Comparación de la calidad en la ventilación de socorristas nóveles y veteranos. Un estudio piloto de simulación.

Antecedentes: Los socorristas son fundamentales en la reanimación del ahogado en parada cardiorrespiratoria. En las víctimas ahogadas es prioritario administrar oxigenación. Distintas técnicas de administración de ventilaciones se han investigado y hay controversia sobre la más efectiva. Objetivos: comparar el efecto de la ventilación boca a boca (VBB), ventilación con bolsa y mascarilla (VBM) y ventilación con pocket-mask (VPM) sobre la calidad de RCP entre socorristas recién certificados y socorristas profesionales en activo. Método: 52 socorristas profesionales (14 recién certificados y 38 en activo sin formación en soporte vital básico (SVB) el último año). Cada socorrista realizó 3 test aleatorizados de RCP en un maniquí Resusci Anne conectado a Wireless SkillReporter (Laerdal Medical, Stavanger, Norway) variando la técnica de ventilación: VBB, VBM y VPM. La RCP fue de 4 minutos de duración, por parejas, con un cambio de roles a los 2 minutos, y con el protocolo de ahogados (iniciando por 5 ventilaciones). La calidad global de RCP fue calculada con la fórmula QCPR = (QCT + VVA)/2. Siendo QCT (calidad de posición de manos + ritmo + reexpansión torácica + profundidad) /4 y VVA las ventilaciones administradas con volumen adecuado (500-600ml). Resultados: Los participantes inexpertos recién certificados alcanzaron resultados mejores en todas las variables analizadas en comparación con los profesionales en activo. Esto incluye la calidad global de la RCP con VBB (50.918.41% vs. 35.4912.06%, p=0.002) y VPM (49.094.74% vs. 34.979.69%, p<0.001), así como la mayoría de las variables de calidad de las ventilaciones con las 3 técnicas: VBB, VBM y VPM. Conclusiones: Los socorristas inexpertos recién certificados realizan mejor RCP, incluyendo la ventilación, que los que no han recibido una formación reciente. Es clave la actualización del SVB frecuente en socorristas

Instruments to Assess Physical Activity in Primary Education Students with Autism Spectrum Disorder: A Systematic Review

The scientific evidence supports that physical inactivity in childhood is a reality throughout the world which generates important consequences in the global development of children. Young people with Autism Spectrum Disorder (ASD), due to the characteristics of the disorder they suffer, constitute a group at risk. Therefore, assessing the levels of physical activity (PA) in this group is fundamental for subsequent decision making and implementation of PA promotion programmes. Consequently, the aim of this systematic review was to identify, summarise and analyse the main instruments used to assess the levels of PA (in terms of time and/or intensity) in primary school children diagnosed with ASD. Scientific articles in English and Spanish published in five databases were reviewed: PsycINFO, WOS, SPORTDiscus, Scopus and PubMed, following the guidelines of the PRISMA statement. Out of the 605 articles identified, 12 met the previously established inclusion criteria. The instruments used by the studies analysed were divided into two main groups: accelerometers and questionnaires. Both showed different strengths and limitations but agreed on the low levels registered of PA in children with ASD. For this reason, it is considered necessary that further research be carried out in this field, as well as the development and implementation of sports programmes adjusted and adapted to the needs and characteristics of the ASD groupS

Analysis of the drowning risk associated with aquatic environment and swimming ability [Análisis del riesgo de ahogamiento asociado al entorno acuático y competencia natatoria]

A high level of swimming can be a protective factor against drowning, however, this relationship has not yet been empirically demonstrated, based on water competence level and aquatic environment. This study designed a drowning risk matrix based on the probabilistic analysis of a questionnaire answered by 3,181 participants. The occurrence of Aquatic Stress/Distress (ASD) was analysed based on 5 skill levels and three aquatic scenarios: a) Pool without waves or currents, b) Lakes, reservoirs, rivers and beaches without waves or currents, c) Rivers, beaches or pools with waves and/or currents. The results were expressed in Odds Ratio (OR). ASD risk exceeded OR of 25 in the most dangerous environment and increased for all scenarios as aquatic competency worsened. Three out of four swimmers have experienced an ASD and this event could have been an incentive to improve their water competence. © 2022, Universidad Autonoma de Madrid y CV Ciencias del Deporte. All rights reserved

Assessment of over-the-head resuscitation method in an inflatable rescue boat sailing at full speed. A non-inferiority pilot study

Introduction: Drowning is a public health problem. Interrupting the drowning process as soon as possible and starting cardiopulmonary resuscitation (CPR) can improve survival rates. Inflatable rescue boats (IRBs) are widely used worldwide to rescue drowning victims. Performing CPR in special circumstances requires adjusting the position based on the environment and space available. The aim of this study was to assess the quality of over-the-head resuscitation performed by rescuers aboard an IRB in comparison to standard CPR.Methods: A quasi-experimental, quantitative, cross-sectional pilot study was conducted. Ten professional rescuers performed 1 min of simulated CPR on a QCPR Resuscy Anne manikin (Laerdal, Norway) sailing at 20 knots using two different techniques: 1) standard CPR (S-CPR) and 2) over-the-head CPR (OTH-CPR). Data were recorded through the APP QCPR Training (Laerdal, Norway).Results: The quality of CPR was similar between S-CPR (61%) and OTH-CPR (66%), with no statistically significant differences (p = 0.585). Both the percentage of compressions and the percentage of correct ventilations did not show significant differences (p > 0.05) between the techniques.Conclusion: The rescuers can perform CPR maneuvers with acceptable quality in the IRB. The OTH-CPR technique did not show inferiority compared to S-CPR, making it a viable alternative when boat space or rescue conditions do not allow the conventional technique to be performed.Universidade de Vigo/CISU

Detection of Upper Limb Asymmetries in Athletes According to the Stage of the Season - A Longitudinal Study

Sports injuries can affect the performance of athletes. For this reason, functional tests are used for injury assessment and prevention, analyzing physical or physiological imbalances and detecting asymmetries. The main aim of this study was to detect the asymmetries in the upper limbs (right and left arms) in athletes, using the OctoBalance Test (OB), depending on the stage of the season. Two hundred and fifty-two participants (age: 23.33 ± 8.96 years old; height: 178.63 ± 11.12 cm; body mass: 80.28 ± 17.61 kg; body mass index: 24.88 ± 4.58; sports experience: 12.52 ± 6.28 years), practicing different sports (rugby, athletics, football, swimming, handball, triathlon, basketball, hockey, badminton and volleyball), assessed with the OB in medial, superolateral, and inferolateral directions in both arms, in four moments of the season (May 2017, September 2017, February 2018 and May 2018). ANOVA test was used with repeated measures with a p ≤ 0.05, for the analysis of the different studied variances. Significant differences were found (p = 0.021) in the medial direction of the left arm, between the first (May 2017) and fourth stages (May 2018), with values of 71.02 ± 7.15 cm and 65.03 ± 7.66 cm. From the detection of asymmetries, using the OB to measure, in the medial, superolateral and inferolateral directions, mobility and balance can be assessed. In addition, it is possible to observe functional imbalances, as a risk factor for injury, in each of the stages into which the season is divided, which will help in the prevention of injuries and in the individualization of training.The APC was funded by Universidad Europea del Atlántico

Schoolteachers as candidates to be basic life support trainers: A simulation trial

Background: The aim was to assess future schoolteachers’ basic life support (BLS) knowledge and willingness to include this content in school lessons. The aim was also to determine the learning effect of a brief BLS hands-on training session, supported by real-time feedback. Methods: A convenience sample of 98 University students of Educational Sciences and Sports were recruited. The training program consisted of brief theoretical and hands-on interactive sessions with a 2/10 instructor/participants ratio. Knowledge and willingness was assessed by means of a survey. Chest compressions (CC) and ventilation quality were registered in 47 cases during 1 min cardiopulmonary resuscitation (CPR) tests. Results: Fifty-eight percent of subjects declared to know how to perform CPR, 62% knew the correct chest compression/ventilation ratio but only one in four knew the CC quality standards. Eighty-eight percent knew what an automated external defibrillator (AED) was; willingness to use the device improved from 70% to 98% after training. Almost half of CCs were performed atan adequate rate. Men performed deeper compressions than women (56.1 ± 4.03 mm vs. 52.17 ± 5.51 mm, p = 0.007), but in both cases the mean value was within recommendations. Full chest recoil was better in women (72.2 ± 32.8% vs. 45.4 ± 32.9%, p = 0.009). All CCs were delivered with correct hand positions. Conclusions: Brief hands-on training supported by real-time feedback of CPR quality helps future schoolteachers improve their knowledge, self-confidence and CPR skills. BLS training should be implemented in University curricula for schoolteachers in order to promote their engagement in effective BLS training of schoolchildren.S

Can a voice assistant help bystanders save lives? A feasibility pilot study chatbot in beta version to assist OHCA bystanders

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 compressionsS

Programación didáctica: Primeros auxilios, un contenido incluido en la LOMCE

This Project shows the design and implementation of a teaching program aimed at students aged between 16-17 years old who are in first course in baccalaureate in the filed of Physical Education, according to the current educational legislation LOMCE (RD 1105/2014, december 26). Planning ranges from the curricular elements such as contents, evaluation criteria, standards assessable learning and key competence, to sequencing and distribution of the teaching units in sessions that develop the items mention above. This teaching program is whithin the areaof Physical Education and aims primarily to teachers to contribute to development of the student, inculcating knowledge and skills related to first aid, content that is stipulated in the current legislation and in the fundamental rights. The methodology with which the teacher develops the contents of first aid, is characterized by being active, participatory, inclusive is the method called “Cooperative learning”. This teaching program highlights by developing students autonomy, decision-making and teamwork as well.En el presente trabajo se expone el diseño y aplicación de una programación didáctica dirigida a alumnos de edades comprendidas entre 16 y 17 años de edad que se encuentran en 1º Bachillerato en la materia de Educación Física, rigiéndose por el Real Decreto del currículo básico de la LOMCE (RD 1105/2014, 26 de diciembre). La planificación abarca desde los elementos curriculares como son los contenidos, criterios de evaluación, estándares de aprendizaje evaluables y competencias clave, hasta la secuenciación y distribución de las unidades didácticas en sesiones que desarrollarán dichos elementos anteriores. Esta programación didáctica se encuentra dentro del área de Educación Física y tiene como objetivo primordial del docente a contribuir en el desarrollo integral del alumno, inculcando conocimientos y habilidades relacionadas con los primeros auxilios, contenido que se contempla en la ley actual y en los derechos fundamentales. El modo o método con el que el docente desarrolla los contenidos de primeros auxilios, se caracteriza por activo, participativo, inclusivo e integrador, como el método denominado “aprendizaje cooperativo”. Esta metodología didáctica, desataca por el desarrollo de autonomía, toma de decisiones y el trabajo en grupo del alumnado

Are smart glasses feasible for dispatch prehospital assistance during on-boat cardiac arrest? A pilot simulation study with fishermen.

The aim of the study was to explore feasibility of basic life support (BLS) guided through smart glasses (SGs) when assisting fishermen bystanders. Twelve participants assisted a simulated out-of-hospital cardiac arrest on a fishing boat assisted by the dispatcher through the SGs. The SGs were connected to make video calls. Feasibility was assessed whether or not they needed help from the dispatcher. BLS-AED steps, time to first shock/compression, and CPR's quality (hands-only) during 2 consecutive minutes (1st minute without dispatcher feedback, 2nd with dispatcher feedback) were analyzed. Reliability was analyzed by comparing the assessment of variables performed by the dispatcher through SGs with those registered by an on-scene instructor. Assistance through SGs was needed in 72% of the BLS steps, which enabled all participants to perform the ABC approach and use AED correctly. Feasibility was proven that dispatcher's feedback through SGs helped to improve bystanders' performance, as after dispatcher gave feedback via SGs, only 3% of skills were incorrect. Comparison of on-scene instructor vs. SGs assessment by dispatcher differ in 8% of the analyzed skills: greatest difference in the "incorrect hand position during CPR" (on-scene: 33% vs. dispatcher: 0%). When comparing the 1st minute with 2nd minute, there were only significant differences in the percentage of compressions with correct depth (1st:48 ± 42%, 2nd:70 ± 31, p = 0.02). Using SGs in aquatic settings is feasible and improves BLS. CPR quality markers were similar with and without SG. These devices have great potential for communication between dispatchers and laypersons but need more development to be used in real emergencies

Quality of ventilations during infant resuscitation: a simulation study comparing endotracheal tube with face mask

Background: There are few studies that analyze ventilation volume and pressure during CPR carried out on infants. The aim of this study was to evaluate the quality of the ventilations administered using a self-inflating bag with an endotracheal tube and a face mask in manikins. Methods: a quasi-experimental simulation study with a randomized case crossover design [endotracheal tube (ET) vs. face mask (FM)] was performed. Sixty participants who were previously trained nursing students participated in the study. The estimated air volumes breathed, and the pressure generated during each ventilation were assessed and the quality of the chest compressions was recorded. Results: the ET test presented a higher percentage of ventilations that reached the lungs (100% vs. 86%; p < 0.001), with adequate volume (60% vs. 28%; p < 0.001) in comparison to FM. Both tests presented peak pressures generated in the airway greater than 30 cm H2O (ET: 22% vs. FM: 31%; p = 0.03). Conclusions: performing quality CPR ventilations on an infant model is not an easy skill for trained nursing students. Both tests presented a significant incidence of excessive peak pressure during ventilations. Specific training, focused on quality of ventilations guided by a manometer attached to the self-inflating bag, must be considered in life support training for pediatric providers