Guia de practica clinica: cuidado de enfermeria en uci a la persona con trauma toracico penetrante

Abstract

In Colombia, violence and its various manifestations are a multi-dimensional problem, socioculturally relevant and highly complex. From the field of health, violence in Colombia is the main public health problem. Statistics relating to this phenomenon show that in western society trauma is the third main cause of death after cancer and cardiovascular disease. The population most affected by this is under 45 years old, the highest impact being on the 20 to 40 years old population. Penetrating thoracic trauma is usually caused by bladed weapons wounds or by firearms. Closed trauma is caused by blows, compression or deceleration, specially due to traffic accidents. To talk about efficient intervention or nursing care for patients with penetrating thoracic trauma implies to go through the results of quantitative and qualitative studies in scientific literature about this subject. The proper technique from the investigative point of view is to design a guide for clinical use based on scientific evidence. The objective was to design a practical clinical guide based on the evidence for nursing care of the person with penetrating thoracic trauma in the Unit of Intensive Care, to provide the best evidence for care. The methodology for the design was the practice of nursery based on evidence. This process was developed in five stages: a) Selection and priority of the subject; b) Preparation of questions with the PICOT methodology as base; c) The defined fields of nursery and the determination of outcomes; d) Search and synthesis of evidence; f) Identification of the studies and qualification of the evidence. 16 questions were made from the defined fields of nursery: diagnostic, nursery care and prognosis, incorporating the evidence of professional users and patients. 41 recommendations were prepared supported by investigative studies with scientific evidence qualified in this manner: 20 (48%) of the recommendations got a B grade of recommendation, 14 (34%), a grade C of recommendation, 4 (9.7%), a grade of recommendation A and 3 (7.3%) a grade of recommendation D.