Violence under the act and look who rescues: representations of professionals in prehospital emergency rooms

Trata-se de um estudo das representa????es, experi??ncias e pr??ticas dos profissionais que atuam no servi??o pr??-hospitalar de urg??ncia e emerg??ncia do Corpo de Bombeiros, na Regi??o Metropolitana do Rio de Janeiro, frente ao cotidiano de atendimento a v??timas de viol??ncia ou em ??reas dominadas pelo crime. O objetivo geral da pesquisa foi relacionar as representa????es de viol??ncia e as percep????es de risco com as experi??ncias, as pr??ticas e o cotidiano destes profissionais. A abordagem metodol??gica se centrou nos referenciais das representa????es sociais e articulou dados quantitativos e qualitativos, numa perspectiva de triangula????o de m??todos. Os dados quantitativos foram constru??dos a partir de duas t??cnicas de coleta de dados: question??rio e pesquisa documental. J?? os dados qualitativos se basearam em entrevistas individuais semi-estruturadas. Os sujeitos da pesquisa foram militares do Corpo de Bombeiros que atuam em guarni????es do Grupamento de Socorro de Emerg??ncia nos dez quart??is da Regi??o Metropolitana do Rio de Janeiro, que registram o maior n??mero de atendimento a eventos envolvendo viol??ncia. Participaram da pesquisa oficiais m??dicos, pra??as t??cnicas em enfermagem e motoristas. A an??lise dos resultados foi organizada em tr??s partes: o contexto, os sujeitos e as representa????es. No contexto, est?? a caracteriza????o das v??timas, da assist??ncia e das les??es geradas pelos eventos violentos intencionais no cerne das causas externas. Destacou-se a maior vitimiza????o masculina, de jovens e negros, al??m da maior frequ??ncia de eventos durante os finais de semana. Foram encontradas, ainda, rela????es significativas entre eventos envolvendo projeteis de armas de fogo com les??es penetrantes em cr??nio e t??rax e tamb??m com o desfecho para ??bito. Para an??lise do perfil e condi????es de trabalho dos sujeitos ??? bombeiros militares ??? a base de compara????o foi estudo recente e similar realizado com policiais no Rio de Janeiro. Com rela????o ??s representa????es e experi??ncias, destacaram-se a presen??a cotidiana da viol??ncia na vida e no trabalho dos profissionais estudados. A prefer??ncia por atendimento a les??es decorrentes de eventos traum??ticos tamb??m foi expressiva. Surgiram, ainda, a naturaliza????o da viol??ncia e a indigna????o frente ?? viol??ncia, principalmente quando envolve grupos vulner??veis e percep????es negativas e positivas de risco. A an??lise das concep????es que os profissionais possu??am com rela????o a diversos aspectos que permeiam o fen??meno da viol??ncia mostrou que os conhecimentos para abordagem t??cnica das les??es decorrentes dos eventos violentos s??o valorizados na ??rea da sa??de. Por??m, a compreens??o cient??fica ampliada e atual da viol??ncia e seus impactos n??o esteve disseminada entre os profissionais estudados.This study discusses about the representation, experiences and practice of pre-hospital emergency care professionals in the face of the assistance to violence victims or on areas controlled by criminals. These professionals were from Fire Brigade of metropolitan region of Rio de Janeiro. The research aimed to relate representations of violence and risk perception with experience, practice and daily work of studied professionals. Methodological approach based on references of social representation and joined together quantitative and qualitative data, using triangulation of methods. Quantitative data were constructed from two techniques of information catch: questionnaire and documental research. Qualitative data came from individual interview semi-structured. Professionals involved in this research were officers??? physicians, nursing technician and ambulance drivers ??? all of them were military from the Rescue and Emergency Squad of Fire Brigade of Rio de Janeiro. These professionals worked on the ten barracks on Rio de Janeiro that attend the most cases of urban violence. Results analyses were organized in three parts: the contexts, the agents and the representations. Context part includes the violence victims, the emergency care and the wounds characterization, comparing the intentional violence events with general external causes. The main victims of lethal violence were black and young men. Violent occurrences happened more frequently on weekends. Other evidence found in this study was the significant relation between firearm events and deep wounds on head and chest and so with death. The analyses of pre-hospital emergency care professionals characteristics were compared with similar studied played with military policemen on Rio de Janeiro. On representation and experience part appeared the daily presence of violence on life and work of studied professionals. Preference for trauma care was also an expressive data. Other research finds were the naturalization and the indignation in face of violence, mainly when it affects vulnerable groups. Negative and positive risk perception was also found. The analysis of health professionals??? conception about some violence aspects showed that their knowledge was focused on technical procedures for wound care. However, a broadened and current scientific comprehension of violence and its impacts was not disseminated between studied professionals