PSYCHIATRIC NATURE CARE PROVIDED BY THE URGENT MOBILE PRE-HOSPITAL SERVICE

a retrospective study with the analysis of records of psychiatric consultations performed by the Mobile Emergency Care Service of a Brazilian Northeast capital in 2014.

Results:

38,317 consultations were performed by the Mobile Emergency Care Service, of which 1,088 (2.8%) were psychiatric. Most of the sample consisted of male users (64.8%), aged between 20 and 59 years old (81.4%), with an average age of 35 years old. There was a predominance of agitation and/or aggression (65.7%) and 8.0% of the users were suspected of using alcoholic beverages. The Basic Support Units were accessed in 96.8% of the occurrences and 91.6% of the users were referred to the psychiatric hospital. The suicide attempts and ideations are highlighted in 7.6% of the cases, with a majority of females (54.9%). A significant association was observed between the time of care and the variables: care reason (p=0.003), performance of procedures (p=0.000) and medication use (p=0.000).

Conclusion:

the study showed a high number of psychiatric consultations performed by the Mobile Emergency Care Service, evidencing its importance as one of the components of the Psychosocial Care Network. However, the fate of the users is still the psychiatric hospital.

DESCRIPTORS:
Nursing in emergency; Emergency medical services; Ambulances; Intervention in crisis; Mental health

Reason of the care	Gender						Total
	Male		Female		Ignored		Total
	n	%	n	%	n	%	n	%
Agitation	159	14.6	107	9.8	02	0.2	268	24.6
Aggressiveness	136	12.5	49	4.5	-	-	185	17.0
Agitation with aggressiveness	189	17.4	73	6.7	-	-	262	24.1
Psychotic outbreak	64	5.9	29	2.6	-	-	93	8.5
Attempt/suicidal ideas	36	3.3	45	4.2	01	0.1	82	7.6
Hallucination and restlessness	09	0.8	04	0.4	-	-	13	1.2
Restlessness and insomnia	07	0.6	05	0.5	-	-	12	1.1
Abstinence crisis	08	0.7	01	0.1	-	-	09	0.8
Mood disorder	04	0.4	05	0.4	-	-	09	0.8
Others^* * Reasons for the care responsible for fewer than 9 occurrences	10	0.9	09	0.9	-	-	19	1.8
Not informed	84	7.7	50	4.6	02	0.2	136	12.5
Total	706	64.8	377	34.7	05	0.5	1088	100.0

Reason of the care	Age Group								Total
	0-19 years old		20-59 years old		≥ 60 years old		Ignored		Total
	n	%	n	%	n	%	n	%	n	%
Agitation	23	2.1	213	19.6	10	0.9	22	2.0	268	24.6
Aggressiveness	11	1.0	152	14.0	14	1.3	08	0.7	185	17.0
Agitation and aggressiveness	25	2.3	213	19.6	15	1.4	09	0.8	262	24.1
Psychotic outbreak	04	0.4	81	7.3	04	0.4	04	0.4	93	8.5
Attempt/suicidal ideas	10	0.9	62	5.7	05	0.5	05	0.5	82	7.6
Hallucination and restlessness	02	0.2	09	0.9	02	0.2	-	-	13	1.2
Restlessness and insomnia	-	-	12	1.1	-	-	-	-	12	1.1
Abstinence crisis	-	-	08	0.7	01	0.1	-	-	09	0.8
Mood disorder	01	0.1	08	0.7	-	-	-	-	09	0.8
Others^* * Reasons for the care responsible for fewer than 9 occurrences	02	0.2	15	1.4	01	0.1	01	0.1	19	1.8
Not informed	07	0.6	113	10.4	06	0.6	10	0.9	136	12.5
Total	85	7.8	886	81.4	58	5.4	59	5.4	1088	100.0

Age Group	Gender						Total
	Male		Female		Ignored		Total
	n	%	n	%	n	%	n	%
0-19 years old	01	1.1	-	-	-	-	01	1.1
20-59 years old	63	72.5	16	18.4	01	1.1	80	92.0
≥ 60 years old	01	1.1	-	-	-	-	01	1.1
Not informed	04	4.6	01	1.2	-	-	05	5.8
Total	69	79.3	17	19.6	01	1.1	87	100.0

Variable	n	%	Care time^* * Average in minutes;	p-value^† † Mann-Whitney and Kruskal-Wallis' tests
Gender				.803 (n=999)
Male	648	64.9	12.8
Female	351	34.7	12.4
Age Group				.961 (n=951)
0-19 years old	81	8.5	12.1
20-59 years old	812	85.4	12.9
≥ 60 years old	58	6.1	12.7
Suspicion of alcohol use				.254 (n=542)
Yes	85	15.7	13.6
No	457	84.3	12.9
Type of ambulance				.107 (n=1004)
Basic support	972	96.8	12.6
Advanced support	32	3.2	14.2
Reason of the care				.003 (n=883)
Agitation/aggressiveness	667	75.5	13.9
Others	216	24.5	10.2
Procedure performance				.000 (n=277)
Yes	60	21.7	18.6
No	217	78.3	12.9
Medication use				.000 (n=1004)
Yes	13	1.3	32.5
No	991	98.7	12.4

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] Correspondence: Claudete Ferreira de Souza Monteiro Postgraduate Program in Nursing Federal University of Piaui, University Campus Ministro Petrônio Portella 64049-550 - Ininga, Teresina, Piauí, Brazil E-mail: claudetefmonteiro@ufpi.edu.br