Evaluation Of Gasometric Parameters In Trauma Patients During Mobile Prehospital Care [avaliação Dos Parâmetros Gasométricos Dos Traumatizados Durante O Atendimento Pré-hospitalar Móvel]

Objective: To evaluate gasometric differences of severe trauma patients requiring intubation in prehospital care. Methods: Patients requiring airway management were submitted to collection of arterial blood samples at the beginning of pre-hospital care and at arrival at the Emergency Room. We analyzed: Glasgow Coma Scale, respiratory rate, arterial pH, arterial partial pressure of CO2 (PaCO2), arterial partial pressure of O2 (PaO2), base excess (BE), hemoglobin O2 saturation (SpO2) and the relation of PaO2 and inspired O2 (PaO2/FiO2). Results: There was statistical significance of the mean differences between the data collected at the site of the accident and at the entrance of the ER as for respiratory rate (p = 0.0181), Glasgow Coma Scale (p = 0.0084), PaO2 (p <0.0001) and SpO2 (p = 0.0018). Conclusion: tracheal intubation changes the parameters PaO2 and SpO2. There was no difference in metabolic parameters (pH, bicarbonate and base excess). In the analysis of blood gas parameters between survivors and non-survivors there was statistical difference between PaO2, hemoglobin oxygen saturation and base excess.404293299Gonsaga, R.A., Brugugnolli, I.D., Fraga, G.P., Comparison between two mobile pre-hospital care services for trauma patients (2012) Word J Emerg Surg., 7 (SUPPL. 1), pp. S6Pereira Júnior, G.A., Carvalho, J.B., Ponte Filho, A.D., Malzone, D.A., Pedersoli, C.E., Transporte intra-hospitalar do paciente crítico (2007) Medicina., 40 (4), pp. 500-508Kue, R., Brown, P., Ness, C., Scheulen, J., Adverse clinical events during intrahospital transport by a specialized team: A preliminary report (2011) Am J Crit Care., 20 (2), pp. 153-161Lima Junior, N.A., Bacelar, S.C., Japiassú, A.M., Cader, S.A., Lima, R.C.F., Dantas, E.H.M., Gasometria arterial em dois diferentes métodos de transporte intra-hospitalar no pós-operatório imediato de cirurgia cardíaca (2012) Rev bras ter intensiva., 24 (2), pp. 162-166Waydhas, C., Schneck, G., Duswald, K.H., Deterioration of respiratory function after intra-hospital transport of critically ill surgical patients (1995) Intensive Care Med., 21 (10), pp. 784-789Zuchelo, L.T.S., Chiavone, P.A., Transporte intra-hospitalar de pacientes sob ventilação invasiva: Repercussões cardiorrespiratórias e eventos adversos (2009) J bras pneumol., 35 (4), pp. 367-374Gervais, H.W., Eberle, B., Konietzke, D., Hennes, H.J., Dick, W., Comparison of blood gases of ventilated patients during transport (1987) Crit Care Med., 15 (8), pp. 761-763Wildner, G., Pauker, N., Archan, S., Gemes, G., Rigaud, M., Pocivalnik, M., Arterial line in prehospital emergency settings-A feasibility study in four physician-staffed emergency medical systems (2011) Resuscitation., 82 (9), pp. 1198-1201Schmelzer, T.M., Perron, A.D., Thomason, M.H., Sing, R.F., A comparison of central venous and arterial base deficit as a predictor of survival in acute trauma (2008) Am J Emerg Med., 26 (2), pp. 119-123Bilello, J.F., Davis, J.W., Lemaster, D., Townsend, R.N., Parks, S.N., Sue, L.P., Prehospital hypotension in blunt trauma: Identifying the "crump factor" (2011) J Trauma., 70 (5), pp. 1038-1042(2012) Atendimento pré-hospitalar ao traumatizado, PHTLS / NAEMT, , Tradução do original Prehospital trauma life support, por Renata Scavone, et al. 7a ed. Rio de Janeiro: ElsevierFraga, G.P., Mantovani, M., Magna, L.A., Índices de trauma em pacientes submetidos à laparotomia (2004) Rev Col Bras Cir., 31 (5), pp. 299-306Barros, M.D.A., Ximenes, R., Lima, M.L.C., Mortalidade por causas externas em crianças e adolescentes: Tendência de 1979 a 1995 (2001) Rev Saúde Pública., 35 (2), pp. 142-149Gonsaga, R.A.T., Rimoli, C.F., Pires, E.A., Zogheib, F.S., Fujino, M.V.T., Cunha, M.B., Avaliação da mortalidade por causas externas (2012) Rev Col Bras Cir., 39 (4), pp. 263-267Batista, S.E.A., Baccani, J.G., Silva, R.A.P., Gualda, K.P.F., Vianna Junior, R.J.A., Análise comparativa entre os mecanismos de trauma, as lesões e o perfil de gravidade das vítimas, em Catanduva-SP (2006) Rev Col Bras Cir., 33 (1), pp. 6-10Carrasco, C.E., Godinho, M., Berti de Azevedo Barros, M., Rizoli, S., Fraga, G.P., Fatal motorcycle crashes: A serious public health problem in Brazil (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S5Marín-León, L., Belon, A.P., Barros, M.B.A., Almeida, S.D.M., Restitutti, M.C., Tendênica dos acidentes de trânsito em Campinas, São paulo, Brasil: Importância crescente dos motociclistas (2012) Cad Saúde Pública., 28 (1), pp. 39-51Jousi, M., Reitala, J., Lund, V., Katila, A., Leppäniemi, A., The role of prehospital blood gas analysis in trauma resuscitation (2010) World J Emerg Surg., 5, p. 10Martin, M., Oh, J., Currier, H., Tai, N., Beekley, A., Eckert, M., An analysis of in-hospital deaths at a modern combat support hospital (2009) J Trauma., 66 (4 SUPPL.), pp. S51-S60. , discussion S60-1Ouellet, J.F., Roberts, D.J., Tiruta, C., Kirkpatrick, A.W., Mercado, M., Trottier, V., Admission base deficit and lactate levels in Canadian patients with blunt trauma: Are they useful markers of mortality? (2012) J Trauma Acute Care Surg., 72 (6), pp. 1532-1535Darlington, D.N., Kheirabadi, B.S., Delgado, A.V., Scherer, M.R., Martini, W.Z., Dubick, M.A., Coagulation changes to systemic acidosis and bicarbonate correction in swine (2011) J Trauma., 71 (5), pp. 1271-1277Rudkin, S.E., Kahn, C.A., Oman, J.A., Dolich, M.O., Lotfipour, S., Lush, S., Prospective correlation of arterial vs venous blood gas measurements in trauma patients (2012) Am J Emerg Med., 30 (8), pp. 1371-1377Hussmann, B., Lefering, R., Waydhas, C., Ruchholtz, S., Wafaisade, A., Kauther, M.D., Prehospital intubation of the moderately injured patient: A cause of morbidity? A matched-pairs analysis of 1,200 patients from the DGU Trauma Registry (2011) Crit Care., 15 (5), pp. R207Park, M., Costa, E.L.V., McIel, A.T., Hirota, A.S., Vasconcelos, E., Azevedo, L.C.P., Alterações hemodinâmicas, respiratórias e metabólicas agudas após o contato do sangue com o circuito extracorpóreo da ECMO: Estudo experimental (2012) Rev bras ter intensiva., 24 (2), pp. 137-14

The business firm model of party organisation: cases from Spain and Italy

Discussion of new forms of party organisation have largely focused on the ways in which institutionalised parties have adapted to pressures towards ‘catch-all’ or ‘electoralprofessional’ behaviour. This article examines the ways in which new parties respond to these pressures. A model of the ‘party as business firm’ is generated from rational choice assumptions and it is suggested that such a model can emerge when new party systems are created in advanced societies. Two cases of political parties which resemble the business firm model in important ways are analysed in order to gauge the consequences of this type of party organisation: UCD in Spain and Forza Italia in Italy. On the basis of this analysis it is argued that business firm parties are likely to be electorally unstable and politically incoherent, and also prone to serving particularistic interests

Scientific Opinion on the effect on public or animal health or on the environment on the presence of seeds of Ambrosia spp. in animal feed

The European Commission requested EFSA to provide a scientific opinion on the effect on public or animal health or on the environment on the further distribution of Ambrosia spp. in the European Union and on the importance of feed materials, in particular bird feed, in the dispersion of Ambrosia spp. The genus Ambrosia (Asteraceae family) is distributed worldwide. Ambrosia artemisiifolia (common ragweed) has heavily colonised several areas of South-East Europe. Ambrosia spp., both in their native range and in invaded areas, are of public health concern due to the allergenic properties of their pollen. The NDA Panel concluded that inhalation of the plant pollen causes rhino-conjunctivitis and asthma, with skin allergies and food allergy playing minor roles. Ambrosia may cross-sensitize patients to other allergens, including food allergens. There is some evidence for allergenicity of Ambrosia pollen in animals. With regard to the effects on the environment of the further distribution of Ambrosia spp. in the European Union, the PLH Panel concluded that there is no direct evidence that Ambrosia spp. cause extinction of plant species. However, there are some indications that A. artemisiifolia could become highly invasive in certain environmentally-valuable habitats and might be linked to an impoverishment of species richness, therefore further ecological studies are needed. The CONTAM Panel focused on the relative importance of animal feed, bird feed in particular, on the dispersion of Ambrosia. Ambrosia seeds may contaminate feed. However, animal feed materials compounded for use in livestock are extensively processed. This processing destroys Ambrosia seeds and hence the contribution of compounded feed to the dispersion of Ambrosia is considered to be negligible. Bird feed often contains significant quantities of Ambrosia seeds and remains unprocessed. Therefore, bird feed seems to play an important role in introducing Ambrosia to new, previously not infested area