Specialist for intensive treatment in Hospital in BarcelonaSpain, Karla Nunez Vazquezhe spoke to medical students from the University of Colima “Fragile patient” program.which was implemented in his clinic for the continuous care and assessment of elderly patients with acute illness and organ dysfunction, who arrive in the intensive care unit.
This video conference was held in Knowledge transfer project created by Red Global MX Chapter Spain in partnership with UdeC. In this network, Mexicans living abroad share their knowledge and experiences with future experts from our country. Initially, she is the director of Faculty of Medicine, Emilio Prieto Diaz Chavezhe wanted to help and motivate the talent of young people in the country with this binational strategy.
In his speech, Nunez Vazquez he stated that, as an expert in the field intensive therapyduring the days on duty, a clinical question arises for him: “Do you care or not about patients over 70 years old, give them a chance (patients who have reached their expected life expectancy) or take better care of those who, because of their age, have more chances to survive and recovery from intensive therapy?”.
That adds up, he said, to an unfortunate scenario in which many medical centers around the world have limited funding from intensive care unit: “I was invited to examine adults over 70 years old with an acute illness and some organic dysfunction. Putting age first blocks access to care for the patient.” Faced with this situation, he added, Program for frail patients.
Nunez Vazquez explained that Program for frail patients It is a form of care that has already been applied by some hospitals in Spanish. Fragility syndrome defined in intensive therapy such as the loss of physiological reserve and systemic function of the organism, and since time is against it, a conventional or usual geriatric assessment that includes measurement of respiratory and hearing capacity, mobility, eye examinations and electrocardiograms cannot be done.
The concept of frailty, he continued, focuses on people over 65 with significant or partial dependence, and on people who are physically and mentally active. That’s how he spoke about that proposal, published in an electronic magazine Intensive care medicinein which he routinely suggests, in all intensive care unitsinitial assessment with clinical history, age, comorbidities and severity scales, and addition to the above Clinical frailty scale (CFS) patient.
Under the proposal, he continued, “we can make more objective decisions about providing appropriate support, recovering their functional situation, and seeing what resources can help patients recover their functional situation, not just deny them because of their age.” He described it said Clinical frailty scale Canadian groups Rockwood It is based on 9 symptoms and focuses on people over 65, excluding people with previous disabilities.
These symptoms are: unexplained weight loss, extreme fatigue, slow gait, spontaneous falls, reduced grip strength, frequent infections, impaired consciousness, loss of balance, and acute delirium or confusion.
In this sense, he said that they want to validate it as a predictive scale in their units: “If the patient can speak, it is important to ask him and confirm with his family or caregiver his situation in the last two weeks. And if there is any doubt as to which scale of fragility it has, always assign it a higher fragility point”.
Finally, students and professors who joined the session via Zoom asked the speaker about the academic and managerial path she took to become part of the clinical team of the hospital in Spanish.