 anos. Revista Brasileira de Terapia Intensiva, 33(2), 282–289. http://criticalcarescience.org.br/artigo/detalhes/0103507X-33-2-12
Chapman, J., Horowitz, M., Bond, R., Fry, J., Joesph, C., & Al-Saghir, Y. (2023). Acute Onset of Movement Disorders Accompanying Common Emergency Room Neurologic Disease Processes. Cureus, 15(3), e35924. https://doi.org/10.7759/cureus.35924
De Souza, D. P., & Waters, C. (2023). Perfil epidemiológico dos pacientes com acidente vascular cerebral: pesquisa bibliográfica. Brazilian Journal of Health Review, 6(1), 1466–1478. https://doi.org/10.34119/bjhrv6n1-115
Esperanza, J. A., Sarlabous, L., de Haro, C., Magrans, R., Lopez-Aguilar, J., & Blanch, L. (2020). Monitoring Asynchrony During Invasive Mechanical Ventilation. Respiratory care, 65(6), 847–869. https://doi.org/10.4187/respcare.07404
Eun Chae Lee, Tae Won Ha, Lee, D.-H., Hong, D.-Y., Park, S.-W., Lee, J.-Y., Man Ryul Lee, & Jae Sang Oh. (2022). Utility of Exosomes in Ischemic and Hemorrhagic Stroke Diagnosis and Treatment. International Journal of Molecular Sciences, 23(15), 8367–8367. https://doi.org/10.3390/ijms23158367
Fernanda, R., Toassi, C., & Petry, P. (n.d.). Metodologia Científica aplicada à área da Saúde 2a edição. https://lume.ufrgs.br/bitstream/handle/10183/218553/001123326.pdf?sequence=1&isAllowed=y
Ferreira, F. S., De França, N. B. M., Lima, R. A., Ferreira, J. R., & Sales, K. N. A. (2019). Physiotherapy in the acute hospital phase of strokes: A bibliographic review. Brazilian Journal of Health and Biomedical Sciences, 18(1), 47–54. https://doi.org/10.12957/bjhbs.2019.53476
Francisco, P. M. S. B., Santos , A. P. S., Assumpção, D. de, & Bacurau , A. G. de M. (2023). Prevalence and associated factors of stroke in older adults in Brazil, 2019. In SciELO Preprints. https://doi.org/10.1590/SciELOPreprints.6199
Georges, A., & Booker, J. G. (2023). Traumatic Brain Injury. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459300/
Hofer, A. S., & Schwab, M. E. (2019). Enhancing rehabilitation and functional recovery after brain and spinal cord trauma with electrical neuromodulation. Current opinion in neurology, 32(6), 828–835. https://doi.org/10.1097/WCO.0000000000000750
Huff, J. S., & Murr, N. (2023, February 7). Seizure. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430765/
Kakuda W. (2020). Rinsho shinkeigaku = Clinical neurology, 60(3), 181–186. https://doi.org/10.5692/clinicalneurol.cn-001399
Kreitzer, N., Rath, K., Kurowski, B. G., Bakas, T., Hart, K., Lindsell, C. J., & Adeoye, O. (2019). Rehabilitation Practices in Patients With Moderate and Severe Traumatic Brain Injury. The Journal of head trauma rehabilitation, 34(5), E66–E72. https://doi.org/10.1097/HTR.0000000000000477
Lee, E. C., Ha, T. W., Lee, D. H., Hong, D. Y., Park, S. W., Lee, J. Y., Lee, M. R., & Oh, J. S. (2022). Utility of Exosomes in Ischemic and Hemorrhagic Stroke Diagnosis and Treatment. International journal of molecular sciences, 23(15), 8367. https://doi.org/10.3390/ijms23158367
Lee, S. Y., Amatya, B., Judson, R., Truesdale, M., Reinhardt, J. D., Uddin, T., Xiong, X. H., & Khan, F. (2019). Clinical practice guidelines for rehabilitation in traumatic brain injury: a critical appraisal. Brain injury, 33(10), 1263–1271. https://doi.org/10.1080/02699052.2019.1641747
Lobo, P. G. G. A., Zanon, V. de B., De Lara, D., Freire, V. B., Nozawa, C. A., de Andrade, J. V. B., Barros, W. C., & Lobo, I. G. A. (2021). Epidemiologia do acidente vascular cerebral isquêmico no Brasil no ano de 2019, uma análise sob a perspectiva da faixa etária / Epidemiology of the ischemic cerebrovascular accident in Brazil in the year of 2019, an analysis from an age group perspective. Brazilian Journal of Health Review, 4(1), 3498–3505. https://doi.org/10.34119/bjhrv4n1-272
Martins, M. E. F., Zaccariotti, A. J., Borges, A. D. L. M., Sousa, C. O. C. de, Peres, L. F. A., & Júnior, J. P. de O. (2023). Epidemiologia das taxas de internação e de mortalidade por acidente vascular cerebral isquêmico no Brasil. Brazilian Medical Students, 8(12). https://doi.org/10.53843/bms.v8i12.323
Montaño, A., Hanley, D. F., & Hemphill, J. C., 3rd (2021). Hemorrhagic stroke. Handbook of clinical neurology, 176, 229–248. https://doi.org/10.1016/B978-0-444-64034-5.00019-5
Ogbebor, O., Tariq, S., Jaber, T., Super, J., Bhanot, N., Rana, S., & Malik, K. (2023). Neurological Emergencies in the Intensive Care Unit. Critical care nursing quarterly, 46(1), 17–34. https://doi.org/10.1097/CNQ.0000000000000435
Owolabi, M. O., Thrift, A. G., Mahal, A., Ishida, M., Martins, S., Johnson, W. D., Pandian, J., Abd-Allah, F., Yaria, J., Phan, H. T., Roth, G., Gall, S. L., Beare, R., Phan, T. G., Mikulik, R., Akinyemi, R. O., Norrving, B., Brainin, M., Feigin, V. L., & Stroke Experts Collaboration Group (2022). Primary stroke prevention worldwide: translating evidence into action. The Lancet. Public health, 7(1), e74–e85. https://doi.org/10.1016/S2468-2667(21)00230-9
Pozuelo-Carrascosa DP, Carmona-Torres JM, Laredo-Aguilera JA, Latorre-Román PÁ, Párraga-Montilla JA, Cobo-Cuenca AI. Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis. International Journal of Environmental Research and Public Health. 2020; 17(15):5356. https://doi.org/10.3390/ijerph17155356
Racca, F., Vianello, A., Mongini, T., Ruggeri, P., Versaci, A., Vita, G. L., & Vita, G. (2019). Practical approach to respiratory emergencies in neurological diseases. Neurological Sciences, 41(3), 497–508. https://doi.org/10.1007/s10072-019-04163-0
Robba, C., Poole, D., McNett, M., Asehnoune, K., Bösel, J., Bruder, N., Chieregato, A., Cinotti, R., Duranteau, J., Einav, S., Ercole, A., Ferguson, N., Guerin, C., Siempos, I. I., Kurtz, P., Juffermans, N. P., Mancebo, J., Mascia, L., McCredie, V., Nin, N., … Stevens, R. D. (2020). Mechanical ventilation in patients with acute brain injury: recommendations of the European Society of Intensive Care Medicine consensus. Intensive care medicine, 46(12), 2397–2410. https://doi.org/10.1007/s00134-020-06283-0
Roberson, S. W., Patel, M. B., Dabrowski, W., Ely, E. W., Pakulski, C., & Kotfis, K. (2021). Challenges of Delirium Management in Patients with Traumatic Brain Injury: From Pathophysiology to Clinical Practice. Current neuropharmacology, 19(9), 1519–1544. https://doi.org/10.2174/1570159X19666210119153839
Rodrigues-Gomes, R. M., Martí, J. D., Rolán, R. M., & Gelabert-González, M. (2022). Rapid chest compression effects on intracranial pressure in patients with acute cerebral injury. Trials, 23(1), 312. https://doi.org/10.1186/s13063-022-06189-w
Rosário, C. F. D., Fernandes Neto, W. G., Pessotti, A. L., Rodrigues, B. C., Baptista, J. D., Segatto, M., Nunes, V. S., Barbosa, L. A., Pereira, A. F. A., Mota, C. L., & Fiorot Júnior, J. A. (2022). Epidemiological analysis of stroke patients with emphasis on access to acute-phase therapies. Arquivos de neuro-psiquiatria, 80(2), 117–124. https://doi.org/10.1590/0004-282X-ANP-2020-0466
Rosenthal E. S. (2021). Seizures, Status Epilepticus, and Continuous EEG in the Intensive Care Unit. Continuum (Minneapolis, Minn.), 27(5), 1321–1343. https://doi.org/10.1212/CON.0000000000001012
Santos, L. B., & Waters, C. (2020). Perfil epidemiológico dos pacientes acometidos por acidente vascular cerebral: revisão integrativa. Brazilian Journal of Development, 6(1), 2749–2775. https://doi.org/10.34117/bjdv6n1-198
Santos, P. R. dos ., Nepomuceno, P., Reuter, É. M., & Carvalho, L. L.. (2020). Percepção da equipe multiprofissional sobre o fisioterapeuta na emergência de um hospital do interior do Rio Grande do Sul. Fisioterapia E Pesquisa, 27(2), 147–154. https://doi.org/10.1590/1809-2950/19010927022020
Seetlani, N. K., Kumari, G., Yasmin, F., Hasan, C. A., Hussaini, M., Awan, S., Mubeen, K. I., Jabeen, R., Ansari, S., Siddiqui, S., Aziz, M., & Farooque, U. (2022). The frequency and pattern of deranged lipid profile in patients with ischemic stroke: a retrospective study. Acta bio-medica : Atenei Parmensis, 93(3), e2022178. https://doi.org/10.23750/abm.v93i3.11576
Taran, S., Wahlster, S., & Robba, C. (2023). Ventilatory targets following brain injury. Current opinion in critical care, 29(2), 41–49. https://doi.org/10.1097/MCC.0000000000001018
Taylor, E. C., Fitzpatrick, C. E., Thompson, S. E., & Justice, S. B. (2022). Acute Traumatic Spinal Cord Injury. Advanced emergency nursing journal, 44(4), 272–280. https://doi.org/10.1097/TME.0000000000000428
Tribelhorn, S., Motara, F., & Lewis, C. M. (2021). Stroke: A retrospective review of the incidence and epidemiology in a South African academic hospital emergency department. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 111(12), 1205–1210. https://doi.org/10.7196/SAMJ.2021.v111i12.15682
Unnithan, A. K. A., Mehta, P., & Das, J. M. (2023, May 8). Hemorrhagic Stroke. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559173/
Venkatasubramanian, C., Lopez, G. A., & O’Phelan, K. H. (2019). Emergency Neurological Life Support: Fourth Edition, Updates in the Approach to Early Management of a Neurological Emergency. Neurocritical Care. https://doi.org/10.1007/s12028-019-00810-8
Vieira, L. G. D. R., Safanelli, J., Araujo, T., Schuch, H. A., Kuhlhoff, M. H. R., Nagel, V., Conforto, A. B., Silva, G. S., Mazin, S., & Cabral, N. L. (2019). The cost of stroke in private hospitals in Brazil: a one-year prospective study. Arquivos De Neuro-psiquiatria, 77(6), 393–403. https://doi.org/10.1590/0004-282X20190056
Wang, J., Ren, D., Liu, Y., Wang, Y., Zhang, B., & Xiao, Q. (2020). Effects of early mobilization on the prognosis of critically ill patients: A systematic review and meta-analysis. International journal of nursing studies, 110, 103708. https://doi.org/10.1016/j.ijnurstu.2020.103708
Young, B., Moyer, M., Pino, W., Kung, D., Zager, E., & Kumar, M. A. (2019). Safety and Feasibility of Early Mobilization in Patients with Subarachnoid Hemorrhage and External Ventricular Drain. Neurocritical Care, 31(1), 88–96. https://doi.org/10.1007/s12028-019-00670-2
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