Browsing by Author "Abecasis, F."
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- [Translation and Validation of the FOUR Scale for Children and its Use as Outcome Predictor: A Pilot Study]Publication . Ferreira, S.; Meireles, D.; Pinto, A.; Abecasis, F.INTRODUCTION: The Full Outline of UnResponsiveness - FOUR scale has been previously validated to assess impaired consciousness in the adult population. The aim of this study is the translation into Portuguese and validation of the FOUR scale in the pediatric population. The study also compares the FOUR scale and Glasgow coma scale score ratings and the clinical outcome of patients hospitalized in Pediatric Intensive Care Units. MATERIAL AND METHODS: This study prospectively rated patients admitted to the Pediatric Intensive Care Units with impaired consciousness during one year. Both scales were applied daily to patients by three types of examiners: intensivists, residents and nurses, from the moment of admission until clinical discharge. Neurological sequelae was evaluated using the King's Outcome Scale for Childhood Head Injury - KOSCHI. RESULTS: Twenty seven patients between one and 17 years of age were included. Both scales are reliable and inter-rater reliability was greater for the FOUR score. Glasgow coma scale showed a minimum score in eight evaluations, whereas the FOUR scale obtained the minimum score in only two of these evaluations. In both scales there was a strong association between the admission score and the patient's outcome (area under curve FOUR = 0.939, versus Glasgow coma scale = 0.925). DISCUSSION: The FOUR scale provides more neurological information than Glasgow coma scale in patients with impaired consciousness and has prognostic interest. CONCLUSION: The FOUR scale can be applied in patients admitted with impaired consciousness in Pediatric Intensive Care Units. We think that a multicenter study would be very beneficial for confirming and generalizing these results.
- Transporte neonatal e pediátrico - organização e perspectivas actuaisPublication . Abecasis, F.Os sistemas organizados de transporte neonatal e pediátrico permitem aos hospitais centrais estender a sua acção à comunidade de modo a que os doentes beneficiem atempadamente de cuidados especializados habitualmente só disponíveis após a sua chegada a estes hospitais. O transporte de um doente envolve riscos e limitações que podem ser compensados se este for realizado por pessoal qualificado com recurso a equipamentos adaptados para esse efeito. Pretende-se com este artigo analisar a situação actual do transporte inter-hospitalar de doente críticos em Pediatria a nível nacional e internacional, discutir as vantagens e desvantagens de um sistema de transporte especializado, apresentar diferentes modelos de organização e por último defender a criação de um sistema organizado de transporte inter-hospitalar pediátrico na Região Sul de Portugal. ABSTRACT Programmes of neonatal and paediatric transport allow tertiary hospitals to extend their action into the community so that patients benefit from specialized care that is usually only available after arrival at these centres. The retrieval of a patient is associated with risks and limitations that can be partly compensated if it is done by qualified personnel with specialized equipments adapted to the transport environment. In this paper the national and international context of interfacility transport of paediatric critically ill patients will be analysed. We will discuss the advantages and disadvantages of a specialized transport system, present different models of organization and suggest the development of an organized interfacility paediatric transport in the South of Portugal.