[Evaluation of the diagnostic test for rapid detection of covid-19 antigen (Panbio Covid rapid test) in primary care]. / Evaluación de la prueba diagnóstica de detección rápida de antígeno de covid-19 (Panbio Covid rapid test) en atención primaria.

OBJECTIVE: COVID-19 infection requires early diagnosis, with PCR being the gold standard test. The protocols advocate the use of rapid antigenic tests that require evaluation in actual clinical practice. The objective was to evaluate the diagnostic test for rapid antigen detection, Panbio Covid rapid test, compared with PCR, in patients with symptoms of 5 or less days of evolution and with a high-suspicion of infection by COVID-19 in a health center. MATERIALS AND METHODS: 103 patients over 14 years of age who attended an urban health center located in the Usera District of Madrid, with high-suspicion of COVID-19 infection, in the first 5 days of evolution from the onset of symptoms during the month of November 2020. INTERVENTIONS: diagnostic tests for COVID-19 are performed: antigen and PCR. RESULTS: The prevalence of the disease was 24.3% according to the PCR test and 17.5% according to the rapid antigenic test. The sensitivity was 72% (95% CI: 54.3-89.6%). The specificity was 100%. The positive and negative predictive values were 100% and 91.8% respectively. In the bivariate analysis, there was no relationship between symptoms and the presence of disease, except for myalgias (p=0.030). The multivariate analysis found a relationship between cough, dyspnea, fever, myalgia, anosmia/ageusia, and ocular symptoms and the presence of disease. CONCLUSIONS: The sensitivity and specificity for the Panbio rapid antigen test are similar to other studies performed in primary care. In high-prevalence of disease and with highly suspected symptoms, positive test results can be considered definitive, but negative results will require confirmation. Myalgia, fever, dyspnea, anosmia/ageusia, and ocular symptoms may be more related to the presence of COVID-19.

[Recommendations on cardiopulmonary resuscitation in patients with suspected or confirmed SARS-CoV-2 infection (COVID-19). Executive summary]. / Recomendaciones sobre reanimación cardiopulmonar en pacientes con sospecha o infección confirmada por SARS-CoV-2 (COVID-19). Resumen ejecutivo.

The SARS-CoV-2 pandemic has created new scenarios that require modifications to the usual cardiopulmonary resuscitation protocols. The current clinical guidelines on the management of cardiorespiratory arrest do not include recommendations for situations that apply to this context. Therefore, the National Cardiopulmonary Resuscitation Plan of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC), in collaboration with the Spanish Group of Pediatric and Neonatal CPR and with the Teaching Life Support in Primary Care program of the Spanish Society of Family and Community Medicine (SEMFyC), have written these recommendations, which are divided into 5 parts that address the main aspects for each healthcare setting. This article consists of an executive summary of them.

[Why do our patients go to hospital emergency departments?]. / Por qué acuden nuestros pacientes a urgencias del hospital?

OBJECTIVE: To analyse the causes of overuse of hospital emergency services (HES). DESIGN: Cross sectional, descriptive study. SETTING: Emergency service at a general hospital. PATIENTS: Patients who attended the HES on their own initiative. MEASUREMENTS AND MAIN RESULTS: Telephone poll to a representative sample of patients attending on their own initiative the emergency department of the 12 de Octubre Hospital in Madrid between October 5th and 12th. Average age: 46.95 (SD, 20.81); 52.2% women and 47.8% men, 50% were ignorant of the existence of primary care emergencies. 77% were ignorant of the existence of ongoing care points. Main motives for attendance at HES were: ignorance of non-hospital emergency services (32%), better technical means (25.6%), quicker care (21%), sensation of vital urgency (11.4%), poor quality of care in PC (8%). The care received at HES was evaluated as positive in 90% of cases, though 33% thought the information provided insufficient, and 34% the waiting-time excessive. Although 40% believed afterwards that their problem could have been resolved in PC, as many as 75% would return to the hospital. CONCLUSIONS: Widespread ignorance of the existence of non-hospital emergency services affects the over-use of HES. Most users use the HES as a service of immediate PC, a rapid way of obtaining health care. Users have a very favourable opinion of HES care, which is not stated in the case of non-hospital emergency services. In order to improve use of the HES, the population needs to receive better health education.