Characterization of obstetrical service attended by occurrences of Mobile Service of Urgency/Samu

Objectives: to characterize obstetric events attended by SAMU/Natal/RN; to know the reason to call to SAMU/Natal/RN; to identify the main complaints of users and behavior taken by health professionals. Methodology: documentary research, retrospective, transversal quantitative, using secondary data of Vehicle Bulletins and Modular Management System of Medical Regulation of SAMU/Natal/RN from November 2010 to April 2011. Results: there were 257 obstetrical attendance and the main complaints were: pain in lower abdomen (25%), vaginal bleeding (21%), uterine contractions (20%) and loss of amniotic fluid (13%). 34% of women were in labor, from them 45% presented broken amniotic sac. Most of the phone calls (60%) were from residence, 34% came from other healthcare institutions and the rest of public space. Conclusion: it becomes indispensable greater precaution in the organization of obstetric attention area, awareness of the population when the purpose of the SAMU avoiding congestion of lines and service fleets in situations considered noncritical. Descriptors: Obstetric Nursing; Nursing in Emergency; Pre-Hospital Assistance. RESUMO Objetivos: caracterizar ocorrências obstétricas atendidas pelo SAMU/Natal/RN; conhecer o motivo de acionamento SAMU/Natal/RN; identificar as principais queixas das usuárias e condutas tomadas pelos profissionais da saúde. Metodologia: pesquisa documental, retrospectiva, transversal quantitativa, usando dados secundários dos Boletins de Viatura e do Sistema de Gerenciamento Modular de Regulação Médica do SAMU/Natal/RN entre novembro de 2010 a abril de 2011. Resultados: ocorreram 257 atendimentos obstétricos e as principais queixas foram: dor em baixo ventre (25%), sangramento vaginal (21%), contrações uterinas (20%) e perda de líquido amniótico (13%); 34% das mulheres estavam em trabalho de parto, dessas 45% apresentaram bolsa rota. A maioria dos chamados (60%) surgiu das residências, 34% de outras instituições de saúde e os demais de vias públicas. Conclusão: torna-se indispensável maior precaução na organização da rede de atenção obstétrica, conscientização da população quando à finalidade do SAMU evitando congestionamento das linhas e frotas do serviço em situações consideradas como não críticas. Descritores: Enfermagem Obstétrica; Enfermagem em Emergência; Assistência Pré-Hospitalar. RESUMEN Objetivos: caracterizar ocurrencias obstétricas atendidas por SAMU/Natal/RN; conocer el motivo de acción a SAMU/Natal/RN; identificar las principales quejas de las usuarias y conductas tomadas por los profesionales de la salud. Metodología: investigación documental, retrospectiva, transversal cuantitativa, usando datos secundarios de los Boletines de Vehículos y del Sistema de Gerencia Modular de Regulación Médica del SAMU/Natal/RN entre noviembre de 2010 a abril de 2011. Resultados: ocurrieron 257 atendimientos obstétricos y las principales quejas fueron: dolor abajo del vientre (25%), sangrado vaginal (21%), contracciones uterinas (20%) y perdida de líquido amniótico (13%); 34% de las mujeres estaban en trabajo de parto, de esas 45% presentaron la bolsa rota. La mayoría de los llamados (60%) surgió de las residencias, 34% de otras instituciones de salud y los demás de vías públicas. Conclusión: se torna indispensable mayor precaución en la organización de la red de atención obstétrica, concientización de la población cuando a la finalidad del SAMU evitando congestionamiento de las líneas y flotas del servicio en situaciones consideradas como no críticas. Descriptores: Enfermería Obstétrica; Enfermería en Emergencia; Asistencia PreHospitalaria. Obstetric Nurse of the Maternity School Januário Cicco/UFRN and Maternity of Divino Amor in the municipality of Parnamirim/RN. Natal (RN), Brazil. Email: akdenfa@gmail.com; Nurse Master of the Liga Norteriograndense against cancer; Mobile service of urgency of Natal/SAMU/Natal. Natal (RN), Brazil. Email glaycelouyse@yahoo.com.br; Obstetric Nurse, Doctorate Professor, Federal University of Rio Grande do Norte/UFRN. Natal (RN), Brazil. Email: rejanemb@uol.com.br; Nurse, Master degree, Post-graduate Program Masters/Doctorate in Nursing, Nursing Department/UFRN. Natal (RN), Brazil. Email: hilderjanecarla@hotmail.com; Obstetric Nurse, Doctorate Professor, Nursing School of Natal/UFRN. Natal (RN), Brazil. Email: jovanka@ufrnet.br ORIGINAL ARTICLE Dantas AKC, Carvalho JBL de, Castro GLT et al. Characterization of obstetrical service attended... English/Portuguese J Nurs UFPE on line., Recife, 7(spe):6156-61, Oct., 2013 6157 DOI: 10.5205/reuol.4397-36888-6-ED.0710esp201313 ISSN: 1981-8963 In 2000, the United Nations (UN) established eight Millennium goals-ODM, which in Brazil are called "Eight ways to change the world". Among them, the 5th step refers to the improvement of the health of pregnant women, because in Brazil the index of maternal mortality corresponds to 2.6 per 1,000 cases. Among the main causes of such a framework is the lack of preparation of the mothers for self-care during pregnancy, malnutrition and inadequate medical assistance, especially with regard to complications of pregnancy, which can lead to the need for urgent or emergency care. According to the Ministry of Health (MS), the States and municipalities shall have a health area organized towards qualified attention to pregnant women, whereas ensuring linkage between units providing prenatal care and maternity/hospitals, as well as transfer of pregnant until a unit that has vague ensured, through the Emergency Mobile Service (SAMU), salvage and rescue service associated, under medical control. This consists of pre-hospital assistance mobile, i.e. held in homes, workplaces and public space, having as its main focus the attendance in urgent/emergency situations. 3 The SAMU was implanted in Brazil from September 2003, expanding rapidly and providing coverage to 47% of the Brazilian population in an average of 84 million individuals in 784 cities until the year 2006. According to MS, the SAMU answers by the telefone192 in 24 hours a day, traumatic nature emergency, clinic, surgical, gestational and obstetric, Pediatric, neonatal and mental health, engaging specially trained teams. In the field of regulation of the municipality, doctors, having as a base, protocols, assess each case clarifying the user, when possible, the best action to be taken, send basic or advanced support units, fire firefighters and civil defense or emergency referral hospital. 5 The attendances within pre-hospital, in cases of urgency, aimed at reducing the number of deaths due to therapeutic delay; reduction in the number of users with sequels caused by late, partial attendance and/or inappropriate; increased availability of resources for the individual; guidelines for use of other means than those hospital emergencies; optimization of the use of ambulatory and hospital ambulances (Basic); availability of qualified staff and Intensive Care Unit (ICU) furniture for the correct serious users transport between hospitals. In pre-hospital attendance there are two types of assistance: Basic Life Support (BLS) in which are carried out by invasive procedures and Advanced Life Support (ALS) which takes place by invasive practices of maintaining circulatory and ventilatory support in cases of greater severity and complexity, functioning as mobile ICU. National Policy Attention to the Urgency (NPAU), in its Ordinance GM no 1,863 of September 29, 2003, focuses on, besides the pre-hospital emergency mobile component, the pre-hospital component fixed, which must be by Basic Health Attention (BHA). 3 One of the justifications and considerations for the institution of NPAU, the Ordinance GM no 1,863 of September 29, 2003 mentions that it is the responsibility of the MS stimulate integral attention to the urgency through the deployment and implementation of primary health care services and family health, nonhospital units to emergency care, hospital doors mobile emergency medical attention to the emergency room, home care services and integral rehabilitation in the country. SAMU organization happens for central system of regulation, given that the Central Regulating medical (CRM) is responsible for the calls and occurrences. This power Central has as basis knowledge of available resources on screening and sorting of priorities, decision-making for streamlining existing resources and in a differentiated manner and individualized to each call, according to the need, while respecting the principle of equality of the Unique Health System (SUS). It is known that the implementation process of the SAMU is the planning of the needs of the population, with the valued resources to facilitate these needs. The critical assessment of policies of job, sickness and practitioner skills on them entered, includes, among other activities, continuing education programs and the preparation of this beneficial service. In order to reduce the number of deaths or sequel arising to the therapeutic delay PreHospital Mobile Attendance (PHMA) emerged as an important advance in the area of health. When triggered via toll-free number 192, the CRM enables tiering and regionalization of services, reduce slowdowns in attendance and capacity of hospitals, being among its instances obstetric cases. It is known that the calls by external causes are currently public health problem with universal dimension to the confrontation and development of public policies. In Brazil, the MS has a data of Mortality Information System (MIS), Hospital INTRODUCTION Dantas AKC, Carvalho JBL de, Castro GLT et al. Characterization of obstetrical service attended... English/Portuguese J Nurs UFPE on line., Recife, 7(spe):6156-61, Oct., 2013 6158 DOI: 10.5205/reuol.4397-36888-6-ED.0710esp201313 ISSN: 1981-8963 Information System of SUS (SIH/SUS) for monitoring of the external causes and, from 2006, with data from the Surveillance System of Violence and Accidents (SSVA) made up of two components