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INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) improves infant survival outcomes after cardiac arrest. If not feasible at the place of arrest, victims must be transported to a suitable room to perform ECMO while effective, sustained resuscitation maneuvers are performed. The objective of this simulation study was to compare the quality of resuscitation maneuvers on an infant manikin during simulated transfer on a stretcher (stretcher test) within a hospital versus standard stationary resuscitation maneuvers (control test). METHODS: A total of 26 nursing students participated in a randomized crossover study. In pairs, the rescuers performed two 2 min tests, consisting of five rescue breaths followed by cycles of 15 compressions and two breaths. The analysis focused on CPR variables (chest compression and ventilation), CPR quality, the rate of perceived exertion and the distance covered. RESULTS: No differences were observed in the chest compression quality variable (82 ± 10% versus 84 ± 11%, p = 0.15). However, significantly worse values were observed in the test for ventilation quality on the stretcher (18 ± 14%) compared to the control test (28 ± 21%), with a value of p = 0.030. Therefore, the overall CPR quality was worse in the stretcher test (50 ± 9%) than in the control test (56 ± 13%) (p = 0.025). CONCLUSIONS: Infant CPR performed by nursing students while walking alongside a moving stretcher is possible. However, in this model, the global CPR quality is less due to the low ventilation quality.
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Aim: Recent emergence of airway clearance devices (ACDs) as a treatment alternative for foreign body airway obstructions (FBAO) lacks substantial evidence on efficacy and safety. This study aimed to assess pediatric residents' knowledge and skills in managing a simulated pediatric choking scenario, adhering to recommended protocols, and using LifeVac© and DeCHOKER© ACDs. Methods: Randomized controlled simulation trial, in which 60 pediatric residents from 3 different hospitals (median age 27 [25.0-29.9]; 76.7% female) were asked to solve an unannounced pediatric simulated choking scenario using three interventions to manage (randomized order): 1) following the recommended protocol of the European Resuscitation Council (encouraging to cough or combination of back blows and abdominal thrusts); 2) using LifeVac©; and 3) using DeCHOKER©. A Little Anne QCPR™ manikin (Laerdal Medical) was used. The variable compliance rate (%) was calculated according to the correct/incorrect execution of the steps constituting the proper actions for each test. Results: Participants demonstrated a correct compliance rate only ranging between 50-75% in following the recommended protocol for managing partial FBAO progressing to severe. Despite unfamiliarity with the ACDs, pediatric residents achieved rates between 75% and 100%, with no significant difference noted between the two devices (p = 0.173). Both scenarios were successfully resolved in under a minute, with LifeVac© demonstrating a significantly shorter response time compared to DeCHOKER© (39.2 [30.4-49.1] vs. 45.1s [33.7-59.2], p = 0.010). Conclusions: Only a minority of pediatric residents were able to adhere to the recommended FBAO protocol, whereas 70% of them were able to adequately use the ACDs. However, since a significant proportion could not, it seems that ACDs themselves do not address all issues.
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Helicobacter pylori (Hp) is the main trigger of chronic gastric atrophy and the main leading cause of gastric cancer. Hp infects the normal gastric mucosa and can lead to chronic inflammation, glandular atrophy, intestinal metaplasia, dysplasia and finally adenocarcinoma. Chronic inflammation and gastric atrophy associated with Hp infection appear initially in the distal part of the stomach (the antrum) before progressing to the proximal part (the corpus-fundus). In recent years, endoscopic developments have allowed for the characterization of various gastric conditions including the normal mucosa (pyloric/fundic gland pattern and regular arrangement of collecting venules), Hp-related gastritis (Kyoto classification), glandular atrophy (Kimura-Takemoto classification), intestinal metaplasia (Endoscopic Grading of Gastric Intestinal Metaplasia), and dysplasia/adenocarcinoma (Vessel plus Surface classification). Despite being independent classifications, all these scales can be integrated into a single model: the endoscopic model for gastric carcinogenesis. This model would assist endoscopists in comprehending the process of gastric carcinogenesis and conducting a systematic examination during gastroscopy. Having this model in mind would enable endoscopists to promptly recognize the implications of Hp infection and the potential patient's risk of developing gastric cancer.
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Extending the access to cardiopulmonary resuscitation (CPR) training to a wider public is an important step in increasing survivability of out-of-hospital cardiac arrest. However, often price and maintenance of CPR manikins are barriers that prevent training at schools. This study aims to evaluate the learning of hands-only (HO) CPR by practicing with a low-cost manikin (LoCoMan) with visual qualitative feedback and to compare the results with the skills acquired by practice on a conventional manikin. A quasi-experimental study with 193 schoolchildren (10 to 12 years old) who were allocated to two groups: the LoCoMan group was taught via an integrative approach (science combined with physical education (PE)) and practiced on a handmade manikin, and a control group practiced in a traditional setting with a commercial manikin (Resusci Junior, Laerdal, Norway). All participants practiced for 1 hands-on skill session before performing a post-test on an instrumented CPR manikin. The outcomes including HO-CPR performance variables were compared between groups. The LoCoMan and control groups both achieved acceptable percentage of HO-CPR quality (57% and 71%, p = 0.004). Among 6th-graders, there were no significant differences in HO-CPR quality between LoCoMan 68% and control 71%, p = 0.66. The control group achieved better chest compression depth while the LoCoMan group showed more compressions with adequate chest recoil. Conclusion: Schoolchildren are able to build and use a low-cost manikin with visual feedback. The integrative learning approach used in this study may be a feasible alternative methodology for training and learning HO-CPR in schools when commercial manikins are not available. What is Known: ⢠Access to CPR training should be universal and independent of age, location, financial means, or access to qualified instructors. ⢠Scientific societies promote the implementation of CPR in schools, so that teachers and schoolchildren can play a multiplier role in their environment, but the gap in CPR learning is related to cultural, economic factors or access to resources and materials. What is New: ⢠LoCoMan may be a useful device for teaching and learning CPR in schoolchildren from the age of 10 and upwards. ⢠LOCOMAN shows that it is feasible and possible to build a low-cost manikin (about 5 in the European Region) and to integrate it into an integrative educational project, and outlines how this could be done. this approach can be an incentive for teachers to attempt teaching CPR, but also for education outside the formal environment.
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Reanimación Cardiopulmonar , Maniquíes , Humanos , Reanimación Cardiopulmonar/educación , Femenino , Masculino , Niño , Paro Cardíaco Extrahospitalario/terapiaRESUMEN
OBJECTIVE: The objective of this study is to conduct a systematic review regarding the relationship between positive psychological factors, such as psychological well-being and pleasant emotions, and sports performance. METHOD: This study, carried out through a systematic review using PRISMA guidelines considering the Web of Science, PsycINFO, PubMed and SPORT Discus databases, seeks to highlight the relationship between other more 'positive' factors, such as well-being, positive emotions and sports performance. SETTINGS: The keywords will be decided by a Delphi Method in two rounds with sport psychology experts. PARTICIPANTS: There are no participants in the present research. ASSESSMENT: The main exclusion criteria were: Non-sport thema, sample younger or older than 20-65 years old, qualitative or other methodology studies, COVID-related, journals not exclusively about Psychology. MAIN OUTCOMES MEASURES: We obtained a first sample of 238 papers, and finally, this sample was reduced to the final sample of 11 papers. RESULTS: The results obtained are intended to be a representation of the 'bright side' of sports practice, and as a complement or mediator of the negative variables that have an impact on athletes' and coaches' performance. CONCLUSIONS: Clear recognition that acting on intrinsic motivation continues to be the best and most effective way to motivate oneself to obtain the highest levels of performance, a good perception of competence and a source of personal satisfaction.
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Atletas , Rendimiento Atlético , Humanos , Rendimiento Atlético/psicología , Atletas/psicología , Emociones , Satisfacción Personal , Motivación , Deportes/psicologíaRESUMEN
Directional data appears in several branches of research. In some cases, those directional variables are only defined in subsets of the K-dimensional unit sphere. For example, in some applications, angles as measured responses are limited on the positive orthant. Analysis on subsets of the K-dimensional unit sphere is challenging and nowadays there are not many proposals that discuss this topic. Thus, from a methodological point of view, it is important to have probability distributions defined on bounded subsets of the K-dimensional unit sphere. Specifically, in this paper, we introduce a nonparametric Bayesian model to describe directional variables restricted to the first orthant. This model is based on a Dirichlet process mixture model with multivariate projected Gamma densities as kernel distributions. We show how to carry out inference for the proposed model based on a slice sampling scheme. The proposed methodology is illustrated using simulated data sets as well as a real data set.
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(1) Objective: The objective was to evaluate the quality of cardiopulmonary resuscitation (CPR, chest compressions and ventilations) when performed by a lone first responder on an infant victim via the over-the-head technique (OTH) with bag-mask ventilation in comparison with the standard lateral technique (LAT) position. (2) Methods: A randomized simulation crossover study in a baby manikin was conducted. A total of 28 first responders performed each of the techniques in two separate CPR tests (15:2 chest compressions:ventilations ratio), each lasting 5 min with a 15 min resting period. Quality CPR parameters were assessed using an app connected to the manikin. Those variables were related to chest compressions (CC: depth, rate, and correct CC point) and ventilation (number of effective ventilations). Additional variables included perceptions of the ease of execution of CPR. (3) Results: The median global CPR quality (integrated CC + V) was 82% with OTH and 79% with LAT (p = 0.94), whilst the CC quality was 88% with OTH and 80% with LAT (p = 0.67), and ventilation quality was 85% with OTH and 85% with LAT (p = 0.98). Correct chest release was significantly better with OTH (OTH: 92% vs. LAT: 62%, p < 0.001). There were no statistically significant differences in the remaining variables. Ease of execution perceptions favored the use of LAT over OTH. (4) Conclusions: Chest compressions and ventilations can be performed with similar quality in an infant manikin by lifeguards both with the standard recommended position (LAT) and the alternative OTH. This option could give some advantages in terms of optimal chest release between compressions. Our results should encourage the assessment of OTH in some selected cases and situations as when a lone rescuer is present and/or there are physical conditions that could impede the lateral rescue position.
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AIM: To analyze the effectiveness of a teaching-learning methodology for teletraining in basic life support (BLS) based on communication through smart glasses. DESIGN: Pilot quasi-experimental non-inferiority study. PARTICIPANTS: Sixty college students. INTERVENTIONS: Randomization of the participants in: tele-training through smart glasses (SG) and traditional training (C) groups. Both training sessions were very brief (less than 8 min) and included the same BLS content. In SG, the instructor trained through a video call with smart glasses. MAIN VARIABLES OF INTEREST: The BLS protocol, the use of AED, the quality of resuscitation and the response times were evaluated. RESULTS: In most of the BLS protocol variables, the resuscitation quality and performance times, there were no statistically significant differences between groups. There were significant differences (in favor of the SG) in the assessment of breathing (SG: 100%, C: 81%; p = 0.013), the not-to-touch warning before applying the shock (SG: 79%, C: 52%; p = 0.025) and compressions with correct recoil (SG: 85%, C: 32%; p = 0.008). CONCLUSIONS: Laypeople BLS-AED brief tele-training through smart glasses could potentially be, at least, as effective as traditional training methods. In addition, smart glasses could be more advantageous than traditional teaching for certain points of the BLS protocol and chest compressions quality, probably due to the capability of real-time visualization of images which supports the BLS sequence. Augmented reality supported teaching should be considered for BLS training, although caution is required in extrapolating findings, and further in-depth studies are needed to confirm its potential role depending on concrete target populations and environments.
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Reanimación Cardiopulmonar , Gafas Inteligentes , Humanos , Reanimación Cardiopulmonar/métodos , Comunicación , Respiración , ManiquíesRESUMEN
Introduction: This study explores the attributions and coping strategies of athletes who experienced psychological impact from sport injuries or illness from a qualitative methodology. Purpose: To understand athletes' unique perspectives on injury and recovery, framed in the Global Model of Sport Injuries, and contribute to the development of effective interventions and support programs for athletes. Methods: A qualitative research approach was employed, conducting semi-structured interviews with an ad hoc sample of 16 athletes, representing diverse backgrounds and competitive levels. Interviews were transcribed and analyzed using NVivo software, identifying themes and codes related to attributions and coping strategies. Results: Athletes attributed their sport injury mostly to bad luck, routine deviations, and negative mental states, while coping strategies used included cognitive restructuring, emotional calming, seeking social support, mental withdrawal, and behavioral risk. Factors such as training deviations, social support, psychological responses, and injury diagnosis seems to have influenced the coping strategies employed. Conclusions: Sport injuries and illnesses significantly impact athletes' careers and wellbeing. Support and effective communication from coaching staff and healthcare professionals were identified as crucial for athletes' wellbeing. These findings contribute to understanding the psychological processes and experiences involved in sport injury recovery and highlight key elements for prevention and intervention protocols. Future research should explore communication patterns in sports contexts and assess attributions and coping strategies at different stages of injury recovery.
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OBJECTIVE: Drowning represents one of the main causes of child mortality. Water-related incidents are preventable and should be addressed through health education. The aim of this study was to evaluate an educational program for eight-year-old students based on a song with content on drowning prevention. METHODS: A feasibility pilot study was conducted, including forty-six children enrolled in a public school in Santiago de Compostela (A Coruña, Spain). The study was developed in three phases. In the first step, a group of experts and musicians created the educational content and the song. Secondly, the evaluation tool was developed, and finally, the program was implemented based on flag recognition, how to help in a drowning situation, safe swimming attitudes, and information about the emergency phone number 112. The percentage of correct responses by children before and after the educational intervention were compared using the McNemar test. RESULTS: Approximately half of the children were unaware of the meaning of the flags. After listening to the song, all students identified the meaning of the red flag, and over 90% recognized the green and yellow flags (p<0.001). Before the intervention, children correctly identified, on average, 75.3% of the safe water attitude pictograms. This perception of safe attitudes significantly increased post-intervention (p<0.001), with recognition of 86.4% of the correct behaviours. The overall water safety score also significantly improved by 22.7% after the intervention (p<0.001). CONCLUSIONS: The educational song is a resource to promote the learning of signals and concepts related to child drowning prevention.
OBJETIVO: El ahogamiento representa una de las principales causas de mortalidad infantil. Los incidentes acuáticos son prevenibles y deben ser abordados desde la educación para la salud. El objetivo de este estudio fue evaluar un programa educativo en alumnado de ocho años basado en una canción con contenido para la prevención del ahogamiento. METODOS: Se realizó un estudio piloto de viabilidad que incluyó a cuarenta y seis niños/as escolarizados en un centro público de Santiago de Compostela (A Coruña, España), siendo desarrollado en tres fases. En el primer paso, un grupo de expertos y músicos crearon el contenido educativo y la canción. En segundo lugar, se elaboró la herramienta de evaluación y, finalmente, se implementó el programa basado en el reconocimiento de las banderas, en cómo ayudar en un ahogamiento, en las actitudes seguras para el baño y en información sobre el teléfono de emergencias 112. El porcentaje de respuestas correctas antes y después de la intervención educativa se compararon utilizando la prueba de McNemar. RESULTADOS: Aproximadamente la mitad de los niños/as desconocía el significado de las banderas. Después de la audición de la canción, todos los escolares identificaron el significado de la bandera roja y más del 90% reconoció la bandera verde y amarilla (p<0,001). Antes de la intervención, los niños identificaron correctamente, en promedio, el 75,3% de los pictogramas de actitudes acuáticas seguras. Esta percepción de actitudes seguras aumentó significativamente postintervención (p<0,001), reconociendo el 86,4% de las conductas correctas. La puntuación general de seguridad del agua también mejoró significativamente después de la intervención un 22,7% (p<0,001). CONCLUSIONES: La canción educativa es un medio para favorecer el aprendizaje de las señales y conceptos sobre la prevención del ahogamiento infantil.
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Ahogamiento , Niño , Humanos , Proyectos Piloto , Instituciones Académicas , España , Agua , Estudios de FactibilidadRESUMEN
Foreign body airway obstruction (FBAO) is a relatively common emergency and a potential cause of sudden death both in children and older people; bystander immediate action will determine the victim's outcome. Although many school children's basic life support (BLS) training programs have been implemented in recent years, references to specific training on FBAO are lacking. Therefore, the aim was to assess FBAO-solving knowledge acquisition in 10-13-year-old school children. A quasi-experimental non-controlled simulation study was carried out on 564 ten-to-thirteen-year-old children from 5 schools in Galicia (Spain). Participants received a 60-min training led by their physical education teachers (5 min theory, 15 min demonstration by the teacher, and 30 min hands-on training) on how to help to solve an FBAO event. After the training session, the school children's skills were assessed in a standardized adult's progressive FBAO simulation scenario. The assessment was carried out by proficient researchers utilizing a comprehensive checklist specifically designed to address the variables involved in resolving a FBAO event according with current international guidelines. The assessment of school children's acquired knowledge during the simulated mild FBAO revealed that 62.2% of participants successfully identified the event and promptly encouraged the simulated patient to cough actively. When the obstruction progressed, its severity was recognized by 86.2% and back blows were administered, followed by abdominal thrusts by 90.4%. When the simulated victim became unconscious, 77.1% of children identified the situation and immediately called the emergency medical service and 81.1% initiated chest compressions. No significant differences in performance were detected according to participants' age. Conclusion: A brief focused training contributes to prepare 10-13-year-old school children to perform the recommended FBAO steps in a standardized simulated patient. We consider that FBAO should be included in BLS training programs for school children. What is Known: ⢠Kids Save Lives strategy states that school children should learn basic life support (BLS) skills because of their potential role as first responders. ⢠This BLS training does not include content for resolving a foreign body airway obstruction (FBAO). What is New: ⢠Following a 60-min theoretical-practical training led by physical education teachers, 10-13-year-old school children are able to solve a simulated FBAO situation. ⢠The inclusion of FBAO content in BLS training in schools should be considered.
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Obstrucción de las Vías Aéreas , Reanimación Cardiopulmonar , Cuerpos Extraños , Adulto , Niño , Humanos , Anciano , Adolescente , Reanimación Cardiopulmonar/educación , Instituciones Académicas , Cuerpos Extraños/complicaciones , Cuerpos Extraños/terapia , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/terapia , Evaluación EducacionalRESUMEN
The aim of this study was to compare the quality of standard infant CPR with CPR in motion (i.e., walking and running) via performing maneuvers and evacuating the infant from a beach. Thirteen trained lifeguards participated in a randomized crossover study. Each rescuer individually performed three tests of 2 min each. Five rescue breaths and cycles of 30 chest compressions followed by two breaths were performed. Mouth-to-mouth-and-nose ventilation was carried out, and chest compressions were performed using the two-fingers technique. The manikin was carried on the rescuer's forearm with the head in the distal position. The analysis variables included compression, ventilation, and CPR quality variables, as well as physiological and effort parameters. Significantly lower compression quality values were obtained in running CPR versus standard CPR (53% ± 14% versus 63% ± 15%; p = 0.045). No significant differences were observed in ventilation or CPR quality. In conclusion, lifeguards in good physical condition can perform simulated infant CPR of a similar quality to that of CPR carried out on a victim who is lying down in a fixed position.
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OBJECTIVE: To determine whether dispatcher assistance via smart glasses improves bystander basic life support (BLS) performance compared with standard telephone assistance in a simulated out-of-hospital cardiac arrest (OHCA) scenario. METHODS: Pilot study in which 28 lay people randomly assigned to a smart glasses-video assistance (SG-VA) intervention group or a smartphone-audio assistance (SP-AA) control group received dispatcher guidance from a dispatcher to provide BLS in an OHCA simulation. SG-VA rescuers received assistance via a video call with smart glasses (Vuzix, Blade) connected to a wireless network, while SP-AA rescuers received instructions over a smartphone with the speaker function activated. BLS protocol steps, quality of chest compressions, and performance times were compared. RESULTS: Nine of the 14 SG-VA rescuers correctly completed the BLS protocol compared with none of the SP-AA rescuers (p = 0.01). A significantly higher number of SG-VA rescuers successfully opened the airway (13 vs. 5, p = 0.002), checked breathing (13 vs. 8, p = 0.03), correctly positioned the automatic external defibrillator pads (14 vs.6, p = 0.001), and warned bystanders to stay clear before delivering the shock (12 vs. 0, p < 0.001). No significant differences were observed for performance times or chest compression quality. The mean compression rate was 104 compressions per minute in the SG-VA group and 98 compressions per minute in the SP-AA group (p = 0.46); mean depth of compression was 4.5 cm and 4.4 cm (p = 0.49), respectively. CONCLUSIONS: Smart glasses could significantly improve dispatcher-assisted bystander performance in an OHCA event. Their potential in real-life situations should be evaluated.
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Reanimación Cardiopulmonar , Paro Cardíaco Extrahospitalario , Gafas Inteligentes , Humanos , Reanimación Cardiopulmonar/métodos , Sistemas de Comunicación entre Servicios de Urgencia , Paro Cardíaco Extrahospitalario/terapia , Proyectos Piloto , TeléfonoRESUMEN
In children, arterial ischemic stroke is a much less understood disease compared to in adults due to its lower frequency and different aetiology. However, it is also a serious disease, with a high incidence of severe and permanent sequelae that exceeds 50% of total cases. The acute management of postnatal arterial ischaemic stroke (MNAIS) has changed drastically in recent years, chiefly on account of recanalization treatments (thrombolysis and endovascular therapies). These treatments, which used to not be recommended in childhood, are increasingly implemented in everyday clinical practice. Although the evidence from studies carried out in children is not of high quality due to their retrospective design and the small number of reported cases, they support the hypothesis that these treatments are as safe and effective as they are in adults as long as appropriate eligibility criteria are applied and they are used within a certain time from the onset of symptoms (therapeutic window). This article reviews the MNAIS based on the current scientific evidence. Since the efficacy of these treatments is highly dependent on their early initiation, a paediatric stroke code needs to be in place as an extension of the stroke code applied to adults. It has started to be introduced in Spain since 2019, although there are still large areas of the country where it has yet to be applied.
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Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Niño , Accidente Cerebrovascular/diagnóstico , Accidente Cerebrovascular/terapia , Isquemia Encefálica/diagnóstico , Isquemia Encefálica/terapia , Isquemia Encefálica/complicaciones , Terapia Trombolítica/efectos adversos , Trombectomía/efectos adversos , Estudios Retrospectivos , Accidente Cerebrovascular Isquémico/complicacionesRESUMEN
Introduction: Laypeople should be trained in basic life support and traditional and innovative methodologies may help to obtain this goal. However, there is a knowledge gap about the ideal basic life support training methods. Smart glasses could have a role facilitating laypeople learning of basic life support. Aim: To analyze the potential impact on basic life support learning of a very brief training supported by smart glasses video communication. Methods: Twelve laypeople were basic life support tele-trained by means of smart glasses by an instructor in this pilot study. During training (assisted trough smart glasses) and after the training (unassisted) participants' performance and quality of basic life support and automated external defibrillation procedure were assessed on a standardized simulated scenario. Results: After the training all participants were able to deliver good quality basic life support, with results comparable to those obtained when real time remotely guided by the instructor through the smart glasses. Mean chest compression rate was significantly higher when not guided (113 /min vs. 103 /min, pâ¯=â¯0.001). When not assisted, the participants spent less time delivering the sequential basic life support steps than when assisted while training. Conclusions: A very brief remote training supported by instructor and smart glasses seems to be an effective educational method that could facilitate basic life support learning by laypeople. This technology could be considered in cases where instructors are not locally available or in general in remote areas, providing basic internet connection is available. Smart glasses could also be useful for laypeople rolling-refreshers.