PAD Launch Day - Yoanna Skrobik

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Prsentation PowerPointThe ICU challenge translating the evidence into everyday practice: managing Pain, Agitation and DeliriumYoanna Skrobik MD FRCP(c) MSc.11Conflicts of interestMember, SCCM Pain, Agitation and Delirium guidelines writing committeeVice-chair, SCCM Pain, Agitation, Delirium, Early Mobility and Sleep guidelinesMember, SCCM family-centered care guideline writing committeeInvestigator initiated research funding, HospiraAcademic chair, Universit de Montral22Academic chairAstellasMerckPfizerBaxterHospiraOtsukaNovartisLillyWhy would you evaluate pain, agitation, delirium?PainlessnessReassuranceFeeling safe Journal of Nursing Scholarship. 32(4):361-7, 2000 Information, orientation, cognitive abnormalities American Journal of Critical Care. 9(3):192-8, 2000 MayplanPain assessment and managementSedation and level of consciousness alterations in the ICUDeliriumAdding mobility and sleepWhy assessing pain, sedation and delirium mattersWhy are we not all doing itpain6painIncidence of pain:Adult M&S ICU patients consistently experience pain, at rest and with routine ICU care (mobilization, suctioning).Pain in adult cardiac surgery patients, especially women, (i.e., incisional pain due to coughing, respiratory care procedures, and mobilization) remains prevalent and poorly treated .Procedural pain is common in adult ICU patients .7Memories and perceptions in ICU survivors: a multidimensional questionnaire G Hernandez, R de la Fuente, C Romero, ME Naranjo, M Zanolli, N Barticevic, L Castillo, G Bugedo Thirst (76%), sleep deprivation (66%) and isolated pain (52%) predominated in factual memories8Pain assessmentShould be routine, right?9Evaluation of pain in my ICUEven though assessment was done 90% of the timeNo severity scale used in 17% of patients Evaluations were not done according to the pain reported by the patient when scales were used 20% of the time Correlation between gold standard adjudicators and nurses was excellent R= 1,000 (0,88 when using all evaluations)Obstacles to the use of the NRS: Assumption that the patient has no painNurses relying on their own evaluation of the patients pain10painRoutine pain assessments in adult ICU patients are associated with improved clinical outcomes. 11Assessing Pain Improves OutcomesPayen JF, et al. Anesthesiology. 2009;111:1308-1316.Outcome Day 2 Pain Assessment?Unadj. ORP-valueAdjusted ORP-valueNoYesICU Mortality22%19%0.910.691.060.71ICU LOS18 d13 d1.70< 0.011.430.04MV duration11 d8 d1.87< 0.011.400.05Vent-acquired pneumonia 24%16%0.61< 0.010.750.211212Correlation between pain assessments and analgesic administration in critical careLess patients evaluated and more treated with analgesics without protocolPain evaluation done routinely in 21% units surveyed in 20060255010075Patients (%)ProtocolNo Protocol**AssessedTreated1. Payen JF, et al. Anesthesiol. 2007;106:687-695.2. Martin J, et al. Crit Care. 2007;11:R124. * P < 0.01 vs. ICUs using a protocol13Measuring painSelf-reporting of pain remains the gold standard 14Patient-directed pain control. Patient assessment16And this is what it looks likeAnd in the patient unable to self-report18Keep in mindRoutine pain assessments in adult ICU patients are associated with improved clinical outcomes. Self-reporting of pain remains the gold standard. For medical, postoperative or trauma adult ICU patients unable to self-report, the BPS and CCPOT (French/ English) pain scales are considered to be the most valid and reliable. vital signs (or observational pain scales that include vital signs) are unreliable in pain assessment in adult ICU patients.19Pain assessment valueCompliance and documentation of pain assessments Impact of pain assessment on analgesic and other medications Impact of pain assessment on level of pain Impact of pain assessment on duration of mechanical ventilation Impact of pain assessment on occurrence of adverse events and complications Impact of pain assessment on patient satisfaction Impact of pain assessment on ICU length of stay (LOS) Impact of pain assessment on mortality sedation21sedationNo textMonitoring sedationThe RASS and SAS scales are valid and reliable for measuring quality and depth of sedation in adult ICU patients .23Sedation-Agitation Scale (SAS)Riker RR, et al. Crit Care Med. 1999;27:1325-1329.Brandl K, et al. Pharmacotherapy. 2001;21:431-436.Score StateBehaviors7Dangerous AgitationPulling at ET tube, climbing over bedrail, striking at staff, thrashing side-to-side6Very AgitatedDoes not calm despite frequent verbal reminding, requires physical restraints5AgitatedAnxious or mildly agitated, attempting to sit up, calms down to verbal instructions4Calm and CooperativeCalm, awakens easily, follows commands3SedatedDifficult to arouse, awakens to verbal stimuli or gentle shaking but drifts off2Very SedatedArouses to physical stimuli but does not communicate or follow commands1UnarousableMinimal or no response to noxious stimuli, does not communicate or follow commands2424Richmond Agitation Sedation Scale (RASS)ScoreState+ 4Combative+ 3Very agitated+ 2Agitated+ 1Restless0Alert and calm-1Drowsyeye contact > 10 sec-2Light sedationeye contact < 10 sec-3Moderate sedationno eye contact-4Deep sedationphysical stimulation-5Unarousableno response even with physicalVerbal StimulusPhysical Stimulus25sedationDepth of sedation vs. clinical outcomes:Maintaining lighter levels of sedation in adult ICU patients is associated improved clinical outcomes ( duration of mechanical ventilation and length of stay).Maintaining lighter sedation levels increases physiologic stress response, but not incidence of myocardial ischemia .The relationship between depth of sedation and psychological stress in these patients is unclear .sedative medications titrated to maintain light (vs. deep) levels of sedation in adult ICU patients are associated with better outcomes .26consciousnessAlteration of consciousness and outcomeComa is bad for youIn my ICU the baseline RASS is -0.4wake up and breatheWhy is it that when an ICU caregiver digs himself into a hole he talks about the light at the end of the tunnel?Who benefits the most?adjustment vs. interruptionOutcomes related to sedationsedation strategies using non-benzodiazepine sedatives have better outcomes than benzodiazepine infusions in mechanically ventilated adult ICU patients.analgesia should be evaluated prior to sedation in adult ICU patients who are mechanically ventilated .38deliriumVan der Mast. PhD Thesis, Delirium After Cardiac Surgery, Erasmus University, Rotterdam, 199439Delirium and outcomesDelirium is strongly associated with increased mortality and LOS in adult ICU patients.4041delirium and distressBreitbart W et al. Psychosomatics 2002;43:18342CAM-ICU(Confusion Assessment Method-ICU) Delirium scales ICDSC(Intensive Care Delirium Screening Checklist)http://www.icudelirium.co.uk/www.icudelirium.org43Delirium nomenclatureDelirium and its consequences44Delirium preventionearly mobilization of adult ICU patients reduces the incidence and duration of delirium.45Protocol to address patient views on what is important in the ICUPainlessnessReassuranceFeeling safe Journal of Nursing Scholarship. 32(4):361-7, 2000 Information, orientation, cognitive abnormalities American Journal of Critical Care. 9(3):192-8, 2000 May4647Analgesia Sedation Delirium ProtocolANALGESIASubjective Pain Scale Short acting narcotics SEDATIONSubjective Sedation Scale (ex RASS)Avoidance of oversedation and caution with benzodiazepinesDELIRUMSubjective Delirium Scale (ICDSC or CAM-ICU)AgitationBeforeAfterGoing home45.2%52.2%P=0.024Patient-driven analgesia, sedation and delirium management in 1200 patients50Delirium symptomsSpecifically, level of consciousnesswakefulnessDoes it influence delirium assessment?CAM-ICU(Confusion Assessment Method-ICU) Delirium scales ICDSC(Intensive Care Delirium Screening Checklist)http://www.icudelirium.co.uk/www.icudelirium.org5353Assessment of Delirium Relative to Daily Sedative InterruptionJT Poston MD, MW Sjoding MD, AS Pohlman RN MSN, BK Gehlbach MD, JB Hall MD, JP Kress MDDaily Assessment Schematic DiagramCAM-ICURASS4-VCACAM-ICU4-VCADaily Sedative Interruptionif 2 VC, repeat in 15 minutesif 3 VC or 2 hours after DSI start 30 minutes after DSI startDaily AssessmentSecond Assessment after DSIRASSDaily Assessment Schematic DiagramCAM-ICURASS4-VCACAM-ICU4-VCADaily Sedative Interruptionif 2 VC, repeat in 15 minutesif 3 VC or 2 hours after DSI start 30 minutes after DSI startDaily AssessmentSecond Assessment after DSIRASSAssessment of Delirium Relative to Daily Sedative InterruptionJT Poston MD, MW Sjoding MD, AS Pohlman RN MSN, BK Gehlbach MD, JB Hall MD, JP Kress MD48%higher delirium identification during sedation administration when compared to assessments made in the same patients after sedation was lightened to the point of wakefulness. This difference persisted for analysis of MV days, ICU days, and total hospital days wakefulnessDelirium assessment is sensitive to the timing of evaluation relative to sedative/analgesic infusion and interruption This robust effect can significantly impact assessed days of delirium well beyond the administration of sedatives/analgesics ImplicationsA standardized assessment accounting for sedatives/analgesics and daily interruption should be part of future investigationsDelirium due solely to sedative/analgesic infusion may portend a different prognosis than delirium that persists in its absenceAwake patients meanPain can be assessedSedation is adjustedDelirium is minimizedMobility can be implementedSleep can be optimizedHow can optimal patient care be provided?a multidisciplinary ICU team approach, that includes provider education, preprinted and/or computerized sedation protocols and order forms, and a quality rounds checklist, can be used to facilitate analgesia, sedation and delirium management in adult ICUs...58But we all know. it takes an average of 17 years for new knowledge to have an impact on bedside standards of practicechangeCanadian collaborativeMeasuring and implemening changeChampionsRealistic plan and follow throughObjective measuresalternativesWeb-based teachingWeb-based benchmark comparisonsEngaging staffEngaging patients and familiesEngaging staffEngaging patients:Mrs Ms taking stickrecapPain assessment and managementSedation and level of consciousness alterations in the ICUDeliriumAdding mobility and sleepWhy combining pain, sedation and delirium mattersWhy are we not all doing itMaking patient care better71Thank youGrfico347.828.5194.71515106025403053814.29.514.5neverfewmostalwayssensorial memories%Tabla ResultadosS1S2S3S4S5S6S7S8S9S10S11S12S13S14C1C2C3C4C5C6C7C8C9C10C11C12C13C14C15C16C17D1D2D3D4D5D6D7D8D9D10D11D12D13D14D15D16D17D18D19D20D21D22D23D24D25P1P2P3P4P5P6F1F2F3F4F5F6F7R1R2n4241424242424242424242424242424242424242424242414242424242424242424242424240404040403942424241414142404242424242414141414141424240423940SI14%7%7%10%5%14%31%26%29%2%38%38%38%12%45%31%36%40%19%26%74%81%54%31%10%29%17%38%60%33%5%36%14%12%35%10%10%12%56%44%39%57%57%33%40%24%46%41%12%22%29%62%40%23%NO74%78%79%76%81%71%55%60%60%81%48%48%48%74%40%57%52%48%69%62%10%5%22%45%74%57%69%48%26%52%79%50%71%74%28%71%74%71%27%39%44%29%29%50%45%56%34%39%68%59%51%36%57%70%Siempre43%5%38%5%3%5%18%10%75%La mayora17%10%5%0%0%18%18%10%Ocasionalmente10%24%18%3%8%25%5%7%Nunca0%48%25%78%75%38%10%29%5%no poda expresarlas5%no los expreso12%Agrado5%Desagrado17%No siente dolor23%33%Ritmo normal10%Rpido13%Lento25%Muy lento38%Ruido0%Luces3%Posicin8%Angustia3%Dolor0%Otra13%poda dormir35%Depende18%Ms optimista43%Igual que siempre48%Ms pesimista7%No Recuerda12%15%14%14%14%14%14%14%12%17%14%14%14%14%14%12%12%12%12%12%17%14%14%24%24%17%14%14%14%14%14%14%14%17%14%14%14%15%15%15%15%15%15%19%17%17%17%17%17%14%15%14%17%17%14%45%20%20%20%20%20%20%2%2%3%2%3%8%total100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%14%100%100%100%100%100%100%100%100%121%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%100%77%100%100%100%100%100%100%100%100%100%100%100%100%100%Paso del tiempocambio visin del mundocambio visin de Diosmundo post UTITotalNNombreApellido1Apellido2RUTSexoEdadDireccinTelfono1Telefono2F. IngresoF. EgresoD. UTID. HosptIngresoMotivo ingresoDiagnsticoPatologa Cr. AgragadaD. VMMotivo VMFalla desteteDVA1DVA1 dosisDVA2DVA2 dosisDVA3DVA3 dosisSedacinD. sedacinAPACHESOFAPa/FibilirrubinPlaquetasCrat plGlascowPCRLactatoCostosComentariosFecha entEntrevistadorLugar entComentario entS1S2S3S4S5S6S7S8S9S10S11S12S13S14C1C2C3C4C5C6C7C8C9C10C11C12C13C14C15C16C17D1D2D3D4D5D6D7D8D9D10D11D12D13D14D15D16D17D18D19D20D21D22D23D24D25P1P2P3P4P5P6F1F2F3F4F5F6F7R1R21EnriqueDelgeonManieu3869242-9161San Pascual 49002-22888649874810108/11/0213/11/02611A, 1By pass gstricoObesidad mrbidaHTA, DM4220000001, 23941551.11590001.6315211.95215787InternetinternetNada222222222222221112221112222210202122422211110117222222222221La verdad es que estuve 3 das dormido o casi, de tal modo que no recuerdo mucho y los dolores que seguramente tuve por la operacin no los sent. Dira que lo ms desagradable de todo fue la sed de lquido tanto de da como de noche. Respecto a la conex2GerardoVillablanca8069346-k143Los Olmos 2568, la pintana, RM02-852124902/12/0217/01/032345A,2Shock spticoSepsis origen abdominal. Falla orgnica mltipleHTA95210.242.50038117710.4630007.1810.8122391439310/01/03G.H, R.F2Nada222221221222121211111111212212120222100102422211112223182112222201102Angustia3DarioVillalon5508385-1157Paradero7 pajaritos altura 1900, RM02-741314730/10/0203/12/0250612, BSDRASDRA post revascularizacin IAM masivoHTA, DM, ACxFA, valvulopata mitral y tricuspidea, enf coronaria 3 vasos261, 4244.200001, 219213265.66340001.731317.51.33694884101/04/03G.H1Muy cristiano y con fe22222212221112212222113, 41122221120222210012422211122223282122222201102NecesariaExperiencia necesaria4VictoriaAlvaradoBarrientos4954635-k263San Martn 745, Castro065-6324429774403809/05/0217/07/0238602, AShock spticoPeritonitis, LNHEsplenectoma, DHCr, TVP vena porta, coleccin abdominal21521000001, 2212772002.11550001.541518.87.73133278516/07/02G.H, R.F2Nada122212221112122222211151221212511222200012012111221188131122122221102Buena atencin, pensar en morir lejos de su casaSensacin de atencin ptima, UTI es initimisante, no tener claro los lmites5MariaFuentesCanales7817728-4240El retorno 2304, las condes, RM02-214310109/06/0204/05/0219191, APeritonitisBy pass gastrco, filtracin anastomosisObesidad mrbida, HTA, hipotiroidea, T. Bipolar123210.0500001, 2101252501, 213700001.021524.61.42113506327/08/02G.H1Nada222222212222121222221138822221021222200002222212113121, 4202222221100102Ruidos en la noche6JoseChandiaContreras4507483-1162Alejandro Fleming 8922, las condes RM02-224501530/06/0209/07/02838A, 2Shock spticoFasceitis necrotizante, DM descompensadaDM55210.47930.04742.21, 24116318111460001.451541.32.3952441413/08/02G.H1Nada121121112211112222211131222221111112230011222211122121, 2, 3, 4, 5101112111100102AgradecidoTraumtico.7JorgeInfanteLecannelier4094202-5165Martin de Zamora 6611, dpto 2003, RM951133504/07/0211/07/027192,AShock spticoCa prstatalcera dudodenal55210.07141.872001, 2622121703.371120002.515304.8842857016/08/02G.H2Recuerda poco de UTI, casi nada222222222212122222221152212111020222230024422222213121, 4182112221100101Ahora piensa que debe cuidarse ms. Agradecido de la medicinaLa familia qued muy agradecida y ya no ve la UTI como una experiencia desastrosa8MaraOlgunGonzalez14170-4270Santo domingo 5090, quinta normal, RM02-357916307/07/0215/07/028121Cx cadera izqFractura cadera izq, cx reemplazoHTA, cardiopata32210.292643.51, 2218113206.451020001.141514.71.1587987306/09/02G.H1Nada222222222222222122221152222221120222230012322222210117212222222211102BuenoSe acuerda poco, pero la ayudo a mejorarseFue muy impactante incertidumbre por muerte de la mam. Molestia por no mayor acceso a familia. UTI buena tecnologica y medicamentos, pero con problemas de comunicacin9SebastinComasAliste14144766-1121Dos sur 7440, parque tobalaba, pealolen, RM02-279007919/07/0229/07/0210332PolitraumatizadoShock hipovolmico, trax volante, trauma abdominalNo6620000001, 2613102148.5640001.281527.31.31587803625/11/02G.H1Nada11222221121122121122111, 3, 41221211012212130011222221213122, 3, 4, 513212222120110210ClaudiaCalvoAbarca829127-3232Eliseo 124 Maip, RM02-53564389254682111/08/0216/08/02610AShock spticoPeritonitis por abceso hepatoduodenalHernia diafragmtica45210.16930.033001, 24953074140000.81516.53.3451634402/12/02G.H1Nada22222222222222222212112, 3, 41221122220222230002322211123117102222222212101Temerosa, experiencia desagradable, se le haban olvidado cosas11IdaAguilarUribe16459042-1254Leuhul 25, poblacin iansa, Curic075-3165019774685526/08/0216/09/028212DisneaInsuficiencia respiratoria, Ac resp, Alk metObesidad mrbida, HTA, dislipidemia41, 6200000014113871.02150.71.5834228826/11/02G.H2Nada22222222222222121221112, 3, 411222110212221300012222112101261122222212002Alegre de haber recibido ayudaAgradecida de la experienciaSe mostr tranquilo porque haba pasado por uti de hospital pblico. La comunicacin mdico fue buena.12LuisBustamanteSanchez7308786-4148Carrera 337, Cauquenes, VII regin073-5116069716578605/09/0207/09/0239AIleo mecnicoileo por bridas, reseccin intestinal hernia diafragmticaHernia diafragmtica, DM32210.0341.6001, 231472100.73670001.3815184516542210/12/02G.H2Nada22222212222222111222223112121121, B3212130021122211113123, 4, 5212112121200102DesagradableCree que la tecnologa lo ayudo a recuperarse. Sensacin agradable al despertar se sinti feliz por estar vivo. Hay poco contacto humano. El personal rota muchoLe pedira a la gente que se detuviera un ratito a conversar13TeresaIturriagaCarlvie4362121-1265San Jose de la Estrella 2273, la florida, P 22, RM3112327311233007/09/0218/09/021246A,2Colitis isqumicaperitonitis estercorcea, perforacin colnica, hartmannNo82210.05600001, 262830.61230001.221526.62.81540929022/11/02G.H1Nada22222212222222121221213, 4112121102121123002132221111211718221221221110114PilarCaneoMuoz14282506-62271 norte 882, placilla. Peuelas93207035032-29101513/11/0228/11/0216481Sepsis abdominalPeritonitis, by pass gstricoObesidad mrbida62210.06700001, 2, 36136172.53440001.161540.91.22130846127/01/03G.H2Nada11112121122122222111111, 4112111111, B2212130031222211113123, 410211122120210215CustodioBravo4046407-7173Briones Luco 6453, psje1, gran avenida P18, RM02-31039029918447908/01/0310/02/0334582 BHDAIsquemia intestinallcera duodenal, vasculitis, prpura, IRA, colecistectoma85210.0626.25001, 2716103721200003.61315.10.63815593303/04/03G.H1Se dio cuenta que mucha gente lo quera22222212121112122112111, 2, 3, 4122222102022221002242221121212620Paso con ventilacin1101102La UTI es lo mejor en hospital. Buena atencinVen la UTI como un lugar ms fro. Siente que es el lugar que salvaron a su pap. Buena acogida16GloriaNaveaDaz4711092-0257Parina 9440, lo caas, Pealolen, RM02-37733029237786319/01/0303/02/0316262 BSDRAShock sptico, TEPHTA, obesidad mrbida, crisis pnico7421, 26141390001.581313.15.81433581703/04/03G.H1Nada22112122221111121111111,2,3,4112222201, B2212230001322212212121.3232122122201102Lo ve como un lugar imprescindible y necesario. Se sinti segura17MargaritaUribeSantibaez6113017-k250Primavera sur 220, villa Eusebio Lillo, Isla de Maipo02-819338824/01/0331/01/038372, BHDAHDA, sepsis foco urinario, IRADM, hipotiroidismo56225.743.7001, 251710225640005.531319.53.81667239201/04/03G.H2Nada12222111221121222222111,2,3,42221212521222230011222211123217102212221112102Un lugar que lo ayudo a salvarseFue una experiencia traumtica fuerte, pero lo ven como un lugar de salvacin. Sienten que fueron super bien informados18Ana MaraRojas6979555-k248El rodeo 13497, La Dehesa02-216263706/02/0314/02/039212, AHSAAneurisma ACMd (op: clipaje)No62210.4454,8 x 10 -460S517102601390000.681.31243094301/04/03G.H1Nada22222222222112212211221, 48121121220212220022422212123223282112221210101Agradecidos del guardia, por que los dejaba entrar19RubenTroncosoRuiz5390917-5157Pasaje canl 1442, Villa Sol. Pudahuel02-645135707/02/0328/02/0322222, BIRAg, SIRSTumor pulmonarInsuf renal404210.2800001.2412110104.43870001.61218.54.75098304723/07/03GH2Nada2222221221122222222111, 4222221111, B222223301131112223224121112111100102DanizaRojeBustamante5115487-8262Desierto de atacama 2819. Puente alto02-289993714/02/0312/04/0354572, ASDRA, Ins respiratoriaBy pass aorto femoralHTA, EPOC, arteroesclerosis274110.1542.11001, 2, 317176240.931234585R.FNada22222212222221222122111, 2, 3, 412221110101212200143211111211710111222110012AmorDonde ms segura me sent, cmoda, protegida, me sent amada en la UTI21SandraPlazaNorambuena9884279-9234San Jose 714. Curic79-3172469219472927/08/0310/09/0314222, BSDRAHSA, poloneuropata del pacinete agudo, neumonia aspirativaNo131210.21800002, 352022160.232370001.148222109845509/10/03R.F2Nada22222221121222122122112121121261, B0222210021321121222121, 2, 410112121110082Problemas para dormir por todo proceso. Sueos con intervenciones, pesadillas.Sensacin no chocante. Adecuado trata preocupacin6.6225371336178.99.01929149372.5221243251No entiendo letra1: Electivo1: Neumonia1: s0: nada0: nada0: nada1: MidazolamDasN: no registra1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: Mdico1: S1: S1: S1: S1: S1: S1: S0: Siempre1: S0: Nunca1: S1: S1: S1: S0: Nunca0: Nunca0: Nunca0: Nunca1: S0: Nunca1: S1: S1: S1: S1: S1: S1: S0: Ritmo normal1: S1: S1: Ruido1: S0: Nunca1: S1: S1: S1: S1: S1: S1: S1: S0: Siempre0: Ms optimistaDe 1 a 101: SPalabraNo hay dato2: Urgencia2: postoperado2: no1: Noradrenalina1: Noradrenalina1: Noradrenalina2: MorfinaNo entiendo letra2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: Enfermera2: No2: No2: No2: No2: No2: No2: No1: La mayora2: No1: Ocasionalmente2: No2: No2: No2: No1: Ocasionalmente1: Ocasionalmente1: Ocasionalmente1: Ocasionalmente2: No1: Ocasionalmente2: No2: No2: No2: No2: No2: No2: No1: Rpido2: No2: No2: Luces2: No1: Ocasionalmente2: No2: No2: No2: No2: No2: No2: No2: No1: Depende1: Igual que siempreNs2: NoNuevoA: Quirrgico3: sepsis2: Dopamina2: Dopamina2: Dopamina3: PropofolNo hay dato3: Paramdico8: no recuerda8: no recuerda2: OcasionalmenteA: Agrado2: Ms de 2/da2: La mayora2: La mayora2: La mayora2: La mayora2: La mayora2: Lento3: Posicin2: La mayora2: Nunca2: Ms pesimistans:no stresB: mdico4: SDRA3: Adrenalina3: Adrenalina3: AdrenalinaS: SensacionesC: Comunicacin4: Kinesilogo4: NuncaB: Desagrado3: Permanentemente3: Siempre3: Siempre3: Siempre3: Siempre3: Siempre3: Muy lento4: Angustia3: Siempre17.666666666732.142857142910.57142857145: Shock4: Dobutamina4: Dobutamina4: Dobutamina17103.12857142865: No distingua5: no poda expresarlas4: No sinti dolor4: No sinti dolor5: DolorP: PiezaF: aspectos finalesDS14.585380808617.71802955836: otra5: fenilefrina5: fenilefrina6: no los expresoD: dimensin corporal6: Otra6: nimotop7: poda dormir8: no recuerda8: no recuerda8: no recuerda%%1: 42,8%51.857142857109/06/0217,1 das19% SDRA10,6 das5% falla destete65% uso Nadrenalina100% uso sedacin9 das15,3 apache7,5 sofa231213000 pl1.6813.620.72.418948130.4285714S 23,8S 10S 14,2S 14,2S 4,7S 23,8S 33,3S 33,3S 28,5S 4,7S 47,6S 42,8S 42,8S 19S 47,6S 23,8S 33,3S 33,3S 28,5S 38S 85,8S 90,5% M 47,620% SI 33,3S 85,8S 42,8S 23,8S 57,2S 71,5% S 42,8SI 42,8N 47,8S 9,5S 38S 9,5S 23,82020202020N 4,7S 9,5S 14,2S 1920S 71,5S 57,2S 57,220S 76,2S 28,5R 23,8S 62N 38202020202020S 55,6S 27,8S 61,1MO 33,320202: 57,2%27/08/0323,8% Shock sptico80% uso DVA85% uso mid, morfN 76,2N 90N 85,8N 85,8N 95,3N 76,2N 66,7N 66,7N 71,5N 95,3N 52,4N 57,2N 57,2N 81N 52,4N 76,2N 66,7N 66,7N 71,5N 62N 14,2N 9,5% E 33,3% SI 70% NO 62N 14,2N 57,2N 76,2N 42,8N 28,5% LM 28,5NO 57,2O 28,5N 90,5N 62N 90,5N 76,2N 15N 95N 95N 25S 50O 4,7N 90,5N 85,8N 81SN 28,5N 42.8N 42,8RNN 23,8N 66,8L 14,2N 38O 14,2S 25S 65S 50S 10S 25S 20N 44,4N 72,2D 27,8IS 5085% maxS 2050% uso 2 DVA% PM 57,2% NO 20% NR 4,7% O 14,555% DESAGM 19O 15S 5OO 40N 40LM 28,6NRNR 4,7P 38LM 9,5N 75N 35N 50N 90N 75N 80N 11,1MP 16,7N 8015% uso 3 DVA% K 57,2% NR 10% N 0P 4,7LM 10LM 30NSD 10S 33,4LA 38S 14,5S 60S 5NSD 28,6MLNR 23,8% NPE 9,5% NLE 4,71: Masculino2: FemeninoEn aosGH: Glenn HernandezRF: Rene de la Fuente1: casa2: UCPaso del tiempocambio visin del mundocambio visin de Diosmundo post UTIamarrado4,2 gr/kg/min1000 mg/250cc a11 cc/hrMargotquinto intermedioolor a anestesia???hermana JeannetteFractura cadera izquierdaInsuficiencia respiratoria aguda, trax volanteHija: Carolina MundacaInsuficiencia respiratoriaBIPAPSra, Bernardita SalazarHartmann??Hja, Carmen BravoAspiracinClipajeAgrega: "mantiene VM por sedacin ?"dice 100 de 10/500 u en peso 69No dice cual"mal trato de auxiliares"No recuerda0,15 mcg/kg/min2,11 mcg/kg/min1, 2: 16 das3: 1 daTraslado de otro hospitalNO recuerdaEpicrisisNNombreApellido1Apellido2RUTSexoEdadDireccinTelfono1Telefono2F. IngresoF. EgresoD. UTID. HosptIngresoMotivo ingresoDiagnsticoPatologa Cr. AgragadaD. VMMotivo VMFalla desteteDVA1DVA1 dosisDVA2DVA2 dosisDVA3DVA3 dosisSedacinD. sedacinAPACHESOFAPa/FiRblancosPlaquetasCrat plGlascowPCRLactatoCostos1EnriqueDelgeonManieu161San Pascual 49002-22888649874810108/11/0213/11/0269ABy pass gstricoObesidad mrbidaHTA, DM4220000001, 23941551590001.6315211.92GerardoVillablanca8069346-k143Los Olmos 2568, la pintana, RM02-852124902/12/0245AShock spticoSepsis origen abdominal. Falla orgnica mltipleHTA5215410003DarioVillalon5508385-1157Paradero7 pajaritos altura 1900, RM02-741314730/10/0203/12/0250612SDRASDRA post revascularizacin IAM masivoHTA, DM, ACxFA, valvulopata mitral y tricuspidea, enf coronaria 3 vasos261, 4244.200001, 219213265.6120006340001.731317.51.3369488414VictoriaAlvaradoBarrientos4954635-k263San Martn 745, Castro065-63244297744038382Shock spticoPeritonitis, LNHEsplenectoma, DHCr, TVP vena porta, coleccin abdominal21520000001, 2215MariaFuentesCanales7817728-4240El retorno 2304, las condes, RM02-214310109/06/0204/05/02191, APeritonitisBy pass gastrco, filtracin anastomosisObesidad mrbida, HTA, hipotiroidea, T. Bipolar123, 6210.0500001, 2101252501, 213700001.021524.61.46JoseChandiaContreras4507483-1162Alejandro Fleming 8922, las condes RM02-224501530/06/0209/07/02841AShock spticoFasceitis necrotizante, DM descompensadaDM55210.47930.04742.21, 24116318111460001.451541.32.395244147JorgeInfanteLecannelier4094202-5165Martin de Zamora 6611, dpto 2003, RM951133504/07/0211/07/027192Shock spticoCa prstatalcera dudodenal55210.07141.872001, 2622121703.371120002.515304.884285708MaraOlgunGonzalez14170-4270Santo domingo 5090, quinta normal, RM02-357916307/07/0215/07/0281Cx cadera izqFractura cadera izq, cx reemplazoHTA, cardiopata32210.292643.51, 2218113206.451020001.141514.71.19SebastinComasAliste14144766-1121Dos sur 7440, parque tobalaba, pealolen, RM02-279007919/07/0229/07/02102PolitraumatizadoShock hipovolmico, trax volante, trauma abdominalNo6620000001, 2613102148.5640001.281527.31.310ClaudiaCalvoAbarca829127-3232Eliseo 124 Maip, RM02-53564389254682111/08/0216/08/02610AShock spticoPeritonitis por abceso hepatoduodenalHernia diafragmtica45210.16930.033001, 24953074140000.81516.53.311IdaAguilarUribe16459042-1254Leuhul 25, poblacin iansa, Curic075-3165019774685526/08/0216/09/0222DisneaInsuficiencia respiratoria, Ac resp, Alk metObesidad mrbida, HTA, dislipidemia41, 6200000014113871.02151.512LuisBustamanteSanchez7308786-4148Carrera 337, Cauquenes, VII regin073-5116069716578605/09/0207/09/023AIleo mecnicoileo por bridas, reseccin intestinal hernia diafragmticaHernia diafragmtica, DM32210.0341.6001, 232100.73670001.3815413TeresaIturriagaCarlvie4362121-12San Jose de la Estrella 2273, la florida, P 22, RM3112327311233007/09/0218/09/0212AColitis isqumicaperitonitis estercorcea, perforacin colnica, hartmannNo82210.05600001, 262830.61230001.221526.62.814PilarCaneoMuoz14282506-62271 norte 882, placilla. Peuelas93207035032-29101513/11/0228/11/0216481Sepsis abdominalPeritonitis, by pass gstricoObesidad mrbida62210.06700001, 2, 36136172.53440001.161540.91.22130846115CustodioBravo4046407-7173Briones Luco 6453, psje1, gran avenida P18, RM02-31039029918447908/01/0310/02/0334582 BHDAIsquemia intestinallcera duodenal, vasculitis, prpura, IRA, colecistectoma85210.0626.25001, 27161037235001200003.61315.10.63815593316GloriaNaveaDaz4711092-0257Parina 9440, lo caas, Pealolen, RM02-37733029237786319/01/0303/02/0316262 BSDRAShock sptico, TEPHTA, obesidad mrbida, crisis pnico7421, 2614213001390001.581313.15.81433581717MargaritaUribeSantibaez6113017-k250Primavera sur 220, villa Eusebio Lillo, Isla de Maipo02-819338824/01/0331/01/0382, BHDAHDA, sepsis foco urinario, IRADM, hipotiroidismo56225.743.7001, 251710225N640005.531319.53.818Ana MaraRojas6979555-k248El rodeo 13497, La Dehesa02-216263706/02/0314/02/039212, AHSAAneurisma ACMd (op: clipaje)No62210.4454,8 x 10 -46S51710260115001390000.681.31243094319RubenTroncosoRuiz5390917-5157Pasaje canl 1442, Villa Sol. Pudahuel02-645135707/02/0328/02/0322222, BIRAg, SIRSTumor pulmonarInsuf renal404210.2800001.2412110104.4179003870001.61218.54.75098304720DanizaRojeBustamante5115487-8262Desierto de atacama 2819. Puente alto02-289993714/02/0354572, ASDRA, Ins respiratoriaBy pass aorto femoralHTA, EPOC, arteroesclerosis274110.1542.11001, 2, 3171763240.93123458521SandraPlazaNorambuena9884279-9234San Jose 714. Curic79-3172469219472927/08/0310/09/03142, BSDRAHSA, poloneuropata del pacinete agudo, neumonia aspirativaNo131210.21800002, 35209216302002370001.14822166224251: ElectivoDas1: Neumonia1: s0: nada0: nada0: nada1: MidazolamDasN: no registra2: Urgencia2: postoperado2: no1: Noradrenalina1: Noradrenalina1: Noradrenalina2: MorfinaA: Quirrgico3: sepsis2: Dopamina2: Dopamina2: Dopamina3: PropofolB: mdico4: SDRA3: Adrenalina3: Adrenalina3: Adrenalina5: Shock4: Dobutamina4: Dobutamina4: Dobutamina6: otra5: fenilefrina5: fenilefrina6: nimotop1: 42,8%51.209/06/0217,1 das29.087527742219% SDRA10,6 das5% falla destete65% uso Nadrenalina100% uso sedacin9 das15,3 apache7,5 sofa231213000 pl1.6813.620.72.4239973032: 57,2%27/08/0319.060310977123,8% Shock sptico80% uso DVA85% uso mid, morf6.842574645750% uso 2 DVA3.033150177615% uso 3 DVANo entiendo letraNo hay datoNuevo1: Masculino2: FemeninoEn aos15 mg/kg/min10 mg/kg/min4,2 gr/kg/min1000 mg/250cc a11 cc/hrMargotTEP?????hermana JeannetteFractura cadera izquierdaInsuficiencia respiratoria aguda, trax volanteHija: Carolina MundacaSegn correcion de la ficha estuvo solo 2 dias en UTIInsuficiencia respiratoriaSra, Bernardita Salazar??Hartmann??Hja, Carmen BravoAspiracinClipajeAgrega: "mantiene VM por sedacin ?"dice 100 de 10/500 u en peso 6950/50/100No dice cual0,15 mcg/kg/min2,11 mcg/kg/min1, 2: 16 das3: 1 daTraslado de otro hospitalHoja1S1S2S3S4S5S6S7S8S9S10S11S12S13S14C1C2C3C4C5C6C7C8C9C10C11C12C13C14C15C16C17D1D2D3D4D5D6D7D8D9D10D11D12D13D14D15D16D17D18D19D20D21D22D23D24D25P1P2P3P4P5P6F1F2F3F4F5F6F7R1R21: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: Mdico1: S1: S1: S1: S1: S1: S1: S0: Siempre1: S0: Nunca1: S1: S1: S1: S0: Nunca0: Nunca0: Nunca0: Nunca1: S0: Nunca1: S1: S1: S1: S1: S1: S1: S0: Ritmo normal1: S1: S1: Ruido1: S0: Nunca1: S1: S1: S1: S1: S1: S1: S1: S0: Siempre0: Ms optimistaDe 1 a 101: SPalabra2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: Enfermera2: No2: No2: No2: No2: No2: No2: No1: La mayora2: No1: Ocasionalmente2: No2: No2: No2: No1: Ocasionalmente1: Ocasionalmente1: Ocasionalmente1: Ocasionalmente2: No1: Ocasionalmente2: No2: No2: No2: No2: No2: No2: No1: Rpido2: No2: No2: Luces2: No1: Ocasionalmente2: No2: No2: No2: No2: No2: No2: No2: No1: Depende1: Igual que siempreNs2: No3: Paramdico8: no recuerda8: no recuerda2: OcasionalmenteA: Agrado2: Ms de 2/da2: La mayora2: La mayora2: La mayora2: La mayora2: La mayora2: Lento3: Posicin2: La mayora2: Nunca2: Ms pesimistans:no stresS: SensacionesC: Comunicacin4: Kinesilogo4: NuncaB: Desagrado3: Permanentemente3: Siempre3: Siempre3: Siempre3: Siempre3: Siempre3: Muy lento4: Angustia3: Siempre5: No distingua5: no poda expresarlas4: No sinti dolor4: No sinti dolor5: DolorP: PiezaF: aspectos finales6: no los expresoD: dimensin corporal6: Otra7: poda dormir8: no recuerda8: no recuerda8: no recuerda%%S 23,8S 10S 14,2S 14,2S 4,7S 23,8S 33,3S 33,3S 28,5S 4,7S 47,6S 42,8S 42,8S 19S 47,6S 23,8S 33,3S 33,3S 28,5S 38S 85,8S 90,5% M 47,620% SI 33,3S 85,8S 42,8S 23,8S 57,2S 71,5% S 42,8SI 42,8N 47,8S 9,5S 38S 9,5S 23,82020202020N 4,7S 9,5S 14,2S 1920S 71,5S 57,2S 57,220S 76,2S 28,5R 23,8S 62N 38202020202020S 55,6S 27,8S 61,1MO 33,32020N 76,2N 90N 85,8N 85,8N 95,3N 76,2N 66,7N 66,7N 71,5N 95,3N 52,4N 57,2N 57,2N 81N 52,4N 76,2N 66,7N 66,7N 71,5N 62N 14,2N 9,5% E 33,3% SI 70% NO 62N 14,2N 57,2N 76,2N 42,8N 28,5% LM 28,5NO 57,2O 28,5N 90,5N 62N 90,5N 76,2N 15N 95N 95N 25S 50O 4,7N 90,5N 85,8N 81SN 28,5N 42.8N 42,8RNN 23,8N 66,8L 14,2N 38O 14,2S 25S 65S 50S 10S 25S 20N 44,4N 72,2D 27,8IS 5085% maxS 20% PM 57,2% NO 20% NR 4,7% O 14,555% DESAGM 19O 15S 5OO 40N 40LM 28,6NRNR 4,7P 38LM 9,5N 75N 35N 50N 90N 75N 80N 11,1MP 16,7N 80% K 57,2% NR 10% N 0P 4,7LM 10LM 30NSD 10S 33,4LA 38S 14,5S 60S 5NSD 28,6MLNR 23,8% NPE 9,5% NLE 4,7Paso del tiempocambio visin del mundocambio visin de Diosmundo post UTIHoja2S1S2S3S4S5S6S7S8S9S10S11S12S13S14miedo a morirangustiadesamparoperdida pudors23.81014.214.24.723.833.333.328.54.747.642.842.81923.814.233.342.8n76.29085.885.895.376.266.766.771.595.352.457.257.28176.285.866.757.2x no74.2344740433C1C2C3C4C5C6C7C8C9C10C11C12C13C14C15C16C17s47.623.833.333.328.53885.890.57033.385.842.823.857.271.5n52.476.266.766.771.56214.29.5206214.257.276.242.828.5% M 47,6% NR 10NR 4,7% S 42,8% E 33,3% LM 28,5% PM 57,2% O 14,5% K 57,2% N 0% NPE 9,5% NLE 4,7C9C17m47.642.8se33.328.5lmpm57.214.5ok57.20no9.5no poda expresar4.7no lo expresoD1D2D3D4D5D6D7D8D9D10D11D12D13D14D15D16D17D18D19D20D21D22D23D24D25SI42.89.5389.523.895509.514.21971.557.257.276.228.562NO57.290.56290.576.254090.585.88128.542.842.823.866.838SNR 4,7N 47,8202020NSD 10N 4,7N20R 23,8N 3855% DESAGO 28,5N 15N 95N 25O 4,720RNL 14,2O 14,2M 19O 15OO 40LM 28,6RP 38LM 9,5P 4,7LM 10LM 30S 33,4LA 38S 14,5S 60S 5NSD 28,6MLNR 23,8D2D7D10D12D25nunca47.815254.738painthirstheattubeocacional28.515404.714.2never47.8152538la mayora19103028.69.5few28.5154014.2siempre4.760533.414.5most1910309.5NSD 28,6NR 23,8always4.760514.5P1P2P3P4P5P6si256550102520no753550907580F1F2F3F4F5F6si55.627.820no44.472.28061.133.385% max27.85011.116.7Hoja20000000000000000000000000000&C&"Arial,Negrita"area sensacionessinocruze0000000000000000000000000000000000&C&"Arial,Negrita"area comunicacionsinopreguntaporcentajeVivencias10000medenfparamedkines000000&C&"Arial,Negrita"RESPUESTA SATISFACTORIA A EXPRESION MIEDOSsiemprela mayoraocasionalnuncano poda expresarno lo expreso%00000000000000000000Paso del tiempoSINOCORPORAL 100000000000000000000SINOCORPORAL 2 (11-20)0000000000SINOCORPORAL 3 (21-25)00000000000000000000nuncaocasionalla mayorasiemprecorporal (d2-d7-d10-d12-d25)000000000000sino%cambios pieza000cambio visin del mundocambio visin de Diosmundo post UTIsinoaspectos finales000000000000siempredependenuncaaceptara nuevamente manejo UTI000mas optimistaigualmas pesimistamundo post uti00000000sinofeeling%0000000000000000neverfewmostalwayssensorial memories%NVAS STREdelusiones (si:1 no:2)EnriqueDelgeon12GerardoVillablanca2101DarioVillalon3101VictoriaAlvarado4102MariaFuentes5102JoseChandia6101JorgeInfante7102MaraOlgun8102SebastinComas9102ClaudiaCalvo10102IdaAguilar1112LuisBustamante12102TeresaIturriaga13102PilarCaneo14102CustodioBravo15101GloriaNavea16102MargaritaUribe17102Ana MaraRojas18102RubenTroncoso19101DanizaRoje2011SandraPlaza2181MarioJarpa222GuillermoAugusto2311PatricioBunster2471EduardoBalaic2561EmaAlarcon2611SaraPhilippi272SandraZaror2811CarmenCruces2942IsaasMendez3012MaraBordali31102JohnJohnson32VirginiaRodriguez332PabloConcha341Sergiode Ferrari3551MirtisOcaranza3610HectorRios372FresiaCastro3810HelenaBlanco3912LuisOsorno4010JavieraContardo4151LeticiaGalvez4210SoniaTrejos134.0909090909si000000000000000000000000000000000000000000VASNNombreApellido1Apellido2Fecha entEntrevistadorLugar entComentario entS1S2S3S4S5S6S7S8S9S10S11S12S13S14C1C2C3C4C5C6C7C8C9C10C11C12C13C14C15C16C17D1D2D3D4D5D6D7D8D9D10D11D12D13D14D15D16D17D18D19D20D21D22D23D24D25P1P2P3P4P5P6F1F2F3F4VAS STREF6F7R1R2Pacientes Alrededor1EnriqueDelgeonManieuInternetinternetNada222222222222221112221112222210202122422211110117222222222221La verdad es que estuve 3 das dormido o casi, de tal modo que no recuerdo mucho y los dolores que seguramente tuve por la operacin no los sent. Dira que lo ms desagradable de todo fue la sed de lquido tanto de da como de noche. Respecto a la conex2GerardoVillablanca10/01/03G.H, R.F2Nada222221221222121211111111212212120222100102422211112223182112222201102Angustia3DarioVillalon01/04/03G.H1Muy cristiano y con fe22222212221112212222113, 41122221120222210012422211122223282122222201102NecesariaExperiencia necesaria4VictoriaAlvaradoBarrientos16/07/02G.H, R.F2Nada122212221112122222211151221212511222200012012111221188131122122221102Buena atencin, pensar en morir lejos de su casaSensacin de atencin ptima, UTI es initimisante, no tener claro los lmites5MariaFuentesCanales27/08/02G.H1Nada222222212222121222221138822221021222200002222212113121, 4202222221100102Ruidos en la noche6JoseChandiaContreras13/08/02G.H1Nada121121112211112222211131222221111112230011222211122121, 2, 3, 4, 5101112111100102AgradecidoTraumtico.7JorgeInfanteLecannelier16/08/02G.H2Recuerda poco de UTI, casi nada222222222212122222221152212111020222230024422222213121, 4182112221100101Ahora piensa que debe cuidarse ms. Agradecido de la medicinaLa familia qued muy agradecida y ya no ve la UTI como una experiencia desastrosa8MaraOlgunGonzalez06/09/02G.H1Nada222222222222222122221152222221120222230012322222210117212222222211102BuenoSe acuerda poco, pero la ayudo a mejorarseFue muy impactante incertidumbre por muerte de la mam. Molestia por no mayor acceso a familia. UTI buena tecnologica y medicamentos, pero con problemas de comunicacin9SebastinComasAliste25/11/02G.H1Nada11222221121122121122111, 3, 41221211012212130011222221213122, 3, 4, 513212222120110210ClaudiaCalvoAbarca02/12/02G.H1Nada22222222222222222212112, 3, 41221122220222230002322211123117102222222212101Temerosa, experiencia desagradable, se le haban olvidado cosas11IdaAguilarUribe26/11/02G.H2Nada22222222222222121221112, 3, 4112221102122213000122221121012611222222120012Alegre de haber recibido ayudaAgradecida de la experienciaSe mostr tranquilo porque haba pasado por uti de hospital pblico. La comunicacin mdico fue buena.12LuisBustamanteSanchez10/12/02G.H2Nada2222221222222211122222311212112B3212130021122211113123, 4, 5212112121200102DesagradableCree que la tecnologa lo ayudo a recuperarse. Sensacin agradable al despertar se sinti feliz por estar vivo. Hay poco contacto humano. El personal rota muchoLe pedira a la gente que se detuviera un ratito a conversar13TeresaIturriagaCarlvie22/11/02G.H1Nada22222212222222121221213, 4112121102121123002132221111211718221221221110114PilarCaneoMuoz27/01/03G.H2Nada11112121122122222111111, 411211111B2212130031222211113123, 410211122120210215CustodioBravo03/04/03G.H1Se dio cuenta que mucha gente lo quera22222212121112122112111, 2, 3, 41222221020222210022422211212126208888881101102La UTI es lo mejor en hospital. Buena atencinVen la UTI como un lugar ms fro. Siente que es el lugar que salvaron a su pap. Buena acogida16GloriaNaveaDaz03/04/03G.H1Nada22112122221111121111111,2,3,411222220B2212230001322212212121.3232122122201102Lo ve como un lugar imprescindible y necesario. Se sinti segura17MargaritaUribeSantibaez01/04/03G.H2Nada12222111221121222222111,2,3,42221212521222230011222211123217102212221112102Un lugar que lo ayudo a salvarseFue una experiencia traumtica fuerte, pero lo ven como un lugar de salvacin. Sienten que fueron super bien informados18Ana MaraRojas01/04/03G.H1Nada22222222222112212211221, 48121121220212220022422212123223282112221210101Agradecidos del guardia, por que los dejaba entrar19RubenTroncosoRuiz23/07/03GH2Nada2222221221122222222111, 422222111B22222330113111222322412111211110010220DanizaRojeBustamanteR.FNada22222212222221222122111, 2, 3, 412221110101212200143211111211710111222110012AmorDonde ms segura me sent, cmoda, protegida, me sent amada en la UTI21SandraPlazaNorambuena09/10/03R.F2Nada2222222112122212212211212112126B0222210021321121222121, 2, 410112121110082Problemas para dormir por todo proceso. Sueos con intervenciones, pesadillas.Sensacin no chocante. Adecuado trata preocupacin22MarioJarpaGilbert13/01/04Mario y NicoCasaNo recuerda la UTI8888888888888888888888888888888888888888888888888888888888888812018Aprecia ms las cosas buenasDebe haber ms espacio para la famila. La gente que ms apoyo emocional brinda es la des aso. Es chocante que los familiares van a la gente de al lado23GuillermoAugusto07/01/04Mario y NicoCasaEstud medicina 5 aos2222221222121211112211111222110A02222000122221211311723220111EficienteTubo calor porque por la ventana entraba mucho sol. Tubo alucinaciones 1 da. (l reconoce haber alucinado)No supo de los dems pacientes24PatricioBunsterBriceo12/01/04Mario y NicoOficinaNo tubo conciencia de la gravedad de la situacin.22222222221211111111111112122202021120000222213121.628212111120172ExelenteSera bueno aislar ms las piesas, es estresante vivir las situaciones de los vecinos. El pacinete de enfrente no lo dej dormir. La mscara de ventilacin que me pusieron es una tortura. Le molest que un mdico dejara unos tubos tirados, le dio la sensa25EduardoBalaicBobadilla26/02/04Mario y NicoTelefonicaTelefonica22222212121122121122116212222102021120000102221122222612112221110061interesante26EmaAlarconAranda (sor amada)06/03/04Mario y NicoCasa12221221122112222122114228212262122223030102221211322220221122210111exelente27SaraPhilippiIzquierdo15/01/04Mario y NicoCasaNo recuerda la UTI8888888888888888888888888888888888888888888888888888888888888822012Le da gracias a Dios de estar viva. No tubo nunca angustia: si me muero me muero (ella es bastante religiosa)Mucho traqueto y circulacin de gente y muchos alumnos. Todo el mundo hablando muy fuerte.28SandraZaror11/03/04Mario y NicoCasa28888888188888222122888888888888888888888888888888888888888888120012regalo29CarmenCrucesSoto05/01/04Mario y NicoCasa2222222118221211122211211222211B121221102112212213121,2,3,620222222210042Le desagrad olor a guantes y a jabn lquido. No pudo dormir por mucho movimiento. Despus de la UTI se le arregl el caracter.30IsaasMendez19/03/04Mario y NicoTelefonicaNo recuerda mucho22222111221112121111111.2112222102022223003442212221111718111121110011cuidado31MaraBordaliMouri13/01/04Mario y NicoCasaPaciente deprimida y de lenguaje un poco inchoherente222222222211221112221162221221623222210002122212211117282222221201102CaroEs un gran adelanto pero no est al alcance de cualquiera. Despus de la uti se puso ms egosta. Le molest que la secaran con la misma sbana para dormir, el aso estaba mal hecho y lo acan muy temprano. Le molet que la chata la vertieran en el lavama32JohnJohnsonPerreto05/01/04Mario y NicoCasaNo recuerda la UTI888888888888888888888888888888888888888888888888888888888888888888833VirginiaRodriguez06/01/04Mario y NicoCsaaTiene amnesia desde una semana antes de entrar al hospital, no recuerda la uti, recupera memoria en intermedio888888888888888888888888888888888888888888888888888888888888881118Dios le ha dado una segunda oportunidad, tiene una misin que continuar. Hay que vivir el minuto, no hacer tantos planes.34PabloConchaBaados135Sergiode Ferrari3/10/04Mario y NicoCasa22222222222212111222211882222162022220000442221111012618222222220152gracias36MirtisOcaranza3/15/04Mario y NicoHospital UCNunca habia consultado un medico antes de esta ocacion2122221222222221212211182222220A1212213004411222213117281112211101102maravilloso37HectorRios3/9/04Mario y NicoCasaNo recuerda la UTI888888888888888888888888888888888888888888888888888888888888882201238FresiaCastro2/27/04Mario y NicoCasa22222222222222222222112182222161021220000448888882217282112111100102no me acuerdo39HelenaBlanco3/26/04Mario y NicoCasa22222221222122122121116182221202021123011442222222221722211221110012reposo40LuisOsornoOsorno3/9/04R.FSan Joaqun22212222122222222222111222221202022220000202222221222610888888120010241JavieraContardo3/17/04Mario y Nico222222222222221212222281222222210B022220010442221111121720121211111051aprendizaje42LeticiaGalvezGlenn22222212221122811122111112111122122221282222213121,3,4281212222211043SoniaTrejos1/28/04Mario y Nico22222212122122212122111121222102081121000442222221121728222211121012confortable443.8741462297457.13513513514647484950515253545556(hasta aqu llega formula de conteo)No entiendo letra1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: S1: Mdico1: S1: S1: S1: S1: S1: S1: S0: Siempre1: S0: Nunca1: S1: S1: S1: S0: Nunca0: Nunca0: Nunca0: Nunca1: S0: Nunca1: S1: S1: S1: S1: S1: S1: S0: Ritmo normal1: S1: S1: Ruido1: S0: Nunca1: S1: S1: S1: S1: S1: S1: S1: S0: Siempre0: Ms optimistaDe 1 a 101: SPalabraNo hay datoNo entiendo letra2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: No2: Enfermera2: No2: No2: No2: No2: No2: No2: No1: La mayora2: No1: Ocasionalmente2: No2: No2: No2: No1: Ocasionalmente1: Ocasionalmente1: Ocasionalmente1: Ocasionalmente2: No1: Ocasionalmente2: No2: No2: No2: No2: No2: No2: No1: Rpido2: No2: No2: Luces2: No1: Ocasionalmente2: No2: No2: No2: No2: No2: No2: No2: No1: Depende1: Igual que siempreNs2: NoNuevoNo hay dato3: Paramdico8: no recuerda8: no recuerda2: OcasionalmenteA: Agrado2: Ms de 2/da2: La mayora2: La mayora2: La mayora2: La mayora2: La mayora2: Lento3: Posicin2: La mayora2: Nunca2: Ms pesimistans:no stresS: SensacionesC: Comunicacin4: Kinesilogo4: NuncaB: Desagrado3: Permanentemente3: Siempre3: Siempre3: Siempre3: Siempre3: Siempre3: Muy lento4: Angustia3: Siempre5: No distingua5: no poda expresarlas4: No sinti dolor4: No sinti dolor5: DolorP: PiezaF: aspectos finales6: Ninguno en particular6: no los expresoD: dimensin corporal6: Otra7: poda dormir8: no recuerda8: no recuerda8: no recuerda%%S 23,8S 10S 14,2S 14,2S 4,7S 23,8S 33,3S 33,3S 28,5S 4,7S 47,6S 42,8S 42,8S 19S 47,6S 23,8S 33,3S 33,3S 28,5S 38S 85,8S 90,5% M 47,620% SI 33,3S 85,8S 42,8S 23,8S 57,2S 71,5% S 42,8SI 42,8N 47,8S 9,5S 38S 9,5S 23,82020202020N 4,7S 9,5S 14,2S 1920S 71,5S 57,2S 57,220S 76,2S 28,5R 23,8S 62N 38202020202020S 55,6S 27,8S 61,1MO 33,32020N 76,2N 90N 85,8N 85,8N 95,3N 76,2N 66,7N 66,7N 71,5N 95,3N 52,4N 57,2N 57,2N 81N 52,4N 76,2N 66,7N 66,7N 71,5N 62N 14,2N 9,5% E 33,3% SI 70% NO 62N 14,2N 57,2N 76,2N 42,8N 28,5% LM 28,5NO 57,2O 28,5N 90,5N 62N 90,5N 76,2N 15N 95N 95N 25S 50O 4,7N 90,5N 85,8N 81SN 28,5N 42.8N 42,8RNN 23,8N 66,8L 14,2N 38O 14,2S 25S 65S 50S 10S 25S 20N 44,4N 72,2D 27,8IS 5085% maxS 20% PM 57,2% NO 20% NR 4,7% O 14,555% DESAGM 19O 15S 5OO 40N 40LM 28,6NRNR 4,7P 38LM 9,5N 75N 35N 50N 90N 75N 80N 11,1MP 16,7N 80% K 57,2% NR 10% N 0P 4,7LM 10LM 30NSD 10S 33,4LA 38S 14,5S 60S 5NSD 28,6MLNR 23,8% NPE 9,5% NLE 4,7GH: Glenn HernandezRF: Rene de la Fuente1: casa2: UCPaso del tiempocambio visin del mundocambio visin de Diosmundo post UTIamarradoquinto intermedioolor a anestesiaBIPAP??"mal trato de auxiliares"No recuerdaNO recuerda