Desenvolvimento e aplicação de um dispositivo de avaliação de força em idosos criticamente enfermos

Abstract

Introduction: The aging process imposes changes in the body composition of individuals. One of the most striking features of this period is the gradual decline of muscle function, therefore it is necessary to perform a daily evaluation of the patient especially the neurocritic ones, as for pain, sedation and loss of muscular mass related to the decrease of the force, since are factors that will influence directly in its clinical condition and consequently in the time of permanence in the ICU. Goal: To test the applicability of an instrument created to evaluate muscular strength in critical noncooperative individuals. Methodology: This is an observational study that evaluated the feasibility, safety and reproducibility of a device created to evaluate muscle strength induced by electrostimulation in sedated patients. Three products were created: explanatory video with the RASS sedation scale, which aims to guide the team about the importance of daily assessment of sedation; Booklet with concepts and nursing diagnoses for pain, aiming to guide the nursing team about the importance of pain evaluation through the available scales; muscular strength evaluation board, aiming to evaluate the muscular strength of the neurocritical sedated patient. Results: In relation to plank the instrument is reproducible, reliable and safe for evaluation. 25 patients performed 2 sessions with 6 measurements with 2 evaluators, totaling 300 measures of NMES induced by NMES. The acceptable reliability was around 0.80, and in the reproducibility tests a maximum value of 0.90 was obtained, which shows the high reliability in the evaluations using the peak of evoked torque. Final considerations: Since today we are inserted into a patient safety context in order to provide fewer and fewer occurrences of care related adverse events, we observe that the assessment of muscular strength assists in this process in a very fundamental way, since the patient which is evaluated and has its diagnosis of mass loss and muscle strength, the intervention is immediate, through the performance of the multiprofessional team. At the end of this research, we will show to the health professionals, the importance of the daily evaluation of the patient hospitalized in ICU.