Evaluación del cumplimiento del protocolo de atención para crisis hipertensivas en el Area de Emergencias del Hospital del IESS de Portoviejo. octubre 2009 – septiembre 2010
Fecha
2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Las Crisis Hipertensivas constituyeron un grave problema en el Área de Emergencias del Hospital
del IESS de Portoviejo, fue causa frecuente de consulta médica. Clínica y fisiopatológicamente se
estableció su diferenciación en dos entidades de distintas características, manejo y tratamiento:
La Urgencia y La Emergencia Hipertensiva; en la primera no existió daño a órganos blanco y no
estuvo comprometida la vida del paciente, en la segunda sí, cada una de ellas debió ser manejada
de modo distinto, pues, de una correcta actuación dependía la vida del enfermo.
Ambulatoriamente fue indispensable que el paciente tuviera información tanto en el aspecto
clínico, como farmacológico. Todo lo cual hizo necesario el conocimiento de la real prevalencia de
Crisis Hipertensivas en el Hospital y la aplicación de un adecuado Protocolo de Atención para
tratar de evitarlas consecuencias que pudo desencadenar esta entidad clínico-patológica. Por
tanto el principal objetivo fue evaluar el cumplimiento del Protocolo de Atención en pacientes con
Crisis Hipertensivas en el Área de Emergencias del Hospital del IESS de Portoviejo. De una manera
más específica se determinó la prevalencia de Crisis Hipertensivas y datos de filiación como edad,
sexo, procedencia, nivel socio-económico; también se definió el tipo de Crisis Hipertensiva,
tratamiento, causas, patologías asociadas y complicaciones; se especificó los factores de riesgo
que influyeron en el desarrollo de una crisis hipertensiva. De igual forma se verificó el
cumplimiento del Protocolo de Atención para pacientes con Crisis Hipertensivas existente, por
parte del personal de salud y se realizó una capacitación para el cumplimiento del mismo, dirigido
al personal del Hospital del IESS de Portoviejo. En relación a la metodología fue un estudio de tipo
descriptivo – correlacional y, el diseño de la investigación fue transversal no experimental. Se
esperó que los resultados fueran similares a los de investigaciones precedentes y que las
Urgencias Hipertensivas fueran mayores que las Emergencias Hipertensivas; referente al
cumplimiento del Protocolo de Atención que este fuera muy escaso, en cuanto al sexo que el
predominio fuera femenino y que el órgano blanco mayormente afectado fuera el corazón,
difiriendo en estos dos últimos aspectos de investigaciones similares, esto fue confirmado
The hypertensive crisis created a grave problem in the area or emergency of the IESS hospital of Portoviejo; this was the cause of frequent medical consults. From the clinical and pathofhysiological point of view we established two different aspects in characteristics, management and treatment. The urgency and the hypertensive emergency; in the first there was no tissue damage to main organs so there was no danger of loss of life. In the second there was, that is why each situation should be managed differently because in one of the two a patient´s life was in the balance. The outpatient department was needed to provide clinical information as well as pharmaceutical. All this made it necessary that the knowledge of real situación of the crisis of the hypertensive emergency in the hospital and the application of a correct protocol of attention to try to avoid the consequences that this might allow in this clinic. That is why our prime objective was to evaluate the fulfillment of the protocol established for patient care with hypertensive crisis in the area of emergencies in the hospital of the IESS of Portoviejo. In a more specific manner we determined the prevalence of the hypertensive crisis and the affiliation information such as the age, sex, background, socio–economical level, type of crisis, treatment, causes of associated pathologyand complications. We specified the risk factors that influenced the development of a hypertensive crisis in effect. In part for the health care workers we provided training for the new protocol, which was directed to the workers of the IESS hospital of Portoviejo. In relation with the methodology, it was a study of the descriptive finding – correlation and the design of the investigation was transversal not experimental. We hoped that the results have similar results to the previous investigations and that the hypertensive urgencies were greater than the hypertensive emergencies. In deciding the fulfillment of the patient attention protocol which was barely off its mark except with the predetermined sex of the patient and the most affected organ that was the heart, these were the only two differentiating, aspects to similar investigations which was confirmed
The hypertensive crisis created a grave problem in the area or emergency of the IESS hospital of Portoviejo; this was the cause of frequent medical consults. From the clinical and pathofhysiological point of view we established two different aspects in characteristics, management and treatment. The urgency and the hypertensive emergency; in the first there was no tissue damage to main organs so there was no danger of loss of life. In the second there was, that is why each situation should be managed differently because in one of the two a patient´s life was in the balance. The outpatient department was needed to provide clinical information as well as pharmaceutical. All this made it necessary that the knowledge of real situación of the crisis of the hypertensive emergency in the hospital and the application of a correct protocol of attention to try to avoid the consequences that this might allow in this clinic. That is why our prime objective was to evaluate the fulfillment of the protocol established for patient care with hypertensive crisis in the area of emergencies in the hospital of the IESS of Portoviejo. In a more specific manner we determined the prevalence of the hypertensive crisis and the affiliation information such as the age, sex, background, socio–economical level, type of crisis, treatment, causes of associated pathologyand complications. We specified the risk factors that influenced the development of a hypertensive crisis in effect. In part for the health care workers we provided training for the new protocol, which was directed to the workers of the IESS hospital of Portoviejo. In relation with the methodology, it was a study of the descriptive finding – correlation and the design of the investigation was transversal not experimental. We hoped that the results have similar results to the previous investigations and that the hypertensive urgencies were greater than the hypertensive emergencies. In deciding the fulfillment of the patient attention protocol which was barely off its mark except with the predetermined sex of the patient and the most affected organ that was the heart, these were the only two differentiating, aspects to similar investigations which was confirmed
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Palabras clave
Protocolos, Atención de salud, Hipertensión, Servicio de emergencia del hospital, Epidemiología descriptiva, Hospital del IESS de Portoviejo, Cantón Portoviejo, Ecuador