Ventilação a jato de alta frequência ‐ uma nova abordagem no manejo da anestesia para ressonância magnética em cardiologia pediátrica: série de casos

Quality management in imaging diagnosis and the nursing team: a case study

OBJECTIVE

to know the contributions of nursing in the implementation of the quality management principle of the accreditation program in imaging diagnosis.

METHODS

a single, qualitative case study carried out in an accredited radiology and imaging diagnosis service. The data collection took place through semi-structured interviews, direct observation, and documentary analysis with the support of software in organizing the data for analysis.

RESULTS

a total of four thematic units emerged: the accreditation process in imaging services, the implementation of the program, the role of nursing in imaging services and patient safety and the management of non-conformities in imaging services. Of the other data sources, the word risk was highlighted and a non-conformity was evidenced in the external audit.

FINAL CONSIDERATIONS

nursing contributed mainly to the management of the risks involved in the performance of imaging and patient safety tests, requirements of the quality management principle of the accreditation program.

In-circuit high-frequency jet ventilation to reduce organ motion in a child undergoing sarcoma ablation

Patients with primary or metastatic solid tumours can be treated with minimally invasive image-guided procedures as an alternative to surgical resection. Reducing organ motion during these procedures is crucial so that tumours can be accurately targeted and treatment delivered within a small margin, limiting potential damage to adjacent structures. As ventilation is the main cause of motion, there has been a shift from conventional ventilation towards the use of in-circuit high-frequency jet ventilation techniques for these procedures. We present the case of a 7-year-old who required computed tomography-guided microwave ablation of a right lung metastatic nodule under general anaesthesia. The patient's lungs were ventilated with in-circuit high-frequency jet ventilation in order to provide optimum conditions for ablation. The treatment was successfully completed and she was discharged home the following day. High-frequency jet ventilation is regularly used in our institution for adult computed tomography-guided treatments and to our knowledge, this application has not been described yet in a child this young. Our experience suggests that this technique can be safely used in paediatric patients, though further investigation of the optimum parameters for in-circuit high-frequency jet ventilation in this population is warranted.