Promoção da qualidade dos cuidados de enfermagem à pessoa com enfarte agudo do miocárdio com elevação do segmento st em contexto extra-hospitalar

Abstract

Acute Myocardial Infarction is a medical emergency whose mortality is of major importance in Europe and in the World (INEM, 2019). Approximately two-thirds of deaths from acute coronary events occur in an out-of-hospital context, so early recognition and rapid institution of targeted therapy are essential in order to frankly reduce this statistic (INEM, 2019). INEM and the hemodynamics centers spread across mainland Portugal, constitute a regional referral network with different levels of technical differentiation responsible for the derivation of patients with STEMI to units capable of percutaneous or surgical coronary reperfusion therapies. Since STEMI is a pathological condition that confers emergent treatment, there is an urgent need for universal protocols between extra-hospital medical emergency services, emergency departments, interventional cardiology units and intensive care units that standardize the provision of assistance to the Critical Ill Person with STEMI in order to avoid delays in revascularization, with a direct impact on the patient's morbidity and mortality. In this way, this report serves as a product of an intrinsic reflection on the acquisition and development of multidimensional skills of specialized Nursing for the Critical Ill Person, with greater focus on the aspect of the person with Acute Myocardial Infarction with Elevation of the ST segment in an out-of-hospital context. In order to identify the “state of the art” on the subject, I mapped the aforementioned concept using a systematic review under the scoping review methodology. I performed two internships in different contexts: urgency and emergency in an extra-hospital context at INEM, providing care manning the Immediate Life Support ambulance and the Medical Emergency and Resuscitation Vehicle; and intensive, in the Cardiothoracic Surgery Intensive Care Unit. In all these contexts, I acquired knowledge and skills that allowed me to analyze the Person with STEMI in all types of revascularization treatment, as well as to develop Specialist Nurse skills through the promotion of the development of scientific knowledge in Nursing and the improvement of care delivery, from the out-of-hospital to the in-hospital, with the main focus on caring for people with STEMI.

Date of Award	8 May 2023
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Isabel Rabiais (Supervisor)