CONSTRUÇÃO E VALIDAÇÃO DE CONTEÚDO DE UM FLUXOGRAMA PARA A EXTRAÇÃO DE VÍTIMAS DE COLISÃO AUTOMOBILÍSTICA

Abstract

Car crashes and accidents are the third leading cause of early death in the world. Pre-hospital care for victims of these accidents is carried out by the Rescue and Rescue Teams of the Fire Departments and Health Teams. It must be carried out through a systematic and integrated approach, and the proper use of techniques and devices. In this sense, the use of a long board to remove these victims, using the zero angle extraction technique (in line extrication), restricts spinal movement and reduces the possibility of aggravation of the traumatic condition in victims with potential spinal injury. Thus, the development of a tool that can be used by different teams and institutions, which provide pre-hospital care for traffic accidents with victims with potential spinal injury, becomes important. Thus, the aim of this study was to build and validate the content of a flowchart for the extraction of victims of automobile collisions. Descriptive methodological study, with a mixed approach, developed in three phases. In the first phase, a Scope Review was carried out in electronic databases and gray literature, in the first half of 2020, in different languages, which addressed techniques for extracting victims of car crashes incarcerated with potential spinal injury. In the second phase, an exploratory descriptive study of the qualitative type was carried out through two focus groups with 18 firefighters from the city of Campo Grande - MS. Finally, in the third phase, the construction and validation of the content was carried out, carried out through a questionnaire with a Likert scale, followed by the psychometric model of Pasquali adapted for the study and content validation using the Delphi technique. Two rounds of the Delphi technique (I and II) were performed. For data analysis’s Confidence Validation Index, Cronbach's α and ordinal’s α were used to validate internal consistency. As a result, a total of 33 studies were included in the Scope Review and, based on their analyses, it was possible to identify the types of extraction and devices described in the literature. The scope review allowed us to observe the need to implement strategies based on scientific evidence, and to identify knowledge gaps on the subject, mainly related to the effectiveness of the use of extraction techniques. The analysis of the focus groups indicated which elements should compose the construction of the flowchart for the extraction of victims of automobile collisions. In addition, it indicated the weakness of evidence-based practice related to vehicle rescue and rescue. The mean of the Confidence Validation Index – (0.91) resulted in a highly reliable instrument for new instruments. The Rescue (Military Firefighters) and Rescue (Military Firefighters and/or Health Teams) phases occur at the same time for the two teams, in a common, systematic and sequential manner under the management of the incident commander. Based on the content validated by the expert judges, the flowchart, the product of this study, was constructed. Future studies should support the validation with practical application of the presented flowchart, as well as its use by professionals who carry out vehicle rescue and rescue in Brazil.

Keywords: Traffic accidents; Wounds and injuries; Transport of patients; emergency medical services; Validation study; Nursing.