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3.
Arch. argent. pediatr ; 116(6): 730-735, dic. 2018. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-973687

RESUMO

Introducción. Las compresiones cardíacas (CC) de alta calidad son el principal componente de la reanimación cardiopulmonar (RCP). Objetivos: Evaluar la profundidad de las CC durante las maniobras de RCP realizadas sobre un simulador pediátrico. Secundariamente, explorar la asociación entre la profundidad de las CC con respecto al género, nivel de formación, índice de masa corporal y entrenamiento físico periódico. Material y métodos. Trabajo prospectivo de observación experimental. Se incluyeron médicos residentes de Pediatría, pediatras, enfermeros y otros profesionales capacitados en RCP que asistían a niños. Se registró, mediante un software, la profundidad de las CC mientras realizaban maniobras de RCP durante 2 minutos. Se definió como equivalente a cansancio el deterioro en el número de CC adecuadas en profundidad (> 50 mm) mayor de 3 entre el primero y el último ciclo. Resultados. Participaron 137 sujetos (85,4 % de mujeres). Solamente 48 (35,8 %) presentaron un desempeño adecuado en cuanto a la profundidad. Se observaron diferencias significativas en favor del género masculino (p < 0,0001) y de los pediatras formados por sobre el resto (p 0,038). El 36,5 % de los participantes empeoraron su desempeño en cuanto a la profundidad a los dos minutos. No se observaron diferencias significativas en cuanto al índice de masa corporal y actividad física. Conclusiones. Las CC disminuyeron en profundidad al cabo de dos minutos. No hubo asociación con el índice de masa corporal ni la actividad física habitual de los reanimadores, pero sí en cuanto a género y nivel de formación.


Introduction. High-quality chest compressions (CCs) are the main component of cardiopulmonary resuscitation (CPR). Objectives. T o assess the depth of CCs during CPR using a pediatric patient manikin. A secondary objective was to explore the association between CC depth and sex, level of training, body mass index, and periodic physical training. Material and methods. Prospective study with experimental observation. Pediatric residents, pediatricians, nurses, and other health care providers trained in CPR and who attended children were included. A software program was used to record the depth of CCs while performing CPR during 2 minutes. Tiredness was defined as a deterioration in the number of adequately deep CCs (> 50 mm) by more than 3 CCs between the first and the last cycles. Results. A total of 137 subjects participated (85.4 % were women). Only 48 participants (35.8 %) showed an adequate performance in terms of depth. Significant differences were observed for men (p < 0.0001) and trained pediatricians compared to the rest (p = 0.038). A worsening was observed in performance in terms of depth after 2 minutes in 36.5 % of participants. No significant differences were observed in relation to body mass index and physical activity. Conclusions. Depth rate reduced after 2 minutes. No association was observed with the body mass index or regular physical activity of resuscitators but with their sex and level of training.


Assuntos
Humanos , Masculino , Feminino , Adulto , Competência Clínica , Reanimação Cardiopulmonar/normas , Pessoal de Saúde/normas , Fadiga/epidemiologia , Fatores de Tempo , Índice de Massa Corporal , Fatores Sexuais , Estudos Prospectivos
4.
Arch Argent Pediatr ; 116(6): e730-e735, 2018 12 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30457721

RESUMO

INTRODUCTION: High-quality chest compressions (CCs) are the main component of cardiopulmonary resuscitation (CPR). Objectives. T o assess the depth of CCs during CPR using a pediatric patient manikin. A secondary objective was to explore the association between CC depth and sex, level of training, body mass index, and periodic physical training. MATERIAL AND METHODS: Prospective study with experimental observation. Pediatric residents, pediatricians, nurses, and other health care providers trained in CPR and who attended children were included. A software program was used to record the depth of CCs while performing CPR during 2 minutes. Tiredness was defined as a deterioration in the number of adequately deep CCs (> 50 mm) by more than 3 CCs between the first and the last cycles. RESULTS: A total of 137 subjects participated (85.4 % were women). Only 48 participants (35.8 %) showed an adequate performance in terms of depth. Significant differences were observed for men (p < 0.0001) and trained pediatricians compared to the rest (p = 0.038). A worsening was observed in performance in terms of depth after 2 minutes in 36.5 % of participants. No significant differences were observed in relation to body mass index and physical activity. CONCLUSIONS: Depth rate reduced after 2 minutes. No association was observed with the body mass index or regular physical activity of resuscitators but with their sex and level of training.


Assuntos
Reanimação Cardiopulmonar/normas , Competência Clínica , Fadiga/epidemiologia , Pessoal de Saúde/normas , Adulto , Índice de Massa Corporal , Criança , Feminino , Humanos , Masculino , Manequins , Estudos Prospectivos , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
7.
Am J Perinatol ; 35(8): 796-800, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29320801

RESUMO

OBJECTIVE: The objective of this study was to evaluate chest compression (CC) quality and operator fatigue during CC, with coordinated ventilation, on a neonatal simulator and to explore its association with provider aerobic activity and body mass index. METHODS: This was a prospective observational experimental study on pediatricians, neonatologists, and neonatal nurses who frequently deliver newborns and who have signed the informed consent. Subjects performed CC coordinated with ventilations at a ratio of 3:1 for 10 minutes on a neonatal mannequin. Proxy of fatigue was defined as four consecutive CC below target. RESULTS: Forty subjects participated; 62% were women. Twenty one (52%) evidenced weariness, as they performed. No gender-based differences were found in weariness. No subject abandoned the procedure due to fatigue. Subjects who participated in aerobic exercise had a significantly better performance than those who did not participate. Early fatigue was significantly associated with higher BMI. The reduction in effectiveness occurred at a mean time of 7.7 minutes (range 3.5-9 minutes). CONCLUSION: CC performance quality decreased and fatigue was frequent before 10 minutes had elapsed on a neonatal simulator. Provider fatigue was associated with both lack of aerobic activity and BMI ≥ 25. Our findings support the need for guidelines requiring frequent rotation of CC providers during prolonged neonatal resuscitation.


Assuntos
Reanimação Cardiopulmonar , Fadiga , Fidelidade a Diretrizes , Massagem Cardíaca/métodos , Manequins , Adulto , Índice de Massa Corporal , Feminino , Parada Cardíaca/terapia , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pressão , Estudos Prospectivos , Fatores de Tempo
8.
Rev. Hosp. Niños B.Aires ; 60(271): 302-308, 2018.
Artigo em Espanhol | LILACS | ID: biblio-986872

RESUMO

Introducción. Se diseñó una tabla de referencia de drogas para emergencias (TRDE) especificando utilidad, dosis, vía de administración y dilución de las drogas más utilizadas durante emergencias pediátricas. El objetivo de este trabajo fue evaluar su utilidad para reducir errores en medicación. Materiales y métodos. Se realizó un estudio controlado aleatorizado con residentes de un hospital general pediátrico durante jornadas de simulación médica de alta fidelidad. Participaron 79 médicos divididos en 12 equipos; 6 asignados aleatoriamente, tuvieron la TRDE disponible y un instructivo para utilizarla. Se analizaron cantidad total de errores en la prescripción de medicación, y tipo de error (elección de la droga, dosis, dilución y vía de administración). Resultados. La media de indicaciones por equipo fue 7,08 drogas (DS 6,25-7,92). Los equipos sin TRDE cometieron 5,17 errores totales más que los que la usaron (IC 90% 0,21-10,12; P=0,08). En el análisis diferenciado por tipo de error aquellos sin TRDE cometieron 2,5 errores más de dilución (IC 90% 0,87-4,13; P=0,02). No hubo diferencias significativas de errores de elección, dosificación y vía de administración de drogas. Conclusión. La TRDE determinó una disminución global de errores en la prescripción de medicación durante situaciones de emergencia, principalmente en la dilución


Background. A drug reference table for emergencies (TE) was designed specifying utility, dose, route of administration and dilution of the drugs used during pediatric emergencies. The aim of this work was to evaluate its utility to reduce errors in medication. Methods. A randomized controlled study was conducted with residents of a pediatric general hospital during high-fidelity medical simulation. 79 residents were divided into 12 teams, 6 randomly assigned teams had the TE available and instructions on how to use it. We analyzed the total number of errors in the prescription of medication, and type of error (choice of drug, dose, dilution and route of administration). Results. The mean of indications per team was 7.08 drugs (DS 6.25-7.92). Teams without TE performed 5.17 total errors more than those who used it (IC 90% 0.21-10.12, P = 0.08). Analyzing by type of error those without TE made 2.5 more dilution errors (IC 90% 0.87-4.13, P = 0.02). There were no significant differences in errors of choice, dosage and route of drug administration. Conclusion. The TE produced overall decrease in medication prescription errors during emergency situations, particularly in dilution errors


Assuntos
Pré-Escolar , Criança , Adolescente , Medicina de Emergência Pediátrica , Erros de Medicação , Segurança do Paciente
9.
Arch. argent. pediatr ; 115(4): 399-403, ago. 2017. tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1038381

RESUMO

Objetivo. Evaluar el desempeno logrado por médicos residentes en el diagnóstico y tratamiento de un caso simulado de anafilaxia luego de 6 meses de haber recibido capacitación con técnicas de simulación. Material y método. Un grupo de residentes de Pediatría fueron capacitados a través de técnicas de simulación en diferentes emergencias pediátricas (primera etapa) y luego clasificados según su grado de desempeno en 3 subgrupos. Se seleccionaron, posteriormente, 4 médicos al azar de cada subgrupo para ser reevaluados luego de 6 meses (segunda etapa). Resultados. Participaron 72 médicos de la primera etapa, 56 (77,8%) resolvieron el caso correctamente. A los 6 meses, los 12 (100%) médicos evaluados trataron en forma adecuada el nuevo caso de anafilaxia. Conclusiones. La capacitación a través de técnicas de simulación permitió corregir u optimizar el tratamiento de casos simulados de anafilaxia en médicos residentes evaluados luego de 6 meses de la capacitación inicial.


Objective: To evaluate the performance of resident physicians in diagnosing and treating a case of anaphylaxis, six months after participating in simulation training exercises. Methods: Initially, a group of pediatric residents were trained using simulation techniques in the management of critical pediatric cases. Based on their performance in this exercise, participants were assigned to one of 3 groups. At six months post-training, 4 residents were randomly chosen from each group to be re-tested, using the same performance measure as previously used. Results: During the initial training session, 56 of 72 participants (78%) correctly identified and treated the case. Six months after the initial training, all 12 (100%) resident physicians who were re-tested successfully diagnosed and treated the simulated anaphylaxis case. Conclusions: The training through simulation techniques allowed correction or optimization of the treatment of simulated anaphylaxis cases in resident physicians evaluated after 6 months of the initial training.


Assuntos
Humanos , Simulação , Tutoria , Anafilaxia , Internato e Residência
10.
Arch Argent Pediatr ; 115(4): 399-403, 2017 08 01.
Artigo em Espanhol | MEDLINE | ID: mdl-28737882

RESUMO

OBJETIVE: To evaluate the performance of resident physicians in diagnosing and treating a case of anaphylaxis, six months after participating in simulation training exercises. METHODS: Initially, a group of pediatric residents were trained using simulation techniques in the management of critical pediatric cases. Based on their performance in this exercise, participants were assigned to one of 3 groups. At six months post-training, 4 residents were randomly chosen from each group to be re-tested, using the same performance measure as previously used. RESULTS: During the initial training session, 56 of 72 participants (78%) correctly identified and treated the case. Six months after the initial training, all 12 (100%) resident physicians who were re-tested successfully diagnosed and treated the simulated anaphylaxis case. CONCLUSIONS: The training through simulation techniques allowed correction or optimization of the treatment of simulated anaphylaxis cases in resident physicians evaluated after 6 months of the initial training.


Assuntos
Anafilaxia/diagnóstico , Anafilaxia/terapia , Internato e Residência , Pediatria/educação , Treinamento por Simulação , Criança , Humanos
11.
Arch. argent. pediatr ; 115(3): 294-299, jun. 2017. tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1038373

RESUMO

Introducción. La probabilidad de incurrir en errores en la prescripción de drogas es importante en pediatría y aumenta considerablemente en situaciones de emergencia. Material y métodos. Estudio prospectivo observacional. Se analizaron las prescripciones escritas durante 23 jornadas de simulación de urgencias pediátricas. Resultados. En 94 casos simulados, participaron 96 médicos. Se analizaron 44 prescripciones en papel (48%), que incluían 120 dosis. Se hallaron errores en 12 medicaciones (10%, IC 95%: 5,517,2). Se atribuyó como principal causa de error el estrés. Conclusiones. La ocurrencia de errores en la prescripción de medicamentos durante las sesiones de simulación de emergencias pediátricas fue frecuente.


Introduction. The probability of making mistakes in the prescription of medicines is high in pediatrics, and substantially increases in emergency situations. Material and methods. This prospective observational study analyzed the prescriptions issued by physicians during 23 cardiopulmonary resuscitation pediatric emergency training sessions. Results. During 94 simulated cases, 96 physicians participated. Forty-four prescriptions on paper were analyzed (48%) including 120 doses. Twelve medication errors were found (10%, CI 95%: 5.517.2). Stress was identified as the primary cause of prescription mistakes. Conclusions. Drug prescription mistakes frequently occurred during pediatric emergency simulations.


Assuntos
Humanos , Criança , Tratamento de Emergência , Treinamento por Simulação , Erros de Medicação/estatística & dados numéricos , Ressuscitação , Estudos Prospectivos , Erros de Medicação/prevenção & controle
12.
Arch Argent Pediatr ; 115(3): 294-299, 2017 06 01.
Artigo em Espanhol | MEDLINE | ID: mdl-28504508

RESUMO

INTRODUCTION: The probability of making mistakes in the prescription of medicines is high in pediatrics, and substantially increases in emergency situations. MATERIAL AND METHODS: This prospective observational study analyzed the prescriptions issued by physicians during 23 cardiopulmonary resuscitation pediatric emergency training sessions. RESULTS: During 94 simulated cases, 96 physicians participated. Forty-four prescriptions on paper were analyzed (48%) including 120 doses. Twelve medication errors were found (10%, CI 95%: 5.517.2). Stress was identified as the primary cause of prescription mistakes. CONCLUSIONS: Drug prescription mistakes frequently occurred during pediatric emergency simulations.


Assuntos
Tratamento de Emergência , Erros de Medicação/estatística & dados numéricos , Treinamento por Simulação , Criança , Humanos , Erros de Medicação/prevenção & controle , Estudos Prospectivos , Ressuscitação
14.
Glob Heart ; 12(4): 335-340.e1, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-27264608

RESUMO

BACKGROUND: The question of whether or not to allow family to be present during resuscitation is relevant to everyday professional health care assistance, but it remains largely unexplored in the medical literature. OBJECTIVES: We conducted an online survey with the aim of increasing our knowledge and understanding of this issue. METHODS: This is a cross-sectional, multicenter, descriptive, national, and international study using a web-based, voluntary survey. The survey was designed and distributed through a medical website in Spanish, targeting physicians who frequently deal with critical patients. RESULTS: A total of 1,286 Argentine physicians and 1,848 physicians from other countries responded to this voluntary survey. Of Argentine respondents, 15.8% (203) treat only children, 68.2% (877) treat adults, and 16% (206) treat patients of any age. The survey found that 23% (296) of Argentine and 20% of other respondents favor the presence of family members during cardiopulmonary resuscitation (p = 0.03). This practice was more common among physicians treating pediatric and neonatal patients than among those who treat adults. The most commonly reported reason (21.8%) for avoiding the presence of relatives was concerns that physicians, communications, and medical practices might be misunderstood or misinterpreted. CONCLUSIONS: Avoiding relatives' presence while performing cardiopulmonary resuscitation is the most frequent choice made by the surveyed physicians who treat critical Argentine patients. The main causes for discouraging family presence during cardiopulmonary resuscitation or other critical procedures include the following: risk of misinterpretation of the physician's actions and/or words; risk of a relative's decompensation; uncertainty about possible reactions; and interpretation of the relative's presence as negative.


Assuntos
Reanimação Cardiopulmonar/ética , Estado Terminal/terapia , Família/psicologia , Internet , Vigilância da População/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Reanimação Cardiopulmonar/psicologia , Criança , Pré-Escolar , Estado Terminal/epidemiologia , Estado Terminal/psicologia , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Estudos Retrospectivos , América do Sul/epidemiologia , Adulto Jovem
15.
Med. UIS ; 29(3): 49-53, sep.-dic. 2016.
Artigo em Inglês | LILACS-Express | ID: biblio-954887

RESUMO

ABSTRACT Introduction: obesity is frequent in argentinian children and arterial hypertension affects 2.4% of scholars. Objective: the objectives of the present study are to evaluate the prevalence of obesity and hypertension and their association, and to analyze the ability of electrocardiograms to detect conditions in healthy children and adolescents who attended to request a medical certificate of fitness. Methods: 1030 children (47.9% females and 52.1% males) ranging from 1 to 18 years old who concurred for a check up between Janury and March 2012, were consecutively included. Their body mass index, blood pressure, weight, height, and electrocardiogram findings were calculated and evaluated by a pediatrician and a cardiologist. Results: obesity was detected in 12.1% of males and 9.9% of females, and malnutrition was found in 1.9% and 1.4, respectively. Overweight was more frequent in males, consistent across all age groups. Systolic hypertension (adjusted to the 95th height percentile) was observed in 8.8% males and 8.6% females, more prevalent in children ranging from 4 to 11 years old. A significant association between hypertension and high body mass index was observed. The ECG assessments resulted in six patients with pauses, one patient with asymptomatic Wenchebach AV block, three patients with asymptomatic sinus arrest, and one patient with ventricular bigeminy. Five cases of Wolf-Parkinson-White syndrome were diagnosed, and 2.7% children had long QTc segments. Conclusions: a high prevalence of hypertension was found, which was more frequent in obese children. The electrocardiogram analysis resulted in patients with potentially high risk conditions. MÉD.UIS. 2016;29(3):49-53.


RESUMEN Introducción: la obesidad es frecuente en niños argentinos y la hipertensión arterial afecta a 2,4% de los escolares. Objetivo: evaluar la prevalencia de obesidad e hipertensión y su asociación, y analizar la detección de anormalidades en el electrocardiograma en una población de niños sanos que concurrieron para certificado de estado físico. Materiales y método: se incluyeron 1030 niños (47,9% de sexo femenino y 52,1% masculinos), de 1 a 18 años, que concurrieron a control durante Enero y Marzo de 2012. Se les realizó un electrocardiograma y medición de presión arterial, peso y talla. Resultados: el 12,1% de los varones y 9,9% de las niñas tenían obesidad y el 1,9% y 1,4%, respectivamente, tenían desnutrición. Fue más frecuente el sobrepeso y la obesidad entre los varones que en las mujeres, con distribución homogénea entre las edades. El 8,8 % de los niños y el 8,6% de las niñas tuvieron valores de presión arterial sistólica por encima del percentil 95 según talla, especialmente entre los 4 y los 11 años, con una asociación estadísticamente significativa entre la hipertensión arterial y el índice de masa corporal elevado. En el electrocardiograma hubo seis pacientes con pausas, un bloqueo aurículoventricular tipo Wenchebach asintomático, tres pacientes con paro sinusal y un paciente con bigeminismo ventricular. Se diagnosticaron cinco Wolf Parkinson White y 2,7% de los niños presentaron QTc prolongado. Conclusiones: hubo alta prevalencia de hipertensión arterial, más frecuente en niños con obesidad. Se detectaron pacientes con trastornos potencialmente graves en el electrocardiograma. MÉD.UIS. 2016;29(3):49-53.Palabras clave: Riesgo. Sistema Cardiovascular. Hipertensión. Obesidad. Índice de Masa Corporal. Electrocardiografía.

16.
Acta méd. peru ; 33(3): 202-207, jul.-Set. 2016. ilus, tab
Artigo em Espanhol | LILACS-Express | ID: biblio-989091

RESUMO

Introducción: La tuberculosis (TB) es la primera causa de morbi-mortalidad en población privada de la libertad, su incidencia oscila entre los 25 a 7000 casos por cada 100 000 personas privadas de la libertad por año en comparación a 25,6 por cada 100 000 habitantes en la población general a nivel mundial. Objetivo: Determinar la prevalencia de tuberculosis pulmonar en población privada de la libertad sintomática respiratoria del departamento del Tolima para el año 2013. Materiales y métodos: Estudio de corte transversal en población privada de la libertad recluida en centros penitenciarios de 10 ciudades de Colombia; se realizó búsqueda activa de personas privadas de la libertad con tos y expectoración; a estos se les tomaron muestras de esputo expectorado y/o saliva, muestras oro-faringeas y se les realizó tinción de Ziehl-Neelsen para bacilos ácido-alcohol resistente (BAAR) y cultivo de Ogawa Kudoh para Mycobacterium tuberculosis. Resultados: Del total de población privada de la libertad el 16,2% (1129/6961) eran sintomáticos respiratorios, la edad media fue de 27 años (rango 24 a 45), 53% (n=601) tuvo tos menos de 15 días, 24% presentó fiebre y 23,6% que presentó sudoración nocturna. La prevalencia de tuberculosis fue del 1,5% (n=17 personas privadas de la libertad) con una tasa de incidencia de 244,22 por cada 100 000 personas privadas de la libertad y una tasa ajustada de incidencia 293,15 por cada 100 000 personas privadas de la libertad para Ibagué. Conclusiones: Este estudio muestra la alta prevalencia de TB en población privada de la libertad del Tolima y resalta la importancia de definir protocolos de tamizaje más rigurosos para la población privada de la libertad que para los de la población general.


Introduction: Tuberculosis (TB) is the leading cause of morbidity and mortality in prisoners, its annual incidence is 25 to 7000 cases per 100,000 prisoners vs. 25.6 per 100,000 in the worldwide general population. Objective: To determine the prevalence of tuberculosis in prisoners with respiratory symptoms in Tolima-Colombia during 2013. Material and methods: Cross-sectional study performed in inmates from prisons in 10 Colombian cities. Active surveillance of inmates with respiratory symptoms (cough and sputum production) was performed; sputum, saliva, and/or oro-pharyngeal samples were obtained, and Ziehl-Neelsen staining for direct examination and Ogawa-Kudoh Mycobacterium tuberculosis cultures were performed. Results: The prevalence of respiratory symptoms was 16.2% (1129/6961), the mean age of these subjects was 27 years (range 24 to 45), 53% (601) had cough for <15 days, 24% had fever and 23.6% had night sweats. The prevalence of tuberculosis was 1.5% (17/1129), the incidence rate for these inmates was 244.22 per 100,000 and the adjusted prevalence rate was 293.15 per 100,000 prisoners in Ibague. Conclusions: This study shows the high prevalence of TB in prisoners of Tolima and highlights the importance of defining more strict TB screening protocols for inmates compared with those for the general population

17.
Arch. argent. pediatr ; 114(3): 232-236, jun. 2016. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-838208

RESUMO

Introducción. Los médicos son víctimas frecuentes de violencia tanto física como verbal. Se requiere capacitación específica para preparar al personal para enfrentar estas situaciones. Objetivo. Evaluar, en médicos residentes de Pediatría, durante una simulación de una emergencia pediátrica, el manejo clínico y la conducta ante una madre violenta. Materiales y método. Estudio observacional, retrospectivo y descriptivo. Se revisaron los videos de simulaciones de un caso de emergencia pediátrica, en los que participaron residentes de un hospital público pediátrico, de marzo a julio de 2014. La madre del caso agredía verbalmente e interfería física y oralmente con los participantes. Se registró lo conversado durante el debriefing (la reunión grupal de evaluación). Resultados. Se observaron un total de 68 médicos residentes divididos en 15 grupos. Doce trataron de manera adecuada el caso; solo 2 de ellos retiraron a la madre a través del personal de vigilancia (conducta recomendada). Otros 2 grupos lograron retirar a la madre del escenario clínico, pero con forcejeos. El 54,4% de los médicos (n= 37) mantuvo contacto físico con la madre. El 95,6% de los médicos no contaba con pautas previas para enfrentar estas situaciones de violencia. Conclusiones. Pocos grupos lograron retirar a la madre violenta de la escena. El contacto físico con la madre sin su consentimiento fue una de las conductas más frecuentemente observadas. Se detectó la falta de pautas institucionales para manejar situaciones de violencia.


Introduction. Physicians are frequently victims of both physical and verbal violence. Specific training is required for staff so that they are able to deal with these situations. Objective. To assess the clinical management and behavior of pediatric medical residents towards a violent mother during a pediatric emergency simulation. Materials and methods. Observational, retrospective and descriptive study. Video recordings of a pediatric emergency simulation with the participation of medical residents working at a public children's hospital between March and July 2014 were reviewed. The case mother was verbally violent and interfered with participants, both physically and orally. During debriefing, discussions were recorded. Results. Sixty-eight pediatric medical residents divided into 15 groups were observed. Twelve handled the episode appropriately; only two groups asked the security staff to remove the mother from the scene (recommended behavior). Other two groups managed to remove the mother from the clinical scenario but in the midst of struggles. Out of all physicians, 54.4% (n = 37) came into physical contact with the mother, and 95.6% had not previously received guidelines on how to manage violent situations. Conclusions. Only a few groups managed to remove the violent mother from the scene. Unconsented physical contact with the mother was one of the most commonly observed behaviors. A lack of institutional guidelines on how to handle violent situations was detected.


Assuntos
Humanos , Masculino , Feminino , Pediatria/educação , Médicos , Comportamento , Atitude do Pessoal de Saúde , Emergências , Violência no Trabalho , Treinamento por Simulação , Internato e Residência , Mães , Estudos Retrospectivos
18.
Arch Argent Pediatr ; 114(3): 232-6, 2016 Jun 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27164335

RESUMO

INTRODUCTION: Physicians are frequently victims of both physical and verbal violence. Specific training is required for staff so that they are able to deal with these situations. OBJETIVE: To assess the clinical management and behavior of pediatric medical residents towards a violent mother during a pediatric emergency simulation. MATERIALS AND METHODS: To assess the clinical management and behavior of pediatric medical residents towards a violent mother during a pediatric emergency simulation. RESULTS: Sixty-eight pediatric medical residents divided into 15 groups were observed. Twelve handled the episode appropriately; only two groups asked the security staff to remove the mother from the scene (recommended behavior). Other two groups managed to remove the mother from the clinical scenario but in the midst of struggles. Out of all physicians, 54.4% (n = 37) came into physical contact with the mother, and 95.6% had not previously received guidelines on how to manage violent situations. CONCLUSIONS: Only a few groups managed to remove the violent mother from the scene. Unconsented physical contact with the mother was one of the most commonly observed behaviors. A lack of institutional guidelines on how to handle violent situations was detected. KEY WORDS: patient simulation, violence, workplace violence.


Assuntos
Atitude do Pessoal de Saúde , Comportamento , Internato e Residência , Mães , Pediatria/educação , Médicos , Treinamento por Simulação , Violência no Trabalho , Criança , Emergências , Feminino , Humanos , Masculino , Estudos Retrospectivos
19.
Arch Argent Pediatr ; 112(2): 192-7, 2014 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-24584796

RESUMO

Cardiopulmonary resuscitation (CPR) courses meet all the definitions of an educational activity for prevention of cardiac arrest death by risk patients' parents and/or the general population. The aim is to improve patients' home care and turn parents confident before their children are discharged from hospital, mainly from intensive care units. Currently these courses are part of discharge protocols in many neonatologist services although there are offers that exceed this target, and extend to other areas such as education and caregivers. Locally the experience of neonatal CPR at the Sociedad Argentina de Pediatría stands out in connection with delivering courses to high risk patients' parents as well as designing and spreading learning material.


Assuntos
Reanimação Cardiopulmonar/educação , Pais , Humanos , Lactente , Recém-Nascido
20.
Arch. argent. pediatr ; 112(2): 192-7, 2014 Apr.
Artigo em Espanhol | BINACIS | ID: bin-133622

RESUMO

Cardiopulmonary resuscitation (CPR) courses meet all the definitions of an educational activity for prevention of cardiac arrest death by risk patients parents and/or the general population. The aim is to improve patients home care and turn parents confident before their children are discharged from hospital, mainly from intensive care units. Currently these courses are part of discharge protocols in many neonatologist services although there are offers that exceed this target, and extend to other areas such as education and caregivers. Locally the experience of neonatal CPR at the Sociedad Argentina de Pediatría stands out in connection with delivering courses to high risk patients parents as well as designing and spreading learning material.

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