RESUMEN
BACKGROUND: We compared the outcome of training schoolchildren how to perform CPR by parents/legal guardians in the family environment versus by teachers at school. METHODS: Randomized study of CPR learning in primary school children (1st and 2nd grades) in the Region of Murcia. Parents/legal guardians (family group) and teachers (teacher group) trained the children using didactic material adapted for that age population (one story and one cartoon video) from the educational series Jacinto y sus Amigos©. We evaluated eight theoretical knowledge items and five practical skills. RESULTS: One hundred and sixty schoolchildren were selected and 116 completed the study; in the family group, 51.3% did not finish the study. Children trained by teachers obtained significantly higher median scores in comparison with the family group both in theoretical knowledge (6.7; IQR=1.8 vs 4.7; IQR=3.1, respectively; p < 0.001) and in all practical skills except for "recognizing an emergency situation". Children in the family group, learning CPR with one story and one cartoon video achieved significantly better scores in five theoretical knowledge items and four skills than with only the story. CONCLUSIONS: Using non-technological educational resources, e.g., stories and animated cartoons for teaching CPR to primary school students, increases their knowledge and skills. Schoolchildren trained in the educational environment acquired more knowledge and skills than those trained by parents. Within the family environment, CPR teaching was more effective through one story and one cartoon video than when only the story was used.
Asunto(s)
Reanimación Cardiopulmonar , Niño , Humanos , Reanimación Cardiopulmonar/educación , Escolaridad , Instituciones Académicas , Estudiantes , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To determine the motions produced during pediatric extrication when using a system of motion estriction and extrication. METHODS: Simulation-based biomechanical analysis study conducted with inertial sensors to measure motion produced in the cervical spine of a pediatric simulator during extrication from a vehicle. RESULTS: The mean of the movements was 3.5° (SD ±1.35°). The mean time was 4 minutes 1 second (SD, ±45.09 seconds). The mean rotation toward the right was 3.34° (SD ±3.52°) and toward the left 2.62° (SD ±2.26°). The mean for lateralization was 6.24° (SD ±3.20°) toward the right and 2.50° (DE ±2.76°) toward the left. The mean for flexion was 2.36° (SD ±2.10°) and for extension 4.21° (SD ±2.15°). CONCLUSIONS: The device analyzed allows for the extrication of the pediatric patient with high levels of motion restriction of the spinal column with the Pediatric Immobilization and Extrication System.
Asunto(s)
Vértebras Cervicales , Inmovilización , Niño , Humanos , Movimiento , Rango del Movimiento Articular , RotaciónRESUMEN
STUDY DESIGN: Mixed-methods study. OBJECTIVE: Evaluate the knowledge that family caregivers of individuals with spinal cord injuries acquired through the use of a high-fidelity simulation-based learning (SBL) program. SETTING: The study was comprised of three phases: a previous qualitative research study detecting training needs, one in which clinical simulation scenarios were designed, and a final quasi-experimental phase in which ten caregivers of individuals with spinal cord injuries were trained in their care using simulations at the Toledo National Hospital for Paraplegics (Spain). METHODS: The competences acquired by the family were evaluated before and after the simulation training. A researcher-validated tool for each scenario was utilized for this evaluation. RESULTS: Four learning scenarios were designed based on the needs identified through the caregiver interviews. Following the training of the caregivers with SBL, an increase in their knowledge and skills was identified. For all the scenarios, the caregivers obtained a higher average score on the post test than on the pre test, and these differences were significant (p < 0.001). CONCLUSIONS: Simulation training is a useful and efficient learning tool for caregivers of individuals with a spinal cord injury.
Asunto(s)
Cuidadores/educación , Familia , Conocimientos, Actitudes y Práctica en Salud , Aprendizaje , Entrenamiento Simulado , Traumatismos de la Médula Espinal/rehabilitación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Traumatismos de la Médula Espinal/enfermeríaRESUMEN
OBJECTIVES: To compare self-extraction with and without a cervical collar in subjects at low risk of cervical spine injuries. MATERIAL AND METHODS: Simulation study analyzing biomechanical data from inertial sensors to detect misalignment of the cervical spine during self-extraction with and without a cervical collar. RESULTS: Misalignment was a mean (SD) 3.12 (34.62) degrees greater during self-extraction with a Stiffneck collar in place (95% CI, -15.33 to 21.57 degrees; P=.7234) than during extraction without a collar. Misalignment was also greater, by 5.95 (31.76) degrees, with an X-collar in place (95% CI, -10.98 to 22.87; P=.4654) than without a collar. The between-collar comparison of differences showed that misalignment was 2.83 (12.10) degrees greater with the X-collar (95% CI, -3.62 to 9.27 degrees; P=.3650). CONCLUSION: Misalignment of the cervical spinal column is similar during self-extraction with or without a cervical collar in place.
OBJETIVO: Comparar la autoextracción (AE) frente a la AE con collarines en sujetos con bajo riesgo de lesión cervical. METODO: Estudio de simulación mediante análisis biomecánico con sensores inerciales, determinando la desalineación de la columna cervical durante la AE con y sin collarines cervicales. RESULTADOS: El desequilibrio fue 3,12 (DE 34,62) grados mayor con el collarín STIFNECK (SN) (IC al 95% de 15,33 a 21,57; p =0,7234) que con AE y también 5,95 (DE 31,76) grados mayor con collarín X-COLLAR (XC) (IC al 95% de 10,98 a 22,87; p = 0,4654) que con AE. Cuando comparamos la AE con los diferentes tipos de collarines, observamos que con el collarín XC se produjeron 2,83 (DE 12,10) grados de desalineación más que con el collarín SN (IC al 95% de 3,62 a 9,27; p = 0,3650). CONCLUSIONES: La desalineación de la columna cervical mediante la AE es similar a la provocada cuando se aplican collarines cervicales.
Asunto(s)
Accidentes de Tránsito , Vértebras Cervicales/lesiones , Traumatismos del Cuello/prevención & control , Equipos de Seguridad , Restricción Física/instrumentación , Traumatismos Vertebrales/prevención & control , Adulto , Fenómenos Biomecánicos , Femenino , Voluntarios Sanos , Humanos , Masculino , Persona de Mediana Edad , Traumatismos del Cuello/etiología , Evaluación de Resultado en la Atención de Salud , Riesgo , Traumatismos Vertebrales/etiologíaRESUMEN
OBJECTIVES: To assess the efficacy of virtual reality (VR) in cardiopulmonary resuscitation (CPR) training. MATERIAL AND METHODS: Experimental, analytic, cross-sectional study of a CPR training method using VR. Participants were randomly assigned to train in a control group or a VR group. RESULTS: The mean (SD) scores on a scale of 10 after training were 9.28 (0.91) in the VR group and 7.78 (1.63) in the control group, for a mean difference of 1.49 (95% CI, 0.96-2.02; P<.001). The VR group achieved a mean of 97.5 (9.7) compressions/min, versus 80.9 (7.7) compressions/min in the control group, for a mean difference of 16.6 compressions/min (95% CI, 15.0-18.2; P=.003). The mean compression depth in the VR group was 34.0 (6.5) mm, versus 27.9 (4.9) mm in the control group, for a mean difference of 6.7 (95% CI, 5.7-7.8; P<.001). CONCLUSION: Training with VR can improve CPR theoretical knowledge and practical skills.
OBJETIVO: Analizar la eficacia de la realidad virtual (RV) en la formación en reanimación cardiopulmonar (RCP). METODO: Estudio experimental, analítico, transversal para analizar el aprendizaje en RCP a través de la RV, en el que los participantes fueron asignados aleatoriamente en grupo control (GC) y grupo RV (GRV). RESULTADOS: La nota del test fue de GRV fue 9,28 (DE 0,91) y el de GC 7,78 (DE 1,63) [diferencia de medias 1,49 (IC95% 0,96-2,02), p < 0,001]. El ritmo medio de las compresiones fue 97,5 (DE 9,7) compresiones/min para el GRV y 80,9 (DE 7,7) compresiones/min para el GC [diferencia de medias 16,6 (IC95% 15,0-18,2), p = 0,003]. La profundidad media fue 34,0 (DE 6,5) mm para el GRV y 27,3 (DE 4,9) mm para el GC [diferencia de medias 6,7 (IC95% 5,7- 7,8), p < 0,001]. CONCLUSIONES: La RV es un método de enseñanza de RCP capaz de mejorar los conocimientos teóricos y habilidades prácticas.
Asunto(s)
Reanimación Cardiopulmonar/educación , Entrenamiento Simulado/métodos , Realidad Virtual , Adulto , Competencia Clínica , Estudios Transversales , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVES: The main objective of the study is to determine the efficiency in the execution of the START (Simple Triage and Rapid Treatment) triage, comparing Virtual Reality (VR) to Clinical Simulation (CS) in a Mass Casualty Incident (MCI). The secondary objective is to determine the stress produced in the health professionals in the two situations described. MATERIALS: A comparative study on the efficiency and the stress during triage in a MSI was conducted. The basal and post levels of salivary α-amylase (sAA) activity were measured in all the participants before and after the simulation. RESULTS: The percentage of victims that were triaged correctly was 87.65% (SDâ¯=â¯8.3); 88.3% (SDâ¯=â¯9.65) for the Clinical Simulation with Actors (CSA) group and 87.2% (SDâ¯=â¯7.2) for the Virtual Reality Simulation (VRG) group, without any significant differences (pâ¯=â¯0.612) between both groups. The basal sAA was 103.26 (SDâ¯=â¯79.13) U/L with a significant increase (pâ¯<â¯0.001) with respect to the post-simulation levels (182.22, SDâ¯=â¯148.65â¯U/L). The increase of sAA was 80.70 (SDâ¯=â¯109.67) U/mL, being greater for the CSA group than the VRG group. CONCLUSION: The results show that virtual reality method is as efficient as clinical simulation for training on the execution of basic triage (START model). Also, based on the sAA results, we can attest that clinical simulation creates a more stressful training experience for the student, so that is should not be substituted by the use of virtual reality, although the latter could be used as a complementary activity.
Asunto(s)
Incidentes con Víctimas en Masa/psicología , Entrenamiento Simulado/métodos , Realidad Virtual , Distribución de Chi-Cuadrado , Simulación por Computador/estadística & datos numéricos , Humanos , Incidentes con Víctimas en Masa/estadística & datos numéricos , Entrenamiento Simulado/estadística & datos numéricos , Triaje/métodos , Triaje/normasRESUMEN
STUDY DESIGN: Qualitative study. OBJECTIVE: To detect the major challenges and needs reported by family member caregivers of people with spinal cord injury (SCI). SETTING: Family member caregivers of people with SCI and expert professionals were evaluated. This study was conducted in Spain, and most of the participants attended the National Paraplegics Hospital of Toledo. METHODS: We performed 25 semi-structured interviews. The data were analyzed from a phenomenological perspective using the Colaizzi method. RESULTS: The metamorphosis of the caregiver is a complex personal and family-related process. Analysis of the adjustment phase of the caregiving role allowed us to describe three stages, patterns, and trends. Five basic needs were identified. CONCLUSIONS: People with SCI and their primary caregivers experienced changes in every sphere of their lives. Their most important needs were psychological support, social support, economic resources, information, training throughout the process of suffering, and the creation of informal groups of mutual aid.
Asunto(s)
Cuidadores/psicología , Familia/psicología , Traumatismos de la Médula Espinal , Adaptación Psicológica , Cuidadores/economía , Cuidadores/educación , Femenino , Personal de Salud/psicología , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Investigación Cualitativa , Traumatismos de la Médula Espinal/economía , Traumatismos de la Médula Espinal/psicología , Traumatismos de la Médula Espinal/terapia , Factores de TiempoRESUMEN
OBJECTIVES: The main purpose of this study in healthy volunteers was to compare the lung function effects of 2 extrication devices that use spinal vests: the Kendrick Extrication Device (KED) and the Ferno KED-XT board. MATERIAL AND METHODS: Randomized crossover trial in 50 healthy adult volunteers. The subjects were placed in the KED and KED-XT devices for 5 minutes each and rested for 10 minutes between devices. Assignment to the first device was randomized. Each subject underwent spirometry at baseline and after placement of each device. The subjects were seated for all tests. The main outcome measures were the mean absolute differences between baseline and other measurements of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and the FVC/FEV1 ratio. RESULTS: Use of the devices led to statistically significant mean decreases from baseline FVC (KED-XT, -0.48 L; 95% CI, -0.16 to -0.81 L [P=.016] and KED, -0.79 L; 95% CI, -0.44 to -1.13 L [P<.001]) and from baseline FEV1 (KED-XT, -0.35 L/s; 95% CI, -0.14 to -0.56 L/s [P=.002] and KED, -0.52 L/s; 95% CI, -0.31 to -0.72 L/s [P<.001]). The decrease in FVC was greater after use of the KED device (mean difference, KED vs KED-XT, -0.30 L; 95% CI, -0.08 to -0.69 L [P<.016]). CONCLUSION: The use of spinal vests leads to decreases in lung function variables. The KED vest causes a greater decrease in FVC than the new KED-XT board, possibly because the crossed straps on the board compress the abdomen less.
OBJETIVO: El objetivo principal del estudio fue comparar el efecto en la función pulmonar de dos chalecos espinales (Kendrick Extrication Device® KED y Ferno-XT® KED-XT) entre sujetos voluntarios sanos. METODO: Ensayo clínico aleatorizado de un solo brazo cruzado que se llevó a cabo en 50 sujetos adultos voluntarios sanos. Se aplicó cada uno de los dispositivos, KED y KED-XT, durante 5 minutos con un periodo de descanso entre ellos de 10 minutos. Se realizó una espirometría basal y otra después de la aplicación de cada uno de los dispositivos en sedestación. Las variables de resultado principales fueron la diferencia absoluta de medias de la capacidad vital forzada (FVC), el volumen espiratorio forzado en el primer segundo (FEV1) y el coeficiente FEV1/FVC entre el momento basal y tras la aplicación de los dispositivos KED y KED-XT. RESULTADOS: La aplicación de los dispositivos hizo disminuir de forma estadísticamente significativa respecto a la situación basal la FVC (diferencia de medias de FCV KED-XT = 0,48 l [IC95% 0,16 a 0,81 l]; p = 0,016 y diferencia de medias de FCV KED = 0,79 l [IC95% 0,44 a 1,13 l]; p < 0,001) y la FEV1 (diferencia de medias de FEV1 KED-XT = 0,35 l/s [IC95% 0,14 a 0,56 l/s]; p = 0,002 y diferencia de medias de FCV KED = 0,52 l/s [IC95% 0,31 a 0,72 l/s]; p < 0,001). El KED produjo una mayor disminución de la FVC que el KED-XT (diferencia de medias de FCV KED vs KED-XT = 0,30 l [IC95% 0,08 a 0,69 l]; p < 0,016). CONCLUSIONES: Los chalecos espinales producen una diminución de los parámetros de la función pulmonar. El dispositivo KED produjo una mayor disminución de la FVC, en comparación con el nuevo dispositivo KED-XT, posiblemente por el diseño de fijaciones oblicuas que no comprimen tanto el abdomen.
Asunto(s)
Volumen Espiratorio Forzado , Pulmón/fisiología , Equipos de Seguridad , Restricción Física/instrumentación , Capacidad Vital , Adulto , Índice de Masa Corporal , Estudios Cruzados , Diseño de Equipo , Femenino , Humanos , Pulmón/fisiopatología , Masculino , Sobrepeso/fisiopatología , Presión , Espirometría , Transporte de PacientesRESUMEN
OBJECTIVES: To compare secondary students' learning of basic life support (BLS) theory and the use of an automatic external defibrillator (AED) through face-to-face classroom instruction versus educational video instruction. MATERIAL AND METHODS: A total of 2225 secondary students from 15 schools were randomly assigned to one of the following 5 instructional groups: 1) face-to-face instruction with no audiovisual support, 2) face-to-face instruction with audiovisual support, 3) audiovisual instruction without face-to-face instruction, 4) audiovisual instruction with face-to-face instruction, and 5) a control group that received no instruction. The students took a test of BLS and AED theory before instruction, immediately after instruction, and 2 months later. RESULTS: The median (interquartile range) scores overall were 2.33 (2.17) at baseline, 5.33 (4.66) immediately after instruction (P<.001) and 6.00 (3.33) (P<.001). All groups except the control group improved their scores. Scores immediately after instruction and 2 months later were statistically similar after all types of instruction. CONCLUSION: No significant differences between face-to-face instruction and audiovisual instruction for learning BLS and AED theory were found in secondary school students either immediately after instruction or 2 months later.
OBJETIVO: Comparar la formación presencial, mediante una clase teórica, frente a la formación no presencial, con un método audiovisual con y sin refuerzo posterior, en el aprendizaje teórico del soporte vital básico (SVB) y el desfibrilador externo automático (DEA) entre los estudiantes de secundaria. METODO: Se llevó a cabo un ensayo clínico aleatorizado que incluyó a 2.225 estudiantes de secundaria procedentes de 15 centros educativos que fueron asignados al azar a uno de los siguientes cinco grupos: 1) Grupo formación presencial sin refuerzo; 2) Grupo formación presencial con refuerzo; 3) Grupo formación audiovisual sin refuerzo; 4) Grupo formación audiovisual con refuerzo; 5) Grupo control. Se realizó un test sobre aspectos teóricos del SVB y DEA antes, después y a los 2 meses de la estrategia formativa. RESULTADOS: Los resultados mostraron diferencias estadísticamente significativas en todos los grupos, excepto el grupo control, entre la puntuación obtenida en el test basal 2,33 (RIC 2,17) y el test inmediato 5,33 (RIC 4,66) (p < 0,001), y entre el test basal y el test final 6,00 (RIC 3,33) (p < 0,001). No hubo diferencias en el aprendizaje inmediato y a los 2 meses entre los diferentes tipos de formaciones. CONCLUSIONES: No se encontraron diferencias entre la formación presencial mediante charlas teóricas y la formación no presencial con método audiovisual en el aprendizaje teórico inmediato y a los dos meses en el aprendizaje teórico del SVB y el DEA entre los estudiantes de secundaria.
Asunto(s)
Reanimación Cardiopulmonar/educación , Multimedia , Grabación en Video , Adolescente , Niño , Desfibriladores , Evaluación Educacional , Cardioversión Eléctrica , Femenino , Humanos , Masculino , España , Estudiantes , EnseñanzaRESUMEN
OBJECTIVE: To determine the stress that is potentially produced in professional health workers due to a mass casualty incident (MCI) simulated exercise, and its relation to prior academic training and the role played in the simulation. METHODS: Observational study of stress in a MCI. For this work, two MCI drills comprised of 40 victims each were conducted. Two randomized groups of 36 students each were created: Master's Students Group (MSG) and Undergraduate Student Group (USG). The role performed by each student (triage or sectorization) was assessed. The stress level was determined by prior and subsequent measurements of alpha-amylase (αA), HR, SBP and DBP. RESULTS: The percentage of victims that were correctly triaged was 88.6%, 91.84% for MSG and 83.76% for the USG (p=0.004). The basal αA was 97,107.50±72,182.67IU/L and the subsequent αA was 136,195.55±90,176.46±IU/L (p<0.001). The baseline HR was 78.74±14.92beats/min and the subsequent HR was 95.65±23.59beats/min (p=0.000). We found significant differences in the αA between students who performed the triage and those who performed sectorization but there were no differences between undergraduate and Masters' students. CONCLUSION: Conducting a simulated exercise caused stress in personnel involved in the MCI, with a greater impact on participants who performed triage, although it was not influenced by their prior academic level. The stress level in our case did not affect or determine the performance of acquired skills.
Asunto(s)
Incidentes con Víctimas en Masa , Entrenamiento Simulado/métodos , Estrés Psicológico/psicología , Análisis y Desempeño de Tareas , Adulto , Algoritmos , Planificación en Desastres/métodos , Servicios Médicos de Urgencia/estadística & datos numéricos , Humanos , Grupo de Atención al Paciente , Triaje/métodos , alfa-Amilasas/análisisRESUMEN
OBJECTIVES: To analyze and compare measurements of spine kinematics during prehospital emergency responders' placement of a patient on a spinal backboard or a scoop stretcher. MATERIAL AND METHODS: Cross sectional, quasi-experimental clinical simulation to compare misalignment (main endpoint) by means of data from a 3-dimensional motion capture system. RESULTS: Mean (SD) misalignment during placement on the 2 devices was 37.53° (14.15°). By device, mean misalignment was 31.08° (6.38°) for the scoop stretcher and 43.97° (7.97°) for the backboard (P=.048). CONCLUSION: Less misalignment occurs during placement on the scoop stretcher than on the spinal backboard.
OBJETIVO: Analizar y comparar la cinemática de la columna vertebral durante la colocación del tablero espinal (TE) y de la camilla de cuchara (CC) en una situación simulada realizada por expertos en emergencias prehospitalarias. METODO: Estudio transversal, cuasiexperimental, de simulación clínica para comparar la desalineación (variable principal), mediante un sistema de captura de movimiento en 3 dimensiones. RESULTADOS: Los resultados obtenidos en la desalineación media durante la colocación de los dispositivos fueron de 37,53°: 31,08° (6,38) para la CC y de 43,97° (7,97) para el TE (p = 0,048). CONCLUSIONES: La colocación de la camilla de cuchara provoca menos desalineación que el tablero espinal.
Asunto(s)
Inmovilización/instrumentación , Traumatismos Vertebrales/prevención & control , Camillas , Transporte de Pacientes , Antropometría , Fenómenos Biomecánicos , Estudios Transversales , Humanos , Movimiento y Levantamiento de Pacientes , Posición SupinaRESUMEN
OBJECTIVES: To measure cervical spine movement during removal of a motorcycle helmet by health care professionals. MATERIAL AND METHODS: Observational study using biomechanical inertial sensors to detect movement in the spinal column during removal of helmets. RESULTS: Thirty-four emergency medicine specialists and nurses participated. The mean (SD) rotation was 1.14° (0.82°) to the left and 3.30° (1.69°) to the right (P<.001). Mean flexion was 9.82° (7.46°) and mean extension was 6.23° (6.86°) (P<.001). Mean lateral displacement was 5.73° (2.97°) to the left and 5.62° (8.22°) to the right (P=.678). The removal maneuvers took a mean of 70 seconds (4 seconds). CONCLUSION: Helmet removal was completed in an average of 70 seconds with flexion and rotation mainly toward the side where the professional supporting the head was positioned.
OBJETIVO: Determinar el movimiento cervical durante la extracción de un casco realizada por profesionales sanitarios. METODO: Estudio observacional mediante análisis biomecánico con sensores inerciales de los movimientos producidos en la columna durante la extracción de un casco. RESULTADOS: La muestra final la componen 34 profesionales de servicios de urgencias y emergencias. La rotación fue de 1,14 (DE 0,82)° hacia el lado izquierdo y de 3,30 (1,69)° hacia el lado derecho (p < 0,001). La flexoextensión fue de 9,82 (7,46)° para la flexión y de 6,23 (6,86)° para la extensión (p < 0,001). La lateralización fue de 5,73 (2,97)° para el lado izquierdo y de 5,62 (8,22)° para el lado derecho (p = 0,678). El tiempo medio de realización de la extracción fue 70 (4) seg. CONCLUSIONES: La extracción del casco se realizó en 70 segundos con flexión y rotación hacia el lado donde se encuentra colocado el profesional que sujeta la cabeza.
Asunto(s)
Vértebras Cervicales/fisiología , Medicina de Emergencia/métodos , Servicio de Urgencia en Hospital , Dispositivos de Protección de la Cabeza , Traumatismos del Cuello/prevención & control , Adulto , Antropometría , Fenómenos Biomecánicos , Enfermería de Urgencia , Femenino , Humanos , Masculino , Motocicletas , RotaciónRESUMEN
AIM: Through a clinical simulation, this study aims to assess the effect of telematics support through Google Glass (GG) from an expert physician on performance of cardiopulmonary resuscitation (CPR) performed by a group of nurses, as compared with a control group of nurses receiving no assistance. METHODS: This was a randomised study carried out at the Catholic University of Murcia (November 2014-February 2015). Nursing professionals from the Emergency Medical Services in Murcia (Spain) were asked to perform in a clinical simulation of cardiac arrest. Half of the nurses were randomly chosen to receive coaching from physicians through GG, while the other half did not receive any coaching (controls). The main outcome of the study expected was successful defibrillation, which restores sinus rhythm. RESULTS: Thirty-six nurses were enrolled in each study group. Statistically significant differences were found in the percentages of successful defibrillation (100% GG vs 78% control; p=0005) and CPR completion times: 213.91 s for GG and 250.31 s for control (average difference=36.39 s (95% CI 12.03 to 60.75), p=0.004). CONCLUSIONS: Telematics support by an expert through GG improves success rates and completion times while performing CPR in simulated clinical situations for nurses in simulated scenarios.
Asunto(s)
Reanimación Cardiopulmonar/normas , Simulación por Computador , Diseño de Equipo/normas , Enfermeras y Enfermeros/normas , Telemedicina/normas , Adulto , Servicio de Urgencia en Hospital/organización & administración , Femenino , Humanos , Masculino , España , Telemedicina/instrumentación , Telemedicina/métodos , Recursos HumanosRESUMEN
OBJECTIVES: To assess the effect of a Google Glass telemedicine application to allow a medical expert to make corrections in simulated out-of-hospital intratracheal intubations performed by nurses. MATERIAL AND METHODS: Randomized clinical simulation trial designed by the Universidad Católica de Murcia between November 2014 and February 2015. Volunteer nurses from the emergency medicine service of Murcia, Spain, were randomized to an intervention group to simulate intubations with telemedicine assistance (n=25) or a control group that did not receive assistance (n=25). The main outcome variable was satisfactory orotracheal intubation. RESULTS: We observed statistically significant between-group differences in percentages of satisfactory intubation (telemedicine group, 96%, vs control group, 72%; P=.024) and time required to intubate the trachea (mean difference, 94.3 seconds, 95% CI, 40.7-147.9 seconds; P=.001). CONCLUSION: Telemedicine assistance from an expert by way of a Google Glass application improves the success rate and completion times of nurses performing out-of-hospital intratracheal intubations in clinical simulations.
OBJETIVO: Evaluar el efecto de la ayuda telemática, a través de las Google Glass® (GG), de un médico experto para la correcta intubación orotraqueal (IOT) realizada en simulación clínica por enfermeros de extrahospitalaria. METODO: Ensayo aleatorizado de simulación clínica desarrollado en la Universidad Católica de Murcia de noviembre 2014 a febrero 2015. Se distribuyó aleatoriamente a los enfermeros voluntarios de la Gerencia de Emergencias 061 de Murcia en un grupo de 25 enfermeros con ayuda telemática mediante las GG (GpG) y un grupo de 25 enfermeros sin ayuda (GpC). La variable principal del estudio fue la correcta IOT. RESULTADOS: Se hallaron diferencias significativas entre ambos grupos en los porcentajes de IOT correcta (96% GpG vs 72% GpC; p = 0,024) y en el tiempo de ejecución de la IOT [diferencia de medias 94,3 (IC95% 40,7-147,9) s; p = 0,001]. CONCLUSIONES: La ayuda telemática de un médico experto, a través de las GG, mejora los porcentajes y tiempos de la IOT correcta de los enfermeros de extrahospitalaria en situaciones clínicas simuladas.
RESUMEN
OBJECTIVES: To analyze the influence of drones equipped with thermal cameras for finding victims and aiding triage during disasters. MATERIAL AND METHODS: We carried out a prospective, cross-sectional analysis and 6 experimental simulations, each with 25 victims to locate and triage. Nurses were randomized to a control group or a drone group. Drone-group nurses were given access to images from the thermal cameras 10 minutes before the exercise started. RESULTS: The mean (SD) distance the nurses searched in the control group (1091.11 [146.41] m) was significantly greater than the distance searched by nurses in the drone group (920 [ 71.93] m (P = .0031). The control group found a mean of 66.7% of the victims, a significantly smaller percentage than the drone group's mean of 92% (P = .0001). Triage quality (undertriage and overtriage) was similar in the 2 groups as shown by maneuvers undertaken to open airways and control bleeding. CONCLUSION: Drones with thermal cameras were useful in searching for victims of simulated disasters in this study, although they had no impact on the quality of the nurses' triage.
OBJETIVO: Analizar la influencia del uso de un dron con cámara térmica en la localización y triaje de las víctimas en una situación de catástrofe. METODO: Se ha llevado a cabo un estudio analítico, experimental, prospectivo y transversal, donde se realizaron 6 simulacros de búsqueda de víctimas y triaje (cada uno de ellos con 25 víctimas). De manera aleatoria se hicieron dos grupos: Grupo Control (GC) y Grupo Dron (GD). Los profesionales del GD pudieron disponer de las imágenes de la cámara térmica instalada en un dron 10 minutos antes de comenzar el ejercicio. RESULTADOS: La distancia media recorrida por el GC fue de 1091,11 (DE: 146,41) metros, significativamente mayor (p = 0,0031) que la del GD 920 (DE: 71,93) metros. El porcentaje medio de víctimas encontradas por cada uno de los profesionales del GC fue del 66,7%, significativamente menor (p = 0,0001) que las encontradas por cada uno de los profesionales del GD, que ascendió al 92%. En la calidad del triaje (infra y supratriaje), apertura de la vía aérea y control de hemorragias no se encontraron diferencias entre los dos grupos analizados. CONCLUSIONES: El uso de drones con cámaras térmicas, en condiciones experimentales, es útil en la búsqueda y localización de víctimas en catástrofes, aunque no tiene impacto sobre la calidad del triaje realizado por los profesionales participantes en el estudio.