Inhalation technique practical skills and knowledge among physicians and nurses in two pediatric emergency settings.

Introduction: Correct technique with a pressurized metered-dose inhaler (pMDI) equipped with a valved holding chamber (VHC) or spacer provides an important advantage for adequate control of asthma and virus-induced wheezing in young children. The aim of this study was to assess the ability and knowledge of physicians and nurses to use a pMDI with a masked VHC in two pediatric emergency units.Methods: Study design: Two-center observational study. Inhaler use technique was assessed in 50 physicians and 50 nurses using a child mannequin and a validated videotaped nine-step scoring method. The participants' knowledge was evaluated by a questionnaire.Results: The inhalation technique was perfectly mastered by 49% of the study participants and almost perfectly mastered by another 34% (mean score 8.3 ± 0.7; range 5-9). Nurses were more likely than doctors to demonstrate the technique perfectly (66% vs. 32%, p < 0.05). The two most common errors were forgetting to shake the pMDI between two consecutive puffs (38% of the participants) and putting the patient in an incorrect position (11%). About half of the participants reported that they checked each patient's inhalation technique at every opportunity and knew how to clean the VHC. A large majority did not employ a reliable method to determine the amount of medication remaining in pMDIs without a counter.Conclusion: Healthcare professionals' practical skills and knowledge on inhalation therapy were not completely mastered and could be improved with a mandatory training program.

[COVID-19: does the end of semi-confinement match with the beginning of the revelations of child abuse ?] / COVID-19: la fin du semi-confinement rime-t-elle avec le début des révélations de mauvais traitements envers les enfants ?

During the semi-confinement period linked to the COVID-19 pandemic, the CHUV's Child Abuse and Neglect Team observed a decrease in cases of child abuse. Has confinement made it easier for families to avoid violence or, on the contrary, to hide it? Within the framework of this second hypothesis, we propose that the relaxation of the measures be an opportunity for professionals to explore in families the possible occurrence of domestic abuse.

Au CHUV, durant la période de semi-confinement liée à la pandémie Coronavirus Disease 2019, le Child Abuse and Neglect Team a observé une baisse des cas de maltraitance. Le confinement a-t-il permis aux familles d'avoir moins recours à la violence ou, au contraire, de la cacher ? Dans le cadre de cette seconde hypothèse, nous proposons que l'assouplissement des mesures soit une opportunité pour les professionnels d'explorer dans les familles la possible survenue de maltraitances intrafamiliales.