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The use of a device called Capsule Vanessa, which promises to help patients and health professionals in the fight against the new coronavirus, became a complaint in the Imbiribeira Emergency Care Unit (UPA), in the Southern Zone of Recife. According to the unit’s health professionals, the device was being used without studies to demonstrate its effectiveness, due to the determination of the unit’s administrative management. After the complaint, the Secretary of State Health (SES) reported the report of the Jornal do Commercio, on a note, that the equipment would no longer be used. The Regional Council of Medicine of Pernambuco (Cremepe) also commented on the case.
UPA health professionals warned that, in addition to using the Vanessa Capsule, patients were prevented from being transferred to the ICU and even intubated due to the capsule. The Pernambuco Medical Union (Simepe) sent a letter to the Pernambuco Prosecutor (MPPE) and registered a police report on the case.
A health professional who works at the UPA and preferred to preserve his identity, says that the device, developed in Manaus, arrived at the unit last Thursday (30). According to her, the doctors and nurses were informed that the Samel company would provide training on how to use the structure. After the arrival of company employees, the capsule was used in a patient admitted with low blood oxygen saturation, a frequent symptom in people with the new coronavirus.
“The patient was placed inside the capsule and improved with NIV (non-invasive ventilation). But the company ended up appointing a physical therapist, who would stay with the UPA to help with the use of the capsule. The problem is that patients they were prevented from being transferred by this physiotherapist, even with the recommendation of the doctors, with the support of the administrative management of the UPA, “he reports.
The capsule, developed by the Transire Institute, in association with the Samel company, promises to reduce the risk of contamination of health professionals and other hospitalized patients when performing NIV in people with suspected covid-19. NIV consists of applying ventilatory support to the patient using a mask or mouthpiece. Unlike intubation, which requires the insertion of a tube into the person’s trachea, NIV is a non-invasive technique, however, it is not indicated in cases of new coronavirus infections, precisely because of the risk of spreading the illness.
The health professional also says that management would be forcing nursing teams not to follow the doctors’ recommendations. “Two patients obtained a place for the ICU, as the APU cannot treat these critically ill patients, nor does it have a lung ventilator for all. The doctors requested the transfer and the same therapist prevented them from treatment. The company is conducting a Illegal study, without evidence, without consent, without anything. No one on the medical staff agrees with management’s conduct, “says the professional.
This Sunday morning (3), the management of Simepe was in the health unit to carry out an inspection, according to the Union, after receiving complaints about interference in the autonomy of doctors by the management of the UPA from Imbiribeira.
“During the inspection, the veracity of the complaints was confirmed and Simepe immediately informed Cremepe and, given that this is an emergency situation, the Secretary of State for Health will be contacted today, since SES is responsible for managing The UPA will also send an official letter to the Pernambuco Prosecutor’s Office (MPPE), informing what is happening and, finally, registering a police report on this situation, “the note says.
At the end of the afternoon, the State Health Secretariat said that “the use of ventilatory capsules was an initiative of the social organization that manages the Imbiribeira Emergency Care Unit (UPA). According to the administration of the service, decided that the kit will no longer be used for patients with suspected new coronaviruses, “an extract from the note duplicates. Then, he adds: “SES-PE reinforces that it has produced an epidemiological clinical protocol to guide health teams in the clinical management of suspected or confirmed patients for Covid-19. The Secretariat also ratifies medical autonomy in the therapeutic conduct of each one always following the recommendations of the existing protocols. “
Cremepe also spoke and said that “he became aware of this situation at the Imbiribeira UPA, at dawn on Sunday (05/03/2020) and notified the unit with an indication of ethical interdiction. The notification requests explanations from the technical direction of the health facility, within 24 hours, “says the note sent to JC.
How does Samel say that Capsule Vanessa works?
“It consists of a light and resistant frame made of PVC tubes, which makes the structure light, being able to be moved and removed by anyone, facilitating its handling and cleaning. The cabin is covered with a transparent vinyl film that provides Visibility to the patient and aid in contagion contagion, it has zipper openings to offer contact windows between the patient and the medical personnel. “
This is the description of the Vanessa Capsule, which appears on the Samel company website. The structure also has an exhaust fan and handles. “We were in the state of Pernambuco, in the city of Recife, at the UPA in Recife. There, we were able to apply our technique in front of more than 30 people and we have the video, the testimony of the doctor of two patients who would suffer from orotracheal intubation and they were treated on the spot with our Vanessa capsule, “says the president of the Samel group, Luiz Alberto Nicolau, in a video to publicize the structure on social media.
According to the company, in addition to Pernambuco, the capsule is also being used in Pará, Roraima and Acre. “We at Samel and the Transire Institute are not for profit. Wherever they call us, we will apply the practice, we will give the training, all for free,” adds the group’s president.
What do medical and physical therapy associations say about the device?
In a document signed by the Brazilian Association of Intensive Medicine (Amib), the Brazilian Association of Emergency Medicine (Abramede), the Brazilian Association of Cardiorespiratory Physiotherapy and Physiotherapy in Intensive Care (Assobrafir) and the Brazilian Society for Quality of Care and Patient Safety (Sobrasp), since April 2020, the entities made considerations about devices such as the Vanessa capsule.
Among the points raised by the associations are the lack of clinical studies that prove the effectiveness of the device as a form of protection for health professionals and the need to decontaminate the structure using an autoclave (laboratory equipment used to sterilize materials). , a technique that could destroy the device.
“Currently (April / 2020) there are no scientific studies demonstrating that the use of a chamber, tents and boxes to contain aerosols during the application of supplemental oxygen therapy and / or the use of non-invasive ventilation provides clinical benefits in the care of patients with suspected or confirmed coronavirus infection, “says the technical note.
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