Análisis de las fases del rescate acuático como elemento discriminativo del rendimiento / Analysis of the phases of lifesaving as a discriminative element of performance

Purpose: The aim of this study was to analyze the different phases of a water rescue, their influence in the whole lifesavingand if lifeguards could be differentiated according to their abilities during a water rescue.Methods: A cross-sectional study was carried out to analyze the different phases and lifeguard’sabilities of a simulated water rescue of 100 m. Thirty-fourprofessional lifeguards performed the test and the time was recorded for the first phase (swimming to the victim), the second phase (towing back the victim) and the third phase (extracting the victim). A discriminant analysis was conducted in order to classifylifeguards in two groups (high or medium level of abilities during the water rescue) and the times were compared on each phase.Results: The time during the second and the third phase classify correctly the lifeguards according to their level of abilities. Lifeguards with higher level of abilities performed the water rescue significantly faster, specifically during the second (p < 0.001, ES =1.38, large) and the third phase (p =0.002, ES = 1.09, medium), but no differences were found in the first part of the water rescue (p > 0.05). Conclusion: The time of a simulated water rescue seems to bea good method to classify lifeguards according to their abilities. These findings could allow rescue teams to know the skills of their lifeguards and design strategiesin order to decrease risks and enhance lifesaving (AU)

Objetivo: Analizar las diferentes fases del rescate para conocer su influencia sobre el resultado final y categorizar a los socorristas de acuerdo a su competencia acuática.Métodos: Se realizó un estudio cruzado simulando un rescate a 100 metros con 34 socorristas, analizando las tres fases del rescate: nado hacia la víctima, traslado a tierra y extracción. Se realizó un análisis discriminante para clasificar a los socorristas según el tiempo de rescate.Resultados: La segunda y la tercera fase clasificó correctamente a los socorristas de acuerdo al tiempo empleado. La mayor competencia fue determinada especialmente en la segunda fase del salvamento (p<0,001, TE=1,38, grande) y en menor medida de la tercera fase (p=0,002, TE=1,09, mediano).Conclusión: El tiempo empleado en la segunda fase parece ser un buen método para clasificar la competencia de los socorristas durante el rescate. Estos hallazgos proporcionan información relevante para el entrenamiento y organización de equipos de rescate (AU)

Resuscitation and emergency care in drowning: A scoping review.

BACKGROUND: The ILCOR Basic Life Support Task Force and the international drowning research community considered it timely to undertake a scoping review of the literature to identify evidence relating to the initial resuscitation, hospital-based interventions and criteria for safe discharge related to drowning. METHODS: Medline, PreMedline, Embase, Cochrane Reviews and Cochrane CENTRAL were searched from 2000 to June 2020 to identify relevant literature. Titles and abstracts and if necessary full text were reviewed in duplicate. Studies were eligible for inclusion if they reported on the population (adults and children who are submerged in water), interventions (resuscitation in water/boats, airway management, oxygen administration, AED use, bystander CPR, ventilation strategies, ECMO, protocols for hospital discharge (I), comparator (standard care) and outcomes (O) survival, survival with a favourable neurological outcome, CPR quality, physiological end-points). RESULTS: The database search yielded 3242 references (Medline 1104, Pre-Medline 202, Embase 1722, Cochrane reviews 12, Cochrane CENTRAL 202). After removal of duplicates 2377 papers were left for screening titles and abstracts. In total 65 unique papers were included. The evidence identified was from predominantly high-income countries and lacked consistency in the populations, interventions and outcomes reported. Clinical studies were exclusively observational in nature. CONCLUSION: This scoping review found that there is very limited evidence from observational studies to inform evidence based clinical practice guidelines for drowning. The review highlights an urgent need for high quality research in drowning.

Nueva técnica de masaje cardíaco en lactantes / A new chest compression technique in infants

Objetivo: Comparar en un maniquí de lactante la calidad de las compresiones torácicas según el método tradicional (MT) o según la nueva técnica de 2pulgares con puños cerrados (NM). Diseño: Estudio controlado, aleatorizado y cruzado en profesionales. Ámbito: Hospital Universitario con UCI Pediátrica del norte de España. Participantes: Residentes y enfermeros de Pediatría, habiendo superado un curso de RCP básica y avanzada pediátrica. Intervenciones: Análisis cuantitativo de calidad de compresiones torácicas en escenario de RCP en lactante durante 2 min, mediante el sistema SimPad(R) con SkillReporter(TM) de Laerdal. Variables de interés principales: Frecuencia media y porcentaje de compresiones en rango recomendada, profundidad media y porcentaje de compresiones en rango recomendado, porcentaje de compresiones con descompresión adecuada y porcentaje de compresiones realizadas con los dedos en el centro del tórax. Resultados: La calidad global de las compresiones (NM: 84,2±23,7% vs. MT: 80,1±25,4% [p=0,25; no sig.]), el porcentaje de compresiones con profundidad correcta (NM: 59,9±35,8% vs. MT: 59,5±35,7% [p=0,76; no sig.]), la profundidad media alcanzada (NM: 37,3±3,8mm vs. MT: 36±5,3mm [p=0,06; no sig.]), el porcentaje de reexpansión completa de la caja torácica (NM: 94,4±9,3% vs. MT: 92,4±18,3% [p=0,58; no sig.]) y el porcentaje de compresiones con la frecuencia recomendada (NM: 62,2±34,6% vs. MT: 51±37,2% [p=0,13; no sig.]) fueron similares con los 2métodos. Conclusiones: La calidad de compresiones torácicas con el nuevo método (pulgares con los puños cerrados) es similar a la obtenida con el método tradicional

Objective: To compare the quality of chest compressions performed according to the classical technique (MT) versus a new technique (NM) (compression with 2thumbs with closed fists) in an infant manikin. Design: A controlled, randomized cross-over study was carried out in professionals assisting pediatric patients. Setting: A University Hospital with a Pediatric ICU in the north of Spain. Participants: Residents and nurses in Pediatrics who had completed a basic and an advanced pediatric cardiopulmonary resuscitation course. Interventions: Quantitative analysis of the variables referred to chest compression quality in a 2-minute cardiopulmonary resuscitation scenario in infants. Laerdal's SimPad(R) with SkillReporter(TM) system was used. Main variables of interest: Mean rate and percentage of compressions in the recommended rate range, mean depth and percentage of compressions within the depth range of recommendations, percentage of compressions with adequate decompression, and percentage of compressions performed with the fingers in the center of the chest. Results: Global quality of the compressions (NM: 84.2±23.7% vs. MT: 80.1±25.4% [p=0.25; p=ns]), percentage of compressions with correct depth (NM: 59.9±35.8% vs. MT: 59.5±35.7% [p=0.76; p=ns]), mean depth reached (NM: 37.3±3.8mm vs. MT: 36±5.3mm [p=0.06; p=ns]), percentage of complete re-expansion of the chest (NM: 94.4±9.3% vs. MT: 92.4±18.3% [p=0.58; p=ns]), and percentage of compressions with the recommended rate (NM: 62.2±34.6% vs. MT: 51±37.2% [p=0.13; p=ns]) proved similar with both methods. Conclusions: The quality of chest compressions with the new method (thumbs with closed fists) is similar to that afforded by the traditional method

Implantación de programas educativos para prevenir ahogamientos. ¿Qué se puede hacer desde la escuela infantil? / Implementation of educational programs to prevent drowning. What can be done in nursery school?

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A new chest compression technique in infants. / Nueva técnica de masaje cardíaco en lactantes.

OBJECTIVE: To compare the quality of chest compressions performed according to the classical technique (MT) versus a new technique (NM) (compression with 2thumbs with closed fists) in an infant manikin. DESIGN: A controlled, randomized cross-over study was carried out in professionals assisting pediatric patients. SETTING: A University Hospital with a Pediatric ICU in the north of Spain. PARTICIPANTS: Residents and nurses in Pediatrics who had completed a basic and an advanced pediatric cardiopulmonary resuscitation course. INTERVENTIONS: Quantitative analysis of the variables referred to chest compression quality in a 2-minute cardiopulmonary resuscitation scenario in infants. Laerdal's SimPad® with SkillReporter™ system was used. MAIN VARIABLES OF INTEREST: Mean rate and percentage of compressions in the recommended rate range, mean depth and percentage of compressions within the depth range of recommendations, percentage of compressions with adequate decompression, and percentage of compressions performed with the fingers in the center of the chest. RESULTS: Global quality of the compressions (NM: 84.2±23.7% vs. MT: 80.1±25.4% [p=0.25; p=ns]), percentage of compressions with correct depth (NM: 59.9±35.8% vs. MT: 59.5±35.7% [p=0.76; p=ns]), mean depth reached (NM: 37.3±3.8mm vs. MT: 36±5.3mm [p=0.06; p=ns]), percentage of complete re-expansion of the chest (NM: 94.4±9.3% vs. MT: 92.4±18.3% [p=0.58; p=ns]), and percentage of compressions with the recommended rate (NM: 62.2±34.6% vs. MT: 51±37.2% [p=0.13; p=ns]) proved similar with both methods. CONCLUSIONS: The quality of chest compressions with the new method (thumbs with closed fists) is similar to that afforded by the traditional method.

Tabla Air Stand-Up Paddle de rescate acuático: ¿Cómo puede ayudar al socorrista? / Air Table Stand-Up Paddle water rescue: How can you help the lifeguard?

Las tablas tradicionales y rígidas en socorrismo acuático han sido rechazadas en muchos servicios de socorrismo por los problemas que generaban. La experiencia con tablas hinchables (AIRSUPRA) ha demostrado muchas ventajas y las objeciones sobre este material están desapareciendo y ya comienzan a utilizarse en servicios de socorrismo, que antes eran reticentes. El objetivo de este estudio fue analizar el efecto del uso de la tabla AIRSUPRA en el tiempo de aproximación en una distancia de 100 metros, con una muestra de 16 socorristas profesionales (13 hombres y 3 mujeres), certificados y actualizados en técnicas de rescate, pero sin experiencia con tablas AIRSUPRA. Los resultados demuestran que cuando se realiza la aproximación con la tabla AIRSUPRA (TR1) se obtiene un tiempo de 54.13 + 8.58, mientras que cuando se realiza la aproximación a nado el tiempo es 93.19 + 25.52, con una diferencia de 39.06 segundos, estadísticamente significativa (p <0.001). Este primer estudio y sus resultados apuntan a la necesidad de profundizar en la investigación con este nuevo material para el rescate (AU)

The use of traditional and rigid boards in aquatic lifesaving cause more problems than advantages, for this reason was frequently rejected in many lifesaving services. However, based on knowledge and experimentation with inflatable boards many advantages have been proven, doubts and objections on this material are disappearing and, in fact, are beginning to be used in lifesaving services that were previously reluctant to use them. The aim of this study was to analyze the effect of using the table AIRSUPRA in the time of approaching for a distance of 100 meters. The sample was integrated by 16 professionals (13 men and 3 women), all of them with rescue techniques certification and updated training, but with no experience managing boards AIRSUPRA. The results show that when the approximation with AIRSUPRA table (TR1) is performed the time was of 54.13 + 8.58, whereas when the approaching is performed swmming the time was of 93.19 + 25.52, with a difference of 39.06 seconds, statistically significant (p <0.001). This first study and its results point to the need for further research with this new material for rescue (AU)

Utilidad de un dispositivo luminoso simple para mejorar el aprendizaje del masaje cardiaco / Utility of a simple lighting device to improve chest compressions learning

Introducción. Las recomendaciones sobre la reanimación cardiopulmonar (RCP) enfatizan la calidad de las maniobras, en especial las compresiones torácicas (CT). Los dispositivos de retroalimentación podrían mejorar la calidad de las CT durante la RCP. El objetivo de este estudio fue evaluar la utilidad de un dispositivo lumínico simple como ayuda visual durante la RCP en un maniquí. Material y métodos. Veintidós mujeres pediatras que asistieron a un curso acreditado de RCP pediátrica realizaron, siguiendo un orden aleatorio, 2min de RCP en un maniquí sin y con la ayuda de un dispositivo luminoso simple, que emite destellos con una frecuencia de 100 ciclos por minuto. Se analizaron mediante un medidor validado de la calidad de las compresiones (CPRmeter®) las siguientes variables de las CT: profundidad, descompresiones, frecuencia, tiempo de RCP y porcentaje de compresiones. Resultados. Con el dispositivo luminoso, las participantes aumentaron la calidad media (60,23±54,50 vs. 79,24±9,80%; p=0,005), la profundidad (48,86±42,67 vs. 72,95±20,25%; p=0,036) y la frecuencia del masaje (35,82±37,54 vs. 67,09±31,95%; p=0,024). Conclusiones. Un dispositivo luminoso simple que parpadea a la frecuencia recomendada mejora la calidad de las CT realizadas por residentes de pediatría en un maniquí. Se debería evaluar la utilidad de este sistema de ayuda de la RCP en pacientes reales (AU)

Introduction. The recommendations on cardiopulmonary resuscitation (CPR) emphasize the quality of the manoeuvres, especially chest compressions (CC). Audiovisual feedback devices could improve the quality of the CC during CPR. The aim of this study was to evaluate the usefulness of a simple lighting device as a visual aid during CPR on a mannequin. Material and methods. Twenty-two paediatricians who attended an accredited paediatric CPR course performed, in random order, 2min of CPR on a mannequin without and with the help of a simple lighting device, which flashes at a frequency of 100 cycles per minute. The following CC variables were analyzed using a validated compression quality meter (CPRmeter®): depth, decompression, rate, CPR time and percentage of compressions. Results. With the lighting device, participants increased average quality (60.23±54.50 vs. 79.24±9.80%; P=.005), percentage in target depth (48.86±42.67 vs. 72.95±20.25%; P=.036) and rate (35.82±37.54 vs. 67.09±31.95%; P=.024). Conclusions. A simple light device that flashes at the recommended frequency improves the quality of CC performed by paediatric residents on a mannequin. The usefulness of this CPR aid system should be assessed in real patients (AU)

Policía Costera de Vigo. Estudio piloto cuasiexperimental sobre rescate y RCP / Coastal Police of Vigo. A quasi-experimental pilot study about rescue and CPR

El ahogamiento es una de las principales causas de muerte en el mundo y en España. Los socorristas ejercen una labor de prevención y vigilancia pero su labor es estacional y temporal. En muchos lugares, la primera respuesta a la emergencia, cuando los socorristas no están de servicio, depende de la policía, a la que se le requiere habilidades de rescate y reanimación cardiopulmonar (RCP). El objetivo de este estudio es determinar la capacidad de rescate y efecto de la fatiga sobre la calidad de la RCP de un grupo de diez policías costeros cuya área de influencia es el litoral de Vigo. El diseño fue cuasi-experimental con dos factores (pretest basal/postest rescate). Los policías pudieron realizar el rescate acuático rápido y seguro 417 ± 54,5 seg, a nivel de lactacidema se registró 12,27 ± 2,36 mmol. La fatiga inducida por el rescate afectó negativamente a la calidad de la compresiones en la RCP (p = 0,002) (AU)

Drowning is a leading cause of death worldwide and in Spain. Lifeguards exert vigilance and prevention efforts but their work is seasonal and temporary. In many places the first emergency response when lifeguards are not on duty, depends on the police, which are required rescue skills and cardiopulmonary resuscitation (CPR). The objective of this study is to determine the ability of lifesaving and effect of fatigue on the quality of CPR of a group of ten coastal police whose area of influence is the coast of Vigo. The design was quasiexperimental with two factors (basal pretest / posttest rescue). Cops with basic training could perform fast and safe water rescue 417 ± 54.5 seconds, lactate level was recorded 12.27 ± 2.36 mmol. Induced fatigue during resuce effort had a nevative effect on the quality of compressions in CPR (p = 0.002) (AU)

Utility of a simple lighting device to improve chest compressions learning. / Utilidad de un dispositivo luminoso simple para mejorar el aprendizaje del masaje cardiaco.

INTRODUCTION: The recommendations on cardiopulmonary resuscitation (CPR) emphasize the quality of the manoeuvres, especially chest compressions (CC). Audiovisual feedback devices could improve the quality of the CC during CPR. The aim of this study was to evaluate the usefulness of a simple lighting device as a visual aid during CPR on a mannequin. MATERIAL AND METHODS: Twenty-two paediatricians who attended an accredited paediatric CPR course performed, in random order, 2min of CPR on a mannequin without and with the help of a simple lighting device, which flashes at a frequency of 100 cycles per minute. The following CC variables were analyzed using a validated compression quality meter (CPRmeter®): depth, decompression, rate, CPR time and percentage of compressions. RESULTS: With the lighting device, participants increased average quality (60.23±54.50 vs. 79.24±9.80%; P=.005), percentage in target depth (48.86±42.67 vs. 72.95±20.25%; P=.036) and rate (35.82±37.54 vs. 67.09±31.95%; P=.024). CONCLUSIONS: A simple light device that flashes at the recommended frequency improves the quality of CC performed by paediatric residents on a mannequin. The usefulness of this CPR aid system should be assessed in real patients.

La coordinación de socorristas acuáticos profesionales en espacios acuáticos naturales (playas) / The management of lifeguards in natural acuatic spaces (beaches)

Este estudio nace con la necesidad de establecer criterios básicos y descripción de recomendaciones para mejorar el nivel de atención de los socorristas acuáticos profesionales en los espacios acuáticos naturales, concretamente en el trabajo realizado en las playas, con el objetivo de aumentar la seguridad de estas zonas de baño. El estudio se ha desarrollado en la Comunidad Autónoma de Cataluña, concretamente en tres playas de varios municipios de la provincia de Barcelona. Se puede afirmar que tras esta investigación la mayor parte de los socorristas acuáticos que han participado en el estudio valoraron positivamente las medidas y criterios propuestos, asumiendo que con los mismos se puede desempeñar mejor su trabajo (AU)

This study arises from the need to establish basic criteria and the description of recommendations to improve the level of responsiveness of lifeguards in natural aquatic areas, specifically in the work done on the beaches, in order to increase the safety of these bathing areas. The study was developed Cataluña, in three beaches of different municipalities in the province of Barcelona. We can aver after this research that most of the lifeguards who participated in the study value positively the proposed measures and criteria, through the assumption that these features help improve their work (AU)

Efecto de la fatiga física del socorrista en los primeros cuatro minutos de la reanimación cardiopulmonar posrescate acuático / Effect of lifeguard fatigue on the first 4 minutes of cardiopulmonary resuscitation after water rescue

Objetivo: Analizar el efecto de la fatiga física provocada por un rescate acuático sobre la calidad de la reanimación cardiopulmonar (RCP).Método: Sesenta socorristas profesionales (30 hombres y 30 mujeres) formados en las Universidades de A Coruña y Vigo realizaron dos tests: el primero consistió en la realización de cuatro minutos de RCP en condiciones de reposo, y en el segundo realizaron RCP durante cuatro minutos inmediatamente después de un rescate acuático. Se utilizó el maniquí Laerdal Resusci Anne® con Laerdal PC Skill Reporting para registrar las compresiones y ventilaciones totales, las correctas e incorrectas y sus porcentajes. Resultados: En reposo y en fatiga se observó un descenso en el número de compresiones correctas y en su porcentaje conforme trascurrían los minutos de RCP. Tras el rescate acuático, aumentaron las compresiones totales (reposo: 75,4, fatiga: 84,2; p < 0,001),descendió el porcentaje de ventilaciones correctas (reposo: 55,1%, fatiga: 34,7%;p < 0,001) y el de compresiones correctas (reposo: 77,5%; fatiga: 63,6%; p < 0,001).Conclusiones: La fatiga física del socorrista, provocada por un rescate, afecta de forma negativa a la calidad de la RCP. Recomendamos, en la medida de lo posible, que se aun socorrista no fatigado el que inicie la RCP (AU)

Objective: To assess the effect of lifeguard fatigue on the quality of cardiopulmonary resuscitation (CPR) after water rescue Methods: Sixty professional lifeguards (30 men, 30 women) trained at the University of A Coruña and the University of Vigo in Spain participated in 2 tests. In the first test, the participants were rested when they performed 4 minutes of CPR. In the second, they undertook 4 minutes of CPR immediately after rescuing a mannequin from the water. The Resusci Anne Skill Reporter mannequin (Laerdal) was used to produce a computerized record of the total number of compressions and ventilations as well as the percentages of each type of maneuver the lifeguards performed correctly and incorrectly. Results: In both rested and fatigued conditions, the participants performed fewer correct compressions (absolute numbers and percentages) as CPR continued over the assigned minutes. After a water rescue, the total number of compressions increased (when rested, 75.4; when fatigued, 84.2) (P<.001), while the percentage of correct ventilations decreased (rested, 55.1%; fatigued, 34.7%; (P<.001) and correct compressions (rested, 77.5%; fatigued, 63.6%)(P<.001).Conclusions: Lifeguard fatigue after a water rescue negatively affects CPR quality. We recommend that a rested lifeguard should perform CPR whenever possible (AU)