RESUMO
OBJECTIVE: Evaluating the usefulness of a chat bot as an assistant during CPR care by laypersons. METHODS: Twenty-one university graduates and university students naive in basic life support participated in this quasi-experimental simulation pilot trial. A version beta chatbot was designed to guide potential bystanders who need help in caring for cardiac arrest victims. Through a Question-Answering (Q&A) flowchart, the chatbot uses Voice Recognition Techniques to transform the user's audio into text. After the transformation, it generates the answer to provide the necessary help through machine and deep learning algorithms. A simulation test with a Laerdal Little Anne manikin was performed. Participants initiated the chatbot, which guided them through the recognition of a cardiac arrest event. After recognizing the cardiac arrest, the chatbot indicated the start of chest compressions for 2 min. Evaluation of the cardiac arrest recognition sequence was done via a checklist and the quality of CPR was collected with the Laerdal Instructor App. RESULTS: 91% of participants were able to perform the entire sequence correctly. All participants checked the safety of the scene and made sure to call 112. 62% place their hands on the correct compression point. A media time of 158 s (IQR: 146-189) was needed for the whole process. 33% of participants achieved high-quality CPR with a median of 60% in QCPR (IQR: 9-86). Compression depth had a median of 42 mm (IQR: 33-53) and compression rate had a median of 100 compressions/min (IQR: 97-100). CONCLUSION: The use of a voice assistant could be useful for people with no previous training to perform de out-of-hospital cardiac arrest recognition sequence. Chatbot was able to guide all participants to call 112 and to perform continuous chest compressions. The first version of the chatbot for potential bystanders naive in basic life support needs to be further developed to reduce response times and be more effective in giving feedback on chest compressions.
Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca Extra-Hospitalar , Humanos , Reanimação Cardiopulmonar/métodos , Estudos de Viabilidade , Manequins , Parada Cardíaca Extra-Hospitalar/terapia , Projetos PilotoRESUMO
OBJECTIVE: Drowning is one of major public health problem in childhood. The aim of this paper was to describe the characteristics, locations, interventions and outcomes of child drowning in Galicia over 17 years. METHODS: Retrospective study of 100% of data of drowning amongst children aged 0-14 in the 2004-2020 period who were attended by the 061 emergency services in Galicia (Spain) was made. The characteristics of the incident, the victim's profile, location, type of medical care given and whether the victim survived or died were analysed using the Chi Square test to compare relative frequencies, and Odds Ratio to estimate the risk. RESULTS: During the period under study, 100 child drownings were recorded. In 55%, the main cause was lack of supervision. Young children (aged 0-4) primarily drowned in pools, and pre-teens and teenagers (aged 10-14) in the sea. In 42% of the incidents, bystanders performed CPR (37% included ventilation). Emergency services took 12 minutes on average to arrive at the scene. 6% died in situ and of the rest, were taken to hospital and admitted in 47% PICU, 26% ward, 8% discharged from Accident and Emergency (43% with pulmonary oedema, 41% with supplemental oxygen, 13% with IMV/NIMV [invasive mechanical ventilation/non-invasive]). Pneumonia was the most common complication and survival to discharge was 77%. CONCLUSIONS: Small children usually drown in pools and water facilities because of lack of supervision, whereas adolescents usually drown in the sea. CPR started by bystanders and the fast response of emergency services contributed to a high rate of survival. A large amount of data was lost during the process: accurate, standardized coding of drowning is necessary.
OBJETIVO: El ahogamiento es un importante problema de Salud Pública en la etapa infantil. El objetivo de este trabajo fue describir las características, localizaciones, intervenciones y resultados del ahogamiento pediátrico en Galicia durante 17 años. METODOS: Se realizó un estudio retrospectivo del 100% de los datos de ahogamiento de personas entre 0 y 14 años de edad del año 2004 a 2020, que fueran atendidos por los servicios de emergencias de Galicia 061. Se analizaron las características del incidente, perfil de la víctima, localización, tipo de asistencia sanitaria recibida y supervivencia respecto a muerte mediante el test Chi Cuadrado para comparar frecuencias relativas, y Odds Ratio para estimar el riesgo. RESULTADOS: Se registraron 100 ahogamientos pediátricos. En el 55% la principal causa fue la falta de supervisión. Los niños y niñas de 0-4 años se ahogaban mayoritariamente en piscinas, mientras que los/las adolescentes (10-14 años) en playas. En el 42% de los incidentes el testigo hizo reanimación cardiopulmonar (un 37% incluyó ventilaciones). Los servicios de emergencia tardaron 12 minutos de media en llegar. Un 6% falleció in situ y el resto fueron trasladados al hospital e ingresaron el 47% en UCI, 26% en planta, y 8% cursaron alta en Urgencias (43% con edema pulmonar, 41% con oxígeno suplementario, 13% con VMI/VMNI [ventilación mecánica invasiva/no invasiva]). La neumonía fue una complicación habitual y la supervivencia al alta fue del 77%. CONCLUSIONES: Los niños/as más pequeños se ahogan habitualmente en instalaciones acuáticas por falta de supervisión mientras que los/las adolescentes se suelen ahogar en playas marítimas. El inicio de la reanimación por parte de testigos y la rápida respuesta de los servicios de emergencias se asocia a una alta tasa de supervivencia. Numerosos datos fueron perdidos durante el proceso por lo que es necesaria una correcta y unificada codificación del ahogamiento.
Assuntos
Reanimação Cardiopulmonar , Afogamento/epidemiologia , Serviços Médicos de Emergência , Adolescente , Reanimação Cardiopulmonar/estatística & dados numéricos , Criança , Pré-Escolar , Afogamento/prevenção & controle , Serviços Médicos de Emergência/estatística & dados numéricos , Humanos , Lactente , Estudos Retrospectivos , Espanha/epidemiologiaRESUMO
FUNDAMENTOS: El ahogamiento es un importante problema de Salud Pública en la etapa infantil. El objetivo de este trabajofue describir las características, localizaciones, intervenciones y resultados del ahogamiento pediátrico en Galicia durante 17 años.MÉTODOS: Se realizó un estudio retrospectivo del 100% de los datos de ahogamiento de personas entre 0 y 14 años de edad delaño 2004 a 2020, que fueran atendidos por los servicios de emergencias de Galicia 061. Se analizaron las características del incidente,perfil de la víctima, localización, tipo de asistencia sanitaria recibida y supervivencia respecto a muerte mediante el test Chi Cuadradopara comparar frecuencias relativas, yOdds Ratio para estimar el riesgo.RESULTADOS: Se registraron 100 ahogamientos pediátricos. En el 55% la principal causa fue la falta de supervisión. Los niños yniñas de 0-4 años se ahogaban mayoritariamente en piscinas, mientras que los/las adolescentes (10-14 años) en playas. En el 42% delos incidentes el testigo hizo reanimación cardiopulmonar (un 37% incluyó ventilaciones). Los servicios de emergencia tardaron 12minutos de media en llegar. Un 6% fallecióin situ y el resto fueron trasladados al hospital e ingresaron el 47% en UCI, 26% en planta, y 8% cursaron alta en Urgencias (43% con edema pulmonar, 41% con oxígeno suplementario, 13% con VMI/VMNI [ventilación mecánicainvasiva/no invasiva]). La neumonía fue una complicación habitual y la supervivencia al alta fue del 77%.CONCLUSIONES: Los niños/as más pequeños se ahogan habitualmente en instalaciones acuáticas por falta de supervisión mien-tras que los/las adolescentes se suelen ahogar en playas marítimas. El inicio de la reanimación por parte de testigos y la rápidarespuesta de los servicios de emergencias se asocia a una alta tasa de supervivencia. Numerosos datos fueron perdidos durante elproceso por lo que es necesaria una correcta y unificada codificación del ahogamiento.(AU)
BACKGROUND: Drowning is one of major public health problem in childhood. The aim of this paper was to describe the characte-ristics, locations, interventions and outcomes of child drowning in Galicia over 17 years. METHODS: Retrospective study of 100% of data of drowning amongst children aged 0-14 in the 20042020 period who were attended by the 061 emergency services in Galicia (Spain) was made. The characteristics of the incident, the victims profile, location, type ofmedical care given and whether the victim survived or died were analysed using the Chi Square test to compare relative frequencies,and Odds Ratio to estimate the risk.RESULTS: During the period under study, 100 child drownings were recorded. In 55%, the main cause was lack of supervision.Young children (aged 0-4) primarily drowned in pools, and pre-teens and teenagers (aged 10-14) in the sea. In 42% of the incidents, bystanders performed CPR (37% included ventilation). Emergency services took 12 minutes on average to arrive at the scene. 6% diedin situ and of the rest, were taken to hospital and admitted in 47% PICU, 26% ward, 8% discharged from A&E (43% with pulmonaryoedema, 41% with supplemental oxygen, 13% with IMV/NIMV [invasive mechanical ventilation/non-invasive]). Pneumonia was the most common complication and survival to discharge was 77%.CONCLUSIONS: Small children usually drown in pools and water facilities because of lack of supervision, whereas adolescentsusually drown in the sea. CPR started by bystanders and the fast response of emergency services contributed to a high rate of survi-val. A large amount of data was lost during the process: accurate, standardized coding of drowning is necessary.(AU)
