Eficacia de una intervención educativa en el manejo de un dispositivo de inhalación entre profesionales de enfermería de un servicio de urgencias / Efficacy of an educational intervention in the management of an inhalation device among nursing professionals of an emergency department

Objetivo: Explorar los errores más frecuentes de la técnica inhalatoria (pilar para el tratamiento farmacológico de las exacerbaciones de asma y/o enfermedad pulmonar obstructiva crónica) en enfermeras de un servicio de urgencias, y evaluar la eficacia de una intervención educativa. Métodos: Estudio cuasiexperimental prospectivo, realizado en un hospital de Argentina durante 2019. Para la evaluación de enfermeras se utilizaron los pasos del Consenso Separ-Alat. La intervención educativa consistió en explicación oral y demostración visual de la técnica inhalatoria. Se realizó análisis de datos pareados, y se calcularon las frecuencias absolutas y relativas con sus respectivos intervalos de confianza de 95%. Resultados: Se incluyó una muestra consecutiva de 72 enfermeros, de los cuales el 95,83% (IC 95% 88,30-99,13) cometieron al menos un error en la evaluación basal. Los errores más frecuentes fueron la falta de indicación al paciente de espirar previo a la inhalación (83,72%), el olvido de retirar la aerocámara y repetir los pasos antes de la segunda dosis (81,40%). Tras la evaluación inmediata después de recibir la intervención educativa, el 74,42% (IC 95% 58,83-86,49) corrigió la técnica. Sin embargo, al mes el 53,49% (23/43; IC 95% 37,66-68,86) realizaba la técnica correctamente. Conclusiones: La intervención educativa puede ser eficaz para subsanar errores en esta práctica, aunque sus efectos tienden a extinguirse con el tiempo. Por ende, consideramos relevante la educación periódica y sistemática para mantener una técnica de inhalación correcta entre los profesionales.(AU)

Objetive: To explore the most frequent errors of the inhalation technique (main topic for the pharmacological treatment of exacerbations of asthma and/or chronic obstructive pulmonary disease) in the nursing staff of an emergency department, and to evaluate the efficacy of an educational intervention. Methods: Prospective quasi-experimental study, carried out in a hospital in Argentina during 2019. For the evaluation of the nursing staff, the steps of the Separ-Alat Consensus were used. The educational intervention consisted of oral explanation and visual demonstration of the inhalation technique. Paired data analysis was performed, and absolute and relative frequencies were calculated with their respective 95% confidence intervals. Results: A consecutive sample of 72 nurses was included, of which 95.83% (95% CI 88.30-99.13) made at least one error in the baseline assessment. The most frequent errors were the lack of indication to the patient to exhale prior to inhalation (83.72%), forgetting to remove the air chamber and repeat the steps before the second dose (81.40%). After immediate evaluation after receiving the educational intervention, 74.42% (95% CI 58.83-86.49) corrected the technique. However, at one month, 53.49% (23/43; 95% CI 37.66-68.86) performed the technique correctly. Conclusions: The educational intervention could be effective in correcting errors in this practice, although its effects tend to fade over time. Therefore, we consider periodic and systematic education relevant to maintain a correct inhalation technique among professionals.(AU)

Efficacy of an educational intervention in the management of an inhalation device among nursing professionals of an emergency department.

OBJECTIVE: To explore the most frequent errors of the inhalation technique (main topic for the pharmacological treatment of exacerbations of asthma and/or chronic obstructive pulmonary disease) in the nursing staff of an emergency department, and to evaluate the efficacy of an educational intervention. METHODS: Prospective quasi-experimental study, carried out in a hospital in Argentina during 2019. For the evaluation of the nursing staff, the steps of the Separ-Alat Consensus were used. The educational intervention consisted of oral explanation and visual demonstration of the inhalation technique. Paired data analysis was performed, and absolute and relative frequencies were calculated with their respective 95% confidence intervals. RESULTS: A consecutive sample of 72 nurses was included, of which 95.83% (95%CI 88.30-99.13) made at least one error in the baseline assessment. The most frequent errors were the lack of indication to the patient to exhale prior to inhalation (83.72%), forgetting to remove the air chamber and repeat the steps before the second dose (81.40%). After immediate evaluation after receiving the educational intervention, 74.42% (95%CI 58.83-86.49) corrected the technique. However, at one month, 53.49% (23/43; 95%CI 37.66-68.86) performed the technique correctly. CONCLUSIONS: The educational intervention could be effective in correcting errors in this practice, although its effects tend to fade over time. Therefore, we consider periodic and systematic education relevant to maintain a correct inhalation technique among professionals.

Edema pulmonar de las alturas. Consideraciones fisiopatológicas : a propósito de un caso / High altitude pulmonary edema. Physiopathological considerations regarding one case

Uno de los problemas médicos de la altitud lo constituye el Edema Pulmonar de las Alturas (EPA). Generalmente este se presenta en personas que ascienden sin aclimatación a más de 2500 mt de altura sobre el nivel del mar ó en los residentes de altitudes mayores a 3000 mt que descienden por periodos cortos de tiempo a nivel del mar y regresan a su lugar de residencia. A pesar de que se han informado decenas de casos se desconoce su etiopatogenia si bien se han implicado en la genesis factores tanto hidrostráticos como de permeabilidad vascular. En este trabajo presentamos el primer caso de EPA descrito en la literatura nacional y se revisan los factores implicados en su fisiopatología.