Disseminating cardiopulmonary resuscitation training by distributing 9,200 personal manikins.

OBJECTIVES: Community members should be trained so that witnesses of cardiac arrests are able to trigger the emergency system and perform adequate resuscitation. In this study, the authors evaluated the results of cardiopulmonary resuscitation (CPR) training of communities in four Brazilian cities, using personal resuscitation manikins. METHODS: In total, 9,200 manikins were distributed in Apucarana, Itanhaém, Maringá, and São Carlos, which are cities where the populations range from 80,000 to 325,000 inhabitants. Elementary and secondary school teachers were trained on how to identify a cardiac arrest, trigger the emergency system, and perform chest compressions. The teachers were to transfer the training to their students, who would then train their families and friends. RESULTS: In total, 49,131 individuals were trained (6.7% of the population), but the original strategy of using teachers and students as multipliers was responsible for only 27.9% of the training. A total of 508 teachers were trained, and only 88 (17.3%) transferred the training to the students. Furthermore, the students have trained only 45 individuals of the population. In Maringá and São Carlos, the strategy was changed and professionals in the primary health care system were prepared and used as multipliers. This strategy proved extremely effective, especially in Maringá, where 39,041 individuals were trained (79.5% of the total number of trainings). Community health care providers were more effective in passing the training to students than the teachers (odds ratio [OR] = 7.12; 95% confidence interval [CI] = 4.74 to 10.69; p < 0.0001). CONCLUSIONS: Instruction of CPR using personal manikins by professionals in the primary health care system seems to be a more efficient strategy for training the community than creating a training network in the schools.

[Access to care for women during childbirth in university hospitals: characterization and associated factors]. / Acesso de parturientes para a assistência ao parto em hospitais universitários: caracterização e fatores associados.

This study aimed to analyze the socioeconomic, demographic, obstetric, neonatal and healthcare factors associated with access to care by women during childbirth. It was a transversal study conducted on puerperal women in two university hospitals in the state of Paraná, Brazil in 2011. Access to childbirth was analyzed according to socioeconomic, demographic, obstetric, neonatal and healthcare variables. The puerperal women were interviewed during hospitalization, in the first 72 hours after birth. The data was analyzed by relative frequencies and calculation of the chi2, considering a significant association when p < or = 0.05. The overall rate of women referred to university hospitals was 17.7%. A significant associated was found between access to childbirth and residing in other cities; premature birth; underweight newborns; complications in the current pregnancy and the use of ambulances. It was concluded that the associated factors found in this study suggest that pregnant women with some risk required referral to university hospitals.

Access to care for women during childbirth in university hospitals: characterization and associated factors / Acceso de las parturientas para prestación de servicios en los hospitales universitarios: caracterización y factores asociados / Acesso de parturientes para a assistência ao parto em hospitais universitários: caracterização e fatores associados

This study aimed to analyze the socioeconomic, demographic, obstetric, neonatal and healthcare factors associated with access to care by women during childbirth. It was a transversal study conducted on puerperal women in two university hospitals in the state of Paraná, Brazil in 2011. Access to childbirth was analyzed according to socioeconomic, demographic, obstetric, neonatal and healthcare variables. The puerperal women were interviewed during hospitalization, in the first 72 hours after birth. The data was analyzed by relative frequencies and calculation of the x2, considering a significant association when p≤ 0.05. The overall rate of women referred to university hospitals was 17.7%. A significant associated was found between access to childbirth and: residing in other cities; premature birth; underweight newborns; complications in the current pregnancy and the use of ambulances. It was concluded that the associated factors found in this study suggest that pregnant women with some risk required referral to university hospitals.

El objetivo del estudio fue analizar los factores socioeconómicos, demográficos, obstétricos, neonatales y asistenciales relacionados con el acceso de las parturientas. Un estudio transversal que incluyó a 310 puérperas en dos hospitales universitarios en el estado de Paraná-Brasil en 2011. Acceso al parto se analizó de acuerdo a las variables socioeconómicas, demográficas, obstétricas, neonatales y asistenciales. Las mujeres fueron entrevistadas durante la estancia hospitalaria, las primeras 72 horas después del parto. Los datos analizados por frecuencias relativas y x2, considerando asociación significativa cuando p≤ 0,05. La tasa total de mujeres encaminadas a los hospitales universitarios fue 17,7%. Se encontró asociación significativa del acceso al parto, con: vivir en otros municipios, parto prematuro, recién nacido con bajo peso, complicaciones en el embarazo actual y el uso de ambulancia. Se concluye que los factores asociados encontrados sugieren que las mujeres embarazadas con algún riesgo requieren el encaminamiento a los hospitales universitarios. .

O estudo teve por objetivo analisar os fatores socioeconômicos, demográficos, obstétricos, neonatais e assistenciais associados ao acesso da parturiente à assistência ao parto. Foi um estudo transversal, realizado com 310 puérperas em dois hospitais universitários do estado do Paraná, Brasil, em 2011. O acesso ao parto foi analisado segundo as variáveis socioeconômicas, demográficas, obstétricas, neonatais e assistenciais. As puérperas foram entrevistadas durante a internação no hospital, nas primeiras 72 horas após o parto. Os dados foram analisados por frequências relativas e cálculo do x 2 , considerando-se associação significativa quando p≤ 0,05. A taxa total de mulheres encaminhadas aos hospitais universitários foi de 17,7%. Encontrou-se associação significativa do acesso ao parto com: residir em outros municípios; parto prematuro; recém-nascido de baixo peso; intercorrências na gestação atual e uso de ambulância. Conclui-se que os fatores associados encontrados neste estudo sugerem que a gestante com algum risco necessitou de encaminhamento para os hospitais universitários.