Análisis de una serie de 134 niños atropellados por vehículos a motor procedente de un servicio de urgencias pediátrico / Pediatric emergency department care of children injured by motor vehicles: report of a series

Se describe el perfil y el patrón lesional del niño atropellado atendido en un servicio de urgencias pediátrico (SUP), su morbimortalidad y la utilidad de la información obtenida en el SUP. El estudio retrospectivo-descriptivo se centró en menores de 18 años y serealizó entre febrero de 2005 y junio de 2006. Se recogieron 134 pacientes (H:M:1,6:1 - mediana de edad: 8,8 años), el 94,1% fueron atropellados en ciudad, por automóviles,el 32,1% en verano y el 45,8% de 17-20 h. El 97% resultó lesionado y el 91%fue leve. Las lesiones localizadas en extremidades (70,1%) y cráneo (37%); se produjeron por contusiones (67,2%) y traumatismo craneoencefálico (TCE) (34,3%). Ingresaron el 23,9% y la mortalidad fue del 1,5%. La información obtenida en el SUP ayuda adefinir el perfil y el patrón lesional esperable. La afectación de áreas vitales es frecuente.Parece razonable reforzar la prevención en verano y al final de las jornadas escolar y laboral (AU)

We describe the type of injuries our hospital’s pediatric emergency department treats in children run over by motorvehicles, estimate morbidity and mortality, and to assess the utility of information recorded in the department. This was a retrospective descriptive study of patients under the age of 18 years who were treated between February 2005 and June2006. Of the 134 patients (ratio of boys to girls, 1.6:1; median age, 8.8 years), 94.1% were run over by cars in the city ;32.1% of the accidents occurred in summer and 45.8% occurred between the hours of 5:00 and 8:00 P.M. Ninety-seven percent of the children sustained injuries; 91% of the injuries were not serious. The injuries were located on the extremities(70.1%) and head (37%); 67.2% were contusions and 34.3% were brain injuries. The department admitted 23.9% of thechildren; mortality was 1.5%. Information recorded by the emergency department helped define the profile of injuries ofthis type that can be expected. Injuries are often near vital structures. We conclude that it would be justifiable to reinforce prevention in the summertime as well as after school and working hours (AU)

Cumplimiento de los requisitos de los servicios de urgencias de España: encuesta de autoevaluación / Compliance with the requirements of paediatric emergency departments in Spain: a self-assessment survey

Introducción: La medicina de urgencias pediátrica en España se practica en servicios de distinta configuración. Nuestro objetivo es conocer su situación y adaptación a los requisitos del Cuerpo Doctrinal de la Sociedad Española de Urgencias Pediátricas. Método: Se envió por correo electrónico una encuesta con el cuestionario de Autoevaluación del Cuerpo Doctrinal a los responsables de 47 servicios. Consta de 101 ítems, 69 considerados de cumplimiento obligatorio. Se establecieron 4 grupos de servicios según el cumplimiento de esos 69 ítems: I o situación óptima (cumplen 69); II o que precisan cambios mínimos (cumplen 62-68); III o que precisan cambios mayores (cumplen 41-61); IV o que precisan grandes modificaciones (cumplen menos de 41). Resultados: Contestaron 39 servicios, que atienden una media de 35.310 urgencias anuales (5.000-115.000). Ninguno ha quedado incluido en el grupo I, 6 en el II, 27 en el III y 6 en el IV. Hay una tendencia a un mayor cumplimiento en los servicios más frecuentados, pero sin relación significativa entre el número de urgencias y los ítems cumplimentados. Conclusiones: 1) Muchos servicios de urgencias pediátricos en España tienen problemas estructurales y funcionales que pueden dificultar dar una asistencia de calidad, sin relación significativa con el volumen de urgencias atendidas; 2) los puntos de mejora afectan principalmente a cuestiones funcionales, que deben ser acometidas por sus responsables; 3) un número significativo tienen serios problemas arquitectónicos y de dotación, que precisarían medidas económicas por parte de sus órganos directivos, y 4) nuestro cuestionario de autoevaluación permite identificar acciones de mejora (AU)

Background: Paediatric emergency medicine in Spain is practiced in differently configured departments, staffing and organisation. Our goal was to determine the situation in Paediatric Emergency Departments (PED) and their adaptation to the quality standards proposed by the Spanish Society of Paediatric Emergencies. Method: A self-assessment questionnaire on standards performance was sent to 47 PED directors by e-mail. It consisted of 101 items, 69 considered mandatory. According to the fulfilment of these 69 items 4 PED groups were selected: group I: in the best position (met 69), group II: requiring minimal changes (meeting 62-68), group III: requiring major changes (meeting 41-61); group IV: requiring a lot of major changes (meeting less than 41). Results: Thirty nine questionnaires were completed in full. The PED included in the study tended to an average of 35310 annual emergencies (5000-115000). No PED was included in group I, 6 in II 27 in III and 6 in IV. There was a tendency towards higher compliance with standards in larger PED, but there was no significant relationship between the number of emergencies and the number of items fulfilled. Conclusions: 1. Staffing and architectural and organizational aspects may not be adequate to achieve optimal patient outcome in many PED in Spain. This fact does not appear to be related to the annual patient census. 2. The areas for improvement mainly affect functional issues that must be undertaken by those responsible. 3. A significant number of PED have serious architectural and staffing deficiencies, which would require economic measures by their managers. 4. Our self-assessment questionnaire identifies improvement actions (AU)

[Compliance with the requirements of paediatric emergency departments in Spain: a self-assessment survey]. / Cumplimiento de los requisitos de los servicios de urgencias de España: encuesta de autoevaluación.

BACKGROUND: Paediatric emergency medicine in Spain is practiced in differently configured departments, staffing and organisation. Our goal was to determine the situation in Paediatric Emergency Departments (PED) and their adaptation to the quality standards proposed by the Spanish Society of Paediatric Emergencies. METHOD: A self-assessment questionnaire on standards performance was sent to 47 PED directors by e-mail. It consisted of 101 items, 69 considered mandatory. According to the fulfilment of these 69 items 4 PED groups were selected: group I: in the best position (met 69), group II: requiring minimal changes (meeting 62-68), group III: requiring major changes (meeting 41-61); group IV: requiring a lot of major changes (meeting less than 41). RESULTS: Thirty nine questionnaires were completed in full. The PED included in the study tended to an average of 35310 annual emergencies (5000-115000). No PED was included in group I, 6 in II 27 in III and 6 in IV. There was a tendency towards higher compliance with standards in larger PED, but there was no significant relationship between the number of emergencies and the number of items fulfilled. CONCLUSIONS: 1. Staffing and architectural and organizational aspects may not be adequate to achieve optimal patient outcome in many PED in Spain. This fact does not appear to be related to the annual patient census. 2. The areas for improvement mainly affect functional issues that must be undertaken by those responsible. 3. A significant number of PED have serious architectural and staffing deficiencies, which would require economic measures by their managers. 4. Our self-assessment questionnaire identifies improvement actions.

Intoxicación accidental por descongestionante tópico nasal / Accidental intoxication due to a topical nasal decongestant

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