Aprendiendo a reanimar en la escuela. Estudio en escolares de 8-12 años / Learning to resuscitate at school. Study in 8-12 year-old schoolchildren

Objetivo: Valorar cuantitativamente la capacidad de aprendizaje en soporte vital básico (teórica y práctica) de escolares de 8-12 años con un programa de formación adaptado a las escuelas. Material y métodos: Estudio cuasiexperimental con una muestra de conveniencia de 567 alumnos de 3° y 5° de Educación Primaria y 1° de Educación Secundaria Obligatoria, de 3 colegios concertados de Galicia, que recibieron 2h (una teórica y otra práctica) de formación en soporte vital básico por parte de sus profesores de Educación Física integrada en el programa escolar. Los niños fueron evaluados mediante un test teórico y una prueba práctica que midió la calidad de las compresiones torácicas y valoró la secuencia de soporte vital básico. (AU)

Objective: To quantitatively assess the learning capacity of school children aged between 8-12 years in basic life support (theory and practice) after a feasible school training programme. Material and methods: Quasi-experimental study with a convenience sample of 567 pupils in 3rd, 5th and 1st year of Primary Education, and Compulsory Secondary Education, respectively, from 3 public schools in Galicia. They received 2h (one theoretical and another practical) of basic life support training by their Physical Education teachers, as part of the school program. The children were evaluated by a theoretical test and a practical skill test that measured the quality of chest compressions, and assessed the performance of the basic life support sequence. (AU)

Learning to resuscitate at school. Study in 8-12 year-old schoolchildren.

OBJECTIVE: To quantitatively assess the learning capacity of school children aged between 8-12 years in basic life support (theory and practice) after a feasible school training programme. MATERIAL AND METHODS: Quasi-experimental study with a convenience sample of 567 pupils in 3rd and 5th year of Primary Education, and first year of Compulsory Secondary Education, from 3 public schools in Galicia. They received 2h (one theoretical and another practical) of basic life support training by their Physical Education teachers, as part of the school program. The children were evaluated by a theoretical test and a practical skill test that measured the quality of chest compressions, and assessed the performance of the basic life support sequence. RESULTS: The level of knowledge increased with respect to the baseline, and was higher in the higher grades (P < .001). The complete basic life support sequence was carried out by 16.5% of pupils in the 3rd year of Primary Education, 54.4% of pupils in the 5th year of Primary Education, and 28.5% of pupils in the 1st year of Secondary Education (P = .030). The following compression quality parameters improved significantly with age: continuity of compressions (P < .001), percentage of compressions performed at correct depth (P = .002), and median depth (P < .001), while the percentage of compressions with correct decompression decreased significantly (P < .001). CONCLUSIONS: Although their anthropometric characteristics may not allow them to achieve the ideal quality of this manoeuvre, a 2h theoretical and practical training programme, taught by Physical Education teachers, helps to improve the ability of children younger than 13 years old to recognise the emergency, start the chain of survival, and initiate chest compressions.

Training frequency for educating schoolchildren in basic life support: very brief 4-month rolling-refreshers versus annual retraining-a 2-year prospective longitudinal trial.

OBJECTIVE: To compare the effectiveness of 4-month rolling-refreshers and annual retraining in basic life support (BLS) on a sample of schoolchildren. DESIGN: Prospective longitudinal trial. SETTING AND PARTICIPANTS: Four hundred and seventy-two schoolchildren (8-12 years old). INTERVENTIONS: Schoolchildren were instructed in BLS and then split into the following three groups: control group (CG), standard group (SG) and rolling-refresher group (RRG). Their BLS skills were assessed within 1 week (T1) and 2 years later (T2). Moreover, CG did not receive any additional training; SG received one 50 min retraining session 1 year later; RRG participated in very brief (5 min) rolling-refreshers that were carried out every 4 months. PRIMARY AND SECONDARY OUTCOMES: Hands-on skills of BLS sequence and cardiopulmonary resuscitation. RESULTS: BLS sequence performance was similar in all groups at T1, but SG and RRG followed the steps of the protocol in more proportion than CG at T2. When compared at T2, RRG showed higher proficiency than SG in checking safety, checking response, opening the airway and alerting emergency medical services. In addition, although the mean resuscitation quality was low in all groups, RRG participants reached a higher percentage of global quality cardiopulmonary resuscitation (CG: 16.4±24.1; SG: 25.3±28.8; RRG: 29.9%±29.4%), with a higher percentage of correct chest compressions by depth (CG: 3.9±11.8; SG: 10.8±22.7; RRG: 15.5±26.1 mm). CONCLUSIONS: In 8-to-12-year-old schoolchildren, although annual 50 min retraining sessions help to maintain BLS performance, 4-month very brief rolling-refreshers were shown to be even more effective. Thus, we recommend implementing baseline BLS training at schools, with subsequently brief rolling-refreshers.

Impact of Extreme Temperatures on Ambulance Dispatches Due to Cardiovascular Causes in North-West Spain.

Introduction and objectives. The increase in mortality and hospital admissions associated with high and low temperatures is well established. However, less is known about the influence of extreme ambient temperature conditions on cardiovascular ambulance dispatches. This study seeks to evaluate the effects of minimum and maximum daily temperatures on cardiovascular morbidity in the cities of Vigo and A Coruña in North-West Spain, using emergency medical calls during the period 2005-2017. Methods. For the purposes of analysis, we employed a quasi-Poisson time series regression model, within a distributed non-linear lag model by exposure variable and city. The relative risks of cold- and heat-related calls were estimated for each city and temperature model. Results. A total of 70,537 calls were evaluated, most of which were associated with low maximum and minimum temperatures on cold days in both cities. At maximum temperatures, significant cold-related effects were observed at lags of 3-6 days in Vigo and 5-11 days in A Coruña. At minimum temperatures, cold-related effects registered a similar pattern in both cities, with significant relative risks at lags of 4 to 12 days in A Coruña. Heat-related effects did not display a clearly significant pattern. Conclusions. An increase in cardiovascular morbidity is observed with moderately low temperatures without extremes being required to establish an effect. Public health prevention plans and warning systems should consider including moderate temperature range in the prevention of cardiovascular morbidity.

Escolares con enfermedades crónicas, ¿qué les preocupa a sus profesores? / Schoolchildren with chronic diseases; what are teachers worried about?

INTRODUCCIÓN: Cada vez hay más niños escolarizados con enfermedades crónicas, por lo que los profesores deben ser conscientes de esta nueva realidad y de las necesidades especiales que pueden tener estos alumnos. Sin embargo, tenemos muy poca información sobre los conocimientos, actitudes y preocupaciones de los profesores ante una posible situación de riesgo en un escolar con alguna enfermedad crónica, motivo por el que se ha realizado el presente estudio. MÉTODOS: Cuestionario anónimo con preguntas sencillas sobre crisis convulsivas, diabetes, anafilaxia y reanimación cardiopulmonar básica, realizado a 244 profesores de educación primaria y secundaria, previa a su participación en talleres breves centrados en el manejo de urgencias médicas en relación con dichas patologías. RESULTADOS: El 60% de los profesores encuestados tenía en clase al menos un alumno con patología crónica, la más frecuente la epilepsia. Su principal preocupación era desconocer cómo actuar ante una situación potencialmente grave. En relación con las crisis hipoglucémicas y la anafilaxia, los profesores que tienen alumnos de riesgo, si bien conocen cuál es la medicación recomendada, no saben utilizarla correctamente. CONCLUSIONES: Los profesores de nuestro medio muestran preocupación ante el desconocimiento de las actuaciones que deben acometer ante un evento urgente en un escolar con enfermedad crónica. Aunque algunos han recibido información sobre la medicación a administrar, no están seguros de ser capaces de hacerlo correctamente. Por tanto, se debería mejorar la formación, capacitación y autoconfianza de los educadores en la atención a posibles situaciones urgentes en escolares con enfermedades crónicas

INTRODUCTION: As the number of schoolchildren with chronic diseases is constantly increasing, teachers must be aware of this new reality and of the special needs of these children. However, there is very little information about the knowledge, skills, and concerns of teachers when faced with a possible urgent situation that could occur in a child with a chronic disease. For this reason, this study has been conducted. METHODS: An anonymous questionnaire with simple questions about seizures, diabetes, anaphylaxis, and basic cardiopulmonary resuscitation (CPR) was completed by 244 primary and secondary school teachers. They subsequently participated in short workshops focused on the management of medical emergencies in relation to these conditions. RESULTS: The majority (60%) of the teachers had at least one child in their classroom with a chronic disease, with epilepsy being the most frequent. Their main concern was not knowing how to act in a potentially serious situation. As regards hypoglycaemic crises and anaphylaxis, teachers who had at-risk pupils were not sure if they would be able to use the recommended medication, although they knew how to use it. CONCLUSIONS: Teachers of the study were concerned about not knowing what to do in an emergency event in a schoolchild with chronic illness. Although some had received information about the medication to be administered, they were not sure if they would be able to do so. The training and self-confidence of teachers should be improved in order to cope with possible critical situations in schoolchildren with chronic diseases

[Learning to resuscitate at school. Study in 8-12 year-old schoolchildren]. / Aprendiendo a reanimar en la escuela. Estudio en escolares de 8-12 años.

OBJECTIVE: To quantitatively assess the learning capacity of school children aged between 8-12 years in basic life support (theory and practice) after a feasible school training programme. MATERIAL AND METHODS: Quasi-experimental study with a convenience sample of 567 pupils in 3rd, 5th and 1st year of Primary Education, and Compulsory Secondary Education, respectively, from 3 public schools in Galicia. They received 2h (one theoretical and another practical) of basic life support training by their Physical Education teachers, as part of the school program. The children were evaluated by a theoretical test and a practical skill test that measured the quality of chest compressions, and assessed the performance of the basic life support sequence. RESULTS: The level of knowledge increased with respect to the baseline, and was higher in the higher grades (P<.001). The complete basic life support sequence was carried out by 16.5% of pupils in the 3rd year of Primary Education, 54.4% of pupils in the 5th year of Primary Education, and 28.5% of pupils in the 1st year of Secondary Education (P=.030). The following compression quality parameters improved significantly with age: continuity of compressions (P<.001), percentage of compressions performed at correct depth (P=.002), and median depth (P<.001), while the percentage of compressions with correct decompression decreased significantly (P<.001). CONCLUSIONS: Although their anthropometric characteristics may not allow them to achieve the ideal quality of this manoeuvre, a 2-h theoretical and practical training programme, taught by Physical Education teachers, helps to improve the ability of children younger than 13 years-old to recognise the emergency, start the chain of survival, and initiate chest compressions.

[Schoolchildren with chronic diseases; what are teachers worried about?] / Escolares con enfermedades crónicas, ¿qué les preocupa a sus profesores?

INTRODUCTION: As the number of schoolchildren with chronic diseases is constantly increasing, teachers must be aware of this new reality and of the special needs of these children. However, there is very little information about the knowledge, skills, and concerns of teachers when faced with a possible urgent situation that could occur in a child with a chronic disease. For this reason, this study has been conducted. METHODS: An anonymous questionnaire with simple questions about seizures, diabetes, anaphylaxis, and basic cardiopulmonary resuscitation (CPR) was completed by 244 primary and secondary school teachers. They subsequently participated in short workshops focused on the management of medical emergencies in relation to these conditions. RESULTS: The majority (60%) of the teachers had at least one child in their classroom with a chronic disease, with epilepsy being the most frequent. Their main concern was not knowing how to act in a potentially serious situation. As regards hypoglycaemic crises and anaphylaxis, teachers who had at-risk pupils were not sure if they would be able to use the recommended medication, although they knew how to use it. CONCLUSIONS: Teachers of the study were concerned about not knowing what to do in an emergency event in a schoolchild with chronic illness. Although some had received information about the medication to be administered, they were not sure if they would be able to do so. The training and self-confidence of teachers should be improved in order to cope with possible critical situations in schoolchildren with chronic diseases.

Un primer paso en la enseñanza del soporte vital básico en las escuelas: la formación de los profesores / A first step to teaching basic life support in schools: Training the teachers

INTRODUCCIÓN: Los profesores pueden tener un papel esencial en la formación en reanimación cardiopulmonar básica (RCP-B) de los escolares. Sin embargo, se dispone de pocos datos acerca de la capacidad de aprendizaje de la RCP-B por estos profesionales. OBJETIVO: Evaluar de forma cuantitativa la calidad de la RCP-B realizada por profesores de colegios, tras un programa formativo breve y sencillo. MATERIAL Y MÉTODOS: Se realizó un estudio cuasiexperimental sin grupo control en el que participaron profesores de cuatro centros concertados de educación infantil, primaria y secundaria, en 3 fases: 1.a de evaluación de conocimientos, 2.a de formación en RCP-B y 3.a de evaluación de las competencias. La formación consistió en una sesión teórica de 40 min y otra práctica de 80 min, con ayuda de maniquís con sistema de retroalimentación de la calidad de las compresiones torácicas. RESULTADOS: Se incluyeron 81 profesores (60,5% mujeres). Tras la formación, el porcentaje de sujetos que realizaron bien la secuencia de RCP-B aumentó de 1,2% a 46% (p < 0,001). La calidad de las compresiones torácicas también mejoró significativamente en cuanto a: posición correcta de las manos (97,6 vs. 72,3%; p < 0,001), profundidad media (48,1 vs. 38,8mm; p < 0,001), porcentaje que alcanzó la profundidad recomendada (46,5 vs. 21,5%; p < 0,001), porcentaje de descompresiones adecuadas (78,7 vs. 61,2%; p < 0,05), y porcentaje de compresiones realizadas al ritmo recomendado (64,2 vs. 26,9%; p < 0,001). CONCLUSIONES: Tras un programa sencillo y breve, los profesores de colegios concertados son capaces de realizar la secuencia de RCP-B y aplicar las compresiones torácicas con una calidad comparable a la de colectivos con el deber de asistir a una víctima de una parada cardíaca. La comprobación de la capacidad de estos profesionales para hacer una RCP-B de calidad es el primer requisito para que puedan implicarse en la enseñanza de la RCP-B a los escolares

INTRODUCTION: Teachers may have an essential role in basic life support (BLS) training in schoolchildren. However, few data are available about their BLS learning abilities. AIM: To quantitatively assess the quality of BLS when performed by school teachers after a brief and simple training program. MATERIALS AND METHODS: A quasi-experimental study with no control group, and involving primary and secondary education teachers from four privately managed and public funded schools was conducted in 3 stages: 1 st. A knowledge test, 2 nd: BLS training, and 3 rd: Performance test. Training included a 40 minutes lecture and 80minutes hands-on session with the help feedback on the quality of the chest compressions. RESULTS: A total of 81 teachers were included, of which 60.5% were women. After training, the percentage of subjects able to perform the BLS sequence rose from 1.2% to 46% (P<.001). Chest compression quality also improved significantly in terms of: correct hands position (97.6 vs. 72.3%; P<.001), mean depth (48.1 vs. 38.8 mm; P<.001), percentage that reached recommended depth (46.5 vs. 21.5%; P<.001), percentage of adequate decompression (78.7 vs. 61.2%; P<.05), and percentage of compressions delivered at recommended rate (64.2 vs. 26.9%; P<.001). CONCLUSIONS: After and brief and simple training program, teachers of privately managed public funded schools were able to perform the BLS sequence and to produce chest compressions with a quality similar to that obtained by staff with a duty to assist cardiac arrest victims. The ability of schoolteachers to deliver good-quality BLS is a pre-requisite to be engaged in BLS training for schoolchildren

Las obligaciones de los profesionales de urgencias en caso de asistolia no controlada / Obligations of emergency responders and staff in cases of refractory asystole

No disponible

[A first step to teaching basic life support in schools: Training the teachers]. / Un primer paso en la enseñanza del soporte vital básico en las escuelas: la formación de los profesores.

INTRODUCTION: Teachers may have an essential role in basic life support (BLS) training in schoolchildren. However, few data are available about their BLS learning abilities. AIM: To quantitatively assess the quality of BLS when performed by school teachers after a brief and simple training program. MATERIALS AND METHODS: A quasi-experimental study with no control group, and involving primary and secondary education teachers from four privately managed and public funded schools was conducted in 3 stages: 1st. A knowledge test, 2nd: BLS training, and 3rd: Performance test. Training included a 40minutes lecture and 80minutes hands-on session with the help feedback on the quality of the chest compressions. RESULTS: A total of 81 teachers were included, of which 60.5% were women. After training, the percentage of subjects able to perform the BLS sequence rose from 1.2% to 46% (P<.001). Chest compression quality also improved significantly in terms of: correct hands position (97.6 vs. 72.3%; P<.001), mean depth (48.1 vs. 38.8mm; P<.001), percentage that reached recommended depth (46.5 vs. 21.5%; P<.001), percentage of adequate decompression (78.7 vs. 61.2%; P<.05), and percentage of compressions delivered at recommended rate (64.2 vs. 26.9%; P<.001). CONCLUSIONS: After and brief and simple training program, teachers of privately managed public funded schools were able to perform the BLS sequence and to produce chest compressions with a quality similar to that obtained by staff with a duty to assist cardiac arrest victims. The ability of schoolteachers to deliver good-quality BLS is a pre-requisite to be engaged in BLS training for schoolchildren.

[Incidence of acute agitation and variation in acute agitation management by emergency services]. / Incidencia y variabilidad de manejo de la agitación aguda en los servicios de emergencias médicas.

OBJECTIVES: To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. MATERIAL AND METHODS: Observational descriptive study based on aggregate data from unpublished internal EMS reports. RESULTS: Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. CONCLUSION: The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

OBJETIVO: Evaluar la incidencia y el manejo de la agitación aguda por los servicios de emergencias médicas (SEM) en España. METODO: Estudio observacional descriptivo que utiliza datos agregados de las memorias de actividad o datos internos no publicados de los SEM. RESULTADOS: Durante el año 2013, los 7 SEM participantes recibieron 4.306.213 llamadas, de las cuales 111.599 (2,6%; 6,2 llamadas/1.000 habitantes) fueron categorizadas como psiquiátricas. Las actuaciones requeridas por motivos psiquiátricos fueron 84.933 (4,2% del total de actuaciones; 4,0 actuaciones/1.000 habitantes) y, de estas, 37.951 fueron por pacientes agitados (1,9% del total de actuaciones; 2,0 actuaciones/1.000 habitantes). Solo 3 SEM disponían de un procedimiento específico para los equipos asistenciales de atención al paciente psiquiátrico y al paciente agitado. CONCLUSIONES: El paciente agitado es un problema común en los equipos asistenciales de los SEM. Pocos de estos equipos cuentan con procedimientos específicos de actuación ante estos casos.

Incidencia y variabilidad de manejo de la agitación aguda en los servicios de emergencias médicas / Incidence of acute agitation and variation in acute agitation management by emergency services

Objetivo. Evaluar la incidencia y el manejo de la agitación aguda por los servicios de emergencias médicas (SEM) en España. Método. Estudio observacional descriptivo que utiliza datos agregados de las memorias de actividad o datos internos no publicados de los SEM. Resultados. Durante el año 2013, los 7 SEM participantes recibieron 4.306.213 llamadas, de las cuales 111.599 (2,6%; 6,2 llamadas/1.000 habitantes) fueron categorizadas como psiquiátricas. Las actuaciones requeridas por motivos psiquiátricos fueron 84.933 (4,2% del total de actuaciones; 4,0 actuaciones/1.000 habitantes) y, de estas, 37.951 fueron por pacientes agitados (1,9% del total de actuaciones; 2,0 actuaciones/1.000 habitantes). Solo 3 SEM disponían de un procedimiento específico para los equipos asistenciales de atención al paciente psiquiátrico y al paciente agitado. Conclusiones. El paciente agitado es un problema común en los equipos asistenciales de los SEM. Pocos de estos equipos cuentan con procedimientos específicos de actuación ante estos casos (AU)

Objective. To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Methods. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Results. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. Conclusions. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients (AU)

Out-of-hospital cardiac arrest (OHCA) attended by mobile emergency teams with a physician on board. Results of the Spanish OHCA Registry (OSHCAR).

Most survival outcomes in out-of-hospital cardiac arrest (OHCA) are provided by emergency medical services (EMS) without a doctor on board. Our objective was to determine such outcomes in a whole country with public physician-led EMS. METHODS: We analyzed data from a nationwide prospective registry of OHCA cases attended by 19 public EMS in Spain, covering the period from 1-October 2013 to 30-October 2014. RESULTS: Advanced life support (ALS) was initiated in 9347 cases (incidence 18.6 cases/105 inhabitants per year). Resuscitation was considered futile in 558 cases (5.9%), and ALS was continued in 8789 cases (94.1%); mean age 63.5±17 years, 72.1% men. Initial rhythm was shockable in 22.1% of cases. Basic life support (BLS) was provided by bystanders in 1602 (24%) cases (635 of them with telephone assistance from the dispatch center). Of 8789 patients receiving ALS, 72.1% men, 2669 (30.4%) patients had return of spontaneous circulation on hospital arrival, 50.6% when the initial rhythm was shockable. Hospital discharge with good neurological status (CPC1-2) was found in 11.1% of the study population and in 27.6% when considering the Utstein comparator group of patients. A total of 216 (2.5%) patients arrived at the hospital with ongoing resuscitation, of whom only one survived with CPC1-2, and 165 (1.9%) patients were included in non-heart-beating donation programs. CONCLUSIONS: In Spain with physician-led EMS, OHCA survival with CPC1-2 reached a reasonable percentage despite only a modest contribution of bystander BLS. Ongoing resuscitation strategy seems to be futile except when considering non-heart beating donation programs.

Efectividad de la consulta de enfermería en una central de coordinación de urgencias sanitarias / Efficacy of nurse consultants in a health emergency coordination center

Objetivo: Describir la actividad del enfermero de consulta (EC) en la Central de Coordinación de Urgencias Sanitarias de Galicia-061 (CCUSG-061), en términos de capacidad de resolución de problemas y adecuación de decisiones. Método: Estudio retrospectivo, observacional y descriptivo que incluyó todas las llamadas telefónicas atendidas por los EC entre julio de 2013 y 2014. Se consideró como resolución efectiva cualquier demanda que tras ser resuelta sin movilizar recursos no originase una nueva llamada telefónica, ingreso hospitalario o fallecimiento del paciente en las 24 horas siguientes. Resultados: Los EC atendieron 37.553 llamadas, 92% resueltas sin necesidad de movilizar recursos o pacientes. De ellas, el 97% no fue objeto de rellamada, ni de complicaciones en las 24 horas siguientes. Conclusiones: Los EC resuelven de forma segura la mayoría de las necesidades asistenciales de los pacientes, sin movilizar pacientes o recursos sanitarios (AU)

Objective: To describe nurse consultants’ work at the Health Emergency Coordination Center of Galicia (CCUSG-061) in terms of their ability to resolve problems and the appropriateness of their decisions. Methods: Retrospective, observational, descriptive study that included all telephone calls attended by nurses between July 2013 and 2014. The results of a consultation were considered successful if a request for help was resolved without mobilization of resources and did not lead to a new call to the emergency service, a hospital admission, or a death in the next 24 hours. Results: The nurses attended 37 553 calls, resolving 92% without mobilizing resources or patients. Ninety-seven percent of the calls resolved did not generate new calls or complications in the next 24 hours. Conclusions: Nurses resolve most patients’ emergency care requirements safely without moving patients or mobilizing health resources (AU)

[Efficacy of nurse consultants in a health emergency coordination center]. / Efectividad de la consulta de enfermería en una central de coordinación de urgencias sanitarias.

OBJECTIVES: To describe nurse consultants' work at the Health Emergency Coordination Center of Galicia (CCUSG-061) in terms of their ability to resolve problems and the appropriateness of their decisions. MATERIAL AND METHODS: Retrospective, observational, descriptive study that included all telephone calls attended by nurses between July 2013 and 2014. The results of a consultation were considered successful if a request for help was resolved without mobilization of resources and did not lead to a new call to the emergency service, a hospital admission, or a death in the next 24 hours. RESULTS: The nurses attended 37 553 calls, resolving 92% without mobilizing resources or patients. Ninety-seven percent of the calls resolved did not generate new calls or complications in the next 24 hours. CONCLUSION: Nurses resolve most patients' emergency care requirements safely without moving patients or mobilizing health resources.

OBJETIVO: Describir la actividad del enfermero de consulta (EC) en la Central de Coordinación de Urgencias Sanitarias de Galicia-061 (CCUSG-061), en términos de capacidad de resolución de problemas y adecuación de decisiones. METODO: Estudio retrospectivo, observacional y descriptivo que incluyó todas las llamadas telefónicas atendidas por los EC entre julio de 2013 y 2014. Se consideró como resolución efectiva cualquier demanda que tras ser resuelta sin movilizar recursos no originase una nueva llamada telefónica, ingreso hospitalario o fallecimiento del paciente en las 24 horas siguientes. RESULTADOS: Los EC atendieron 37.553 llamadas, 92% resueltas sin necesidad de movilizar recursos o pacientes. De ellas, el 97% no fue objeto de rellamada, ni de complicaciones en las 24 horas siguientes. CONCLUSIONES: Los EC resuelven de forma segura la mayoría de las necesidades asistenciales de los pacientes, sin movilizar pacientes o recursos sanitarios.

Factores pronóstico de supervivencia en la parada cardiaca extrahospitalaria atendida con desfibriladores externos semiautomáticos en Galicia / Factors predicting survival of out-of-hospital cardiac arrest managed with semiautomatic external defibrillators in Galicia

Objetivos: Determinar los factores pronóstico de las paradas cardiacas extrahospitalarias (PCE) atendidas por el servicio de emergencias médicas (SEM) en Galicia en las que se utilizó un desfibrilador externo semiautomático (DESA). Método: Estudio descriptivo retrospectivo de las PCE atendidas con DESA durante un periodo de 5 años, con recogida de datos según el estilo Utstein. Las variables analizadas fueron: sexo, edad, fecha y hora del suceso, asistencia en medio rural o urbano, localización, PCE presenciada, inicio maniobras por testigos, primer ritmo cardiaco monitorizado, intubación orotraqueal (IOT), y tiempos de alerta y asistenciales. Resultados: Se analizaron 2.005 casos (0,14/1.000 habitantes-año), 68,2% varones, 70,8% atendidos en medio rural y 61% con localización en el domicilio. Se logró la reanimación cardiaca extrahospitalaria (RCE) in situ en el 10,9% de los pacientes (29,9% en los casos encontrados en ritmos desfibrilables y 3,3% en aquellos en asistolia). Se realizó IOT en el15,7% de los casos, de los que lograron RCE el 24,8%. La disminución del tiempo medio entre la alerta y la asistencia (12:26 minutos en los que se logró la RCE y de 16:16 minutos en los fallecidos) resulta significativo para el aumento de la RCE (p < 0,001), así como los ritmos desfibrilables (p = 0,001). Contrariamente los ritmos asistolia disminuyen las posibilidades de supervivencia (p < 0,005). Conclusiones: La presencia de ritmos desfibrilables y los tiempos asistenciales breves son los factores significativamente relacionados con la supervivencia de la PCE atendida con DESA en Galicia (AU)

Objectives: To determine prognostic factors in out-of-hospital cardiac arrests managed with semiautomatic external defibrillators (SAEDs) by emergency health service responders in Galicia, Spain. Method: Retrospective descriptive study of out-of-hospital cardiac arrests treated with SAEDs over a period of 5 years. We collected Utstein outcome data from the database and analyzed the following variables: sex, age, date and time of cardiac event, rural vs urban setting, type of location, witnessed or not, bystander resuscitation attempts or not, time first heart rhythm was detected, use of orotracheal intubation or not, time of call for help, and time to arrival of emergency responders. Results: We analyzed 2005 cases (0.14/1000 person-years; 68.2% male, 70.8% in rural locations, 61% at home). Return of spontaneous circulation (ROSC) was achieved in situ in 10.9% (in 29.9% of patients with shockable rhythms and in 3.3% of those in asystole). Intubation was necessary in 15.7%; ROSC was achieved in 24.8% of the intubated patients. ROSC was achieved in significantly more patients when responders arrived soon after the call for help (mean: 12 minutes, 26 seconds) than when arrival was delayed (mean: 16 minutes, 16 seconds when ROSC was not achieved; P <001 ). The presence of a shockable rhythm was also significantly more frequent when response time was faster (P<001 ). Asystole, on the other hand, reduced the likelihood of survival (P< 005). Conclusion: Prognostic factors related to survival of SAED-managed out-of-hospital cardiac arrest in Galicia were the presence of a shockable rhythm, shorter response time, continuation of basic life support measures including advanced airway management, bystander life-support maneuvers, an urban location, and night timing of the arres (AU)

Influencia del clima en el infarto de miocardio en Galicia / Influence of weather in the incidence of acute myocardial infarction in Galicia (Spain)

Objetivo: Analizar la influencia del clima y el impacto de cada parámetro meteorológico sobre la incidencia del infarto agudo de miocardio (IAM) en Galicia. Métodos: Estudio retrospectivo analizando el número de IAM diagnosticados y trasladados a hospitales por la Fundación Pública de Urgencias Sanitarias de Galicia-061 entre 2002 y 2009. Incluimos pacientes con criterios clínicos y electrocardiográficos de IAM, y analizamos su correlación con variables meteorológicas diezminutales (temperatura, humedad, presión, precipitaciones acumuladas y velocidad del viento) registradas por MeteoGalicia. Resultados: Se incluyeron 4.717 infartos diagnosticados (72,8% varones y 27,2% mujeres), sin detectar variación estacional. La temperatura media diaria (p = 0,683) y la velocidad media del viento (p = 0,895) no mostraron relación significativa con la incidencia de IAM. La presión atmosférica presenta una asociación estadísticamente significativa con la incidencia de IAM (p < 0,005), así como la humedad relativa, asociada a una mayor incidencia en el cuarto cuartil (p = 0,005). Conclusiones: Nuestro estudio muestra una asociación estadísticamente significativa entre la presión atmosférica y la humedad relativa media diaria con la incidencia de IAM en Galicia. Dado que las condiciones locales en las diferentes estaciones son muy variables, los futuros trabajos deberían dirigirse a establecer la relación entre patrones climáticos (definidos por combinaciones de parámetros meteorológicos individuales), en lugar de variaciones estacionales, y la incidencia de IAM (AU)

Objective: To assess the interactions between weather and the impact of each individual meteorological parameters in the incidence of acute myocardial infarctions (AMI) in Galicia. Methods: Retrospective study analyzing the number of AMI diagnosed and transferred to the hospital by the Emergencies Sanitary System of Galicia between 2002 and 2009. We included patients with clinical and ECG findings of AMI. The correlation between 10-minute meteorological variables (temperature, humidity, pressure, accumulated rainfall and wind speed) recorded by MeteoGalicia and the incidence of AMI was assessed. Results: A total of 4,717 AMI were registered (72.8% men, 27.2% women). No seasonal variations were found. No significant correlations were detected with regard to average daily temperature (P = .683) or wind speed (P = .895). Correlation between atmospheric pressure and incidence of AMI was significant (P < .005), as well as with the daily relative humidity average (P = .005). Conclusions: Our study showed a statistical significant association with atmospheric pressure and with the daily relative humidity average. Since the local conditions of weather are widely variable, future studies should establish the relationship between weather patterns (including combinations of meteorological parameters), rather than seasonal variations, and the incidence of AMI (AU)

[Factors predicting survival of out-of-hospital cardiac arrest managed with semiautomatic external defibrillators in Galicia]. / Factores pronóstico de supervivencia en la parada cardiaca extrahospitalaria atendida con desfibriladores externos semiautomáticos en Galicia.

OBJECTIVES: To determine prognostic factors in out-of-hospital cardiac arrests managed with semiautomatic external defibrillators (SAEDs) by emergency health service responders in Galicia, Spain. MATERIAL AND METHODS: Retrospective descriptive study of out-of-hospital cardiac arrests treated with SAEDs over a period of 5 years. We collected Utstein outcome data from the database and analyzed the following variables: sex, age, date and time of cardiac event, rural vs urban setting, type of location, witnessed or not, bystander resuscitation attempts or not, time first heart rhythm was detected, use of orotracheal intubation or not, time of call for help, and time to arrival of emergency responders. RESULTS: We analyzed 2005 cases (0.14/1000 person-years; 68.2% male, 70.8% in rural locations, 61% at home). Return of spontaneous circulation (ROSC) was achieved in situ in 10.9% (in 29.9% of patients with shockable rhythms and in 3.3% of those in asystole). Intubation was necessary in 15.7%; ROSC was achieved in 24.8% of the intubated patients. ROSC was achieved in significantly more patients when responders arrived soon after the call for help (mean: 12 minutes, 26 seconds) than when arrival was delayed (mean: 16 minutes, 16 seconds when ROSC was not achieved; P<.001). The presence of a shockable rhythm was also significantly more frequent when response time was faster (P<.001). Asystole, on the other hand, reduced the likelihood of survival (P<.005). CONCLUSION: Prognostic factors related to survival of SAED-managed out-of-hospital cardiac arrest in Galicia were the presence of a shockable rhythm, shorter response time, continuation of basic life support measures including advanced airway management, bystander life-support maneuvers, an urban location, and night timing of the arrest.

OBJETIVO: Determinar los factores pronóstico de las paradas cardiacas extrahospitalarias (PCE) atendidas por el servicio de emergencias médicas (SEM) en Galicia en las que se utilizó un desfibrilador externo semiautomático (DESA). METODO: Estudio descriptivo retrospectivo de las PCE atendidas con DESA durante un periodo de 5 años, con recogida de datos según el estilo Utstein. Las variables analizadas fueron: sexo, edad, fecha y hora del suceso, asistencia en medio rural o urbano, localización, PCE presenciada, inicio maniobras por testigos, primer ritmo cardiaco monitorizado, intubación orotraqueal (IOT), y tiempos de alerta y asistenciales. RESULTADOS: Se analizaron 2.005 casos (0,14/1.000 habitantes-año), 68,2% varones, 70,8% atendidos en medio rural y 61% con localización en el domicilio. Se logró la reanimación cardiaca extrahospitalaria (RCE) in situ en el 10,9% de los pacientes (29,9% en los casos encontrados en ritmos desfibrilables y 3,3% en aquellos en asistolia). Se realizó IOT en el 15,7% de los casos, de los que lograron RCE el 24,8%. La disminución del tiempo medio entre la alerta y la asistencia (12:26 minutos en los que se logró la RCE y de 16:16 minutos en los fallecidos) resulta significativo para el aumento de la RCE (p < 0,001), así como los ritmos desfibrilables (p = 0,001). Contrariamente los ritmos asistolia disminuyen las posibilidades de supervivencia (p < 0,005). CONCLUSIONES: La presencia de ritmos desfibrilables y los tiempos asistenciales breves son los factores significativamente relacionados con la supervivencia de la PCE atendida con DESA en Galicia.

[Influence of weather in the incidence of acute myocardial infarction in Galicia (Spain)]. / Influencia del clima en el infarto de miocardio en Galicia.

OBJECTIVE: To assess the interactions between weather and the impact of each individual meteorological parameters in the incidence of acute myocardial infarctions (AMI) in Galicia. METHODS: Retrospective study analyzing the number of AMI diagnosed and transferred to the hospital by the Emergencies Sanitary System of Galicia between 2002 and 2009. We included patients with clinical and ECG findings of AMI. The correlation between 10-minute meteorological variables (temperature, humidity, pressure, accumulated rainfall and wind speed) recorded by MeteoGalicia and the incidence of AMI was assessed. RESULTS: A total of 4,717 AMI were registered (72.8% men, 27.2% women). No seasonal variations were found. No significant correlations were detected with regard to average daily temperature (P=.683) or wind speed (P=.895). Correlation between atmospheric pressure and incidence of AMI was significant (P<.005), as well as with the daily relative humidity average (P=.005). CONCLUSIONS: Our study showed a statistical significant association with atmospheric pressure and with the daily relative humidity average. Since the local conditions of weather are widely variable, future studies should establish the relationship between weather patterns (including combinations of meteorological parameters), rather than seasonal variations, and the incidence of AMI.