Patient Safety – ABC CARDIOL

IJCS

Letter to the Editor

Effectiveness of Rapid Response Teams and the Importance of Preprints

Hermano Alexandre Lima Rocha et al. Sabrina Gabriele Maia Oliveira Rocha Antônia Célia de Castro Alcântara

To the Editor of the International Journal of Cardiovascular Sciences,

We have read with interest the Point of View: “Performance of the Rapid Response Systems in Health Care Improvement: Benefits and Perspectives” by Viviane Cordeiro Veiga and Salomón Soriano Ordinola Rojas, published ahead of print in the International Journal of Cardiovascular Sciences on April 15, 2019. Rapid response teams to treat trauma patients in Australia 30 years ago, in 1989. From the outset, the aim was to early recognize signs of deterioration and provide a quick response, hence the name of the methodology. The discussion about the activation criteria is relevant and up to date and was treated in a solid manner by the authors in the introduction of the point of view. Indeed, it is known that this is the cause of part of the heterogeneity of results found in studies on the subject.

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IJCS

Editorial

Is Bovine Heparin, an Old Fellow, a Safe Anticoagulation Approach during Extracorporeal Circulation Inside the Cardiac Operating Room?

Ivis Levy Fernandes Martins et al. Christianne Bretas Vieira Scaramello

Antithrombotic agents include anticoagulants, antiplatelet and fibrinolytic drugs. They are prescribed in several situations related to hemostasis disturbances that favor thrombi formation. Since bleeding is a common adverse effect of these drugs, a cost-benefit analysis of antithrombotic therapy prior to surgery should be performed. In order to consider the preoperative therapy for patients undergoing cardiac surgery, the risk of thrombosis must outweigh the risk of bleeding. Nonetheless, the literature has reported the use of anticoagulant therapy with unfractionated heparin (UFH) during extracorporeal circulation (ECC) inside and outside the cardiac operating room.^–

The development of the heart-lung machine made ECC possible. Therefore, heart surgery became a routine practice. The literature describes that complications related to ECC have diminished due to modern monitoring, highly trained staff, special cannulation methods, as well as the latest advances in techniques. However, some authors suggest that guidelines based on more researches would improve the safety of this procedure. During cardiac surgery, ECC preserves the functional characteristics of the heart, provides a clean surgical environment and offers safety to the team.

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IJCS

Viewpoint

Performance of the Rapid Response Systems in Health Care Improvement: Benefits and Perspectives

Viviane Cordeiro Veiga et al. Salomón Soriano Ordinola Rojas

Introduction

In the last two decades, the rapid response systems (RRS) have been explored as initiatives to increase the safety of hospitalized patients. The main function is to identify and treat patients at risk, or who are presenting signs of clinical instability, and to prevent adverse events during hospital stay, with a consequent reduction in in-hospital mortality. Every year in the United States, more than 200,000 intrahospital cardiac arrests (CAs) occur, most of which could be avoided. RRS are formed by two health care components called the afferent limb and the efferent limb. The afferent limb is represented by the health care team in the admission units, responsible for the care of hospitalized patients and trained to activate the afferent limb, when physiological changes that predict adverse events are detected, especially cardiac arrests. The efferent limb is represented by a team of health care professionals, who respond to codes, and may be headed by a physician, a nurse or a physiotherapist. The efferent limb is better known as the rapid response team (RRT). In addition to these health care components, the rapid response systems must also have two other components, namely the administrative arm, which provides the necessary documentation and is responsible for the systems daily activities and the quality and governance arm, which contributes to continuous improvement and reassessment of the system. These systems have been implemented around the globe, but still in a non-uniform way in institutions and health systems with different characteristics. However, in Brazil, there are few reports on this issue.^,

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Ler artigo completo

Effectiveness of Rapid Response Teams and the Importance of Preprints

Is Bovine Heparin, an Old Fellow, a Safe Anticoagulation Approach during Extracorporeal Circulation Inside the Cardiac Operating Room?

Performance of the Rapid Response Systems in Health Care Improvement: Benefits and Perspectives

Introduction

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