Epidemiology, use, and practice of the intraosseous route in an out-of-hospital emergency department: a retrospective cross-sectional study

IntroductionThe Spanish Emergency Medical Services, according to the model we know today, were formed during the 80s and 90s of the 20th century. The Health Emergency Service (EMS), 061 La Rioja, began to assist the population of La Rioja in November 1999. An essential part of the mission of the SES is the provision of care and the transfer of critical patients using advanced life support unit (ALSU) techniques. In daily practice, out-of-hospital emergency services are faced with situations in which they must deal with the care of serious or critically ill patients, in which the possibility of being able to channel peripheral vascular access as part of ALSU quickly may be difficult or impossible. In these cases, cannulation of intraosseous (IO) vascular access may be the key to early and adequate care.AimThis study aimed to determine the incidence and epidemiology use of IO vascular access in SES 061 La Rioja during the year 2022.Matherial and methodsWe performed observational retrospective cross-sectional studies conducted in 2022. It included a population of 4.364 possible patients as a total of interventions in the community of La Rioja in that year.ResultsA total of 0.66% of patients showed a clinical situation that required the establishment of IO vascular access to enable out-of-hospital stabilization; this objective was achieved in 41.3%. A total of 26.1% of patients who presented with cardiorespiratory arrest (CA) were stabilized, while 100% presented with shock and severe trauma.DiscussionIO vascular access provides a suitable route for out-of-hospital stabilization of critically ill patients when peripheral vascular access is difficult or impossible

Effectiveness of early warning scores for early severity assessment in outpatient emergency care : a systematic review

Edited by Prof. Sandra C. ButtigiegBackground and Objectives: Patient assessment and possible deterioration prediction are a healthcare priority. Increasing demand for outpatient emergency care services requires the implementation of simple, quick, and effective systems of patient evaluation and stratification. The purpose of this review is to identify the most effective Early Warning Score (EWS) for the early detection of the risk of complications when screening emergency outpatients for a potentially serious condition.Materials and Methods: Systematic review of the bibliography made in 2022. Scientific articles in Spanish and English were collected from the databases and search engines of Pubmed, Cochrane, and Dialnet, which were published between 2017 and 2021 about EWSs and their capacity to predict complications.Results: For analysis eleven articles were selected. Eight dealt with the application of different early warning scores in outpatient situations, concluding that all the scoring systems they studied were applicable. Three evaluated the predictive ability of various scoring systems and found no significant differences in their results. The eight articles evaluated the suitability of NEWS/NEWS2 to outpatient conditions and concluded it was the most suitable in pre-hospital emergency settings.Conclusions: The early warning scores that were studied can be applied at the pre-hospital level, as they can predict patient mortality in the short term (24 or 48 h) and support clinical patient evaluation and medical decision making. Among them, NEWS2 is the most suitable for screening potentially deteriorating medical emergency outpatients.peer-reviewe

Guía básica sobre la correcta administración de fármacos para estudiantes de enfermería

Este manual va dirigido principalmente a estudiantes del Grado en Enfermería, pudiendo ser empleado también por profesionales de enfermería con el fin de ayudarles en su práctica diaria. Se ha llevado a cabo buscando, en todo momento, un enfoque didáctico y práctico. Para ello, se han empleado imágenes y una estructura visual que ayude al lector a recordar aquellos conceptos clave. Se hace referencia a ejemplos y casos clínicos reales y a problemas graves detectados en la práctica clínica de estos profesionales sanitarios. El estudiantado de enfermería y los propios profesionales de enfermería tienen que hacer frente en su práctica diaria a cálculos rápidos y precisos con el fin de poder administrar correctamente la medicación a sus pacientes. Nos encontramos con que, en ocasiones, muchos de ellos presentan dificultades a la hora de realizarlos. Se trata de una profesión en la que es indispensable conocer cómo se debe preparar la dosis precisa de un medicamento y cualquier error puede resultar de suma gravedad. Este manual, es una guía en la que se va paso a paso, comenzando con cálculos sencillos para poco a poco ir haciendo frente a cálculos más complejos y poner al alumnado en escenarios que se asemejen a su futura práctica clínica. A lo largo de este documento se emplean múltiples infografías, viñetas y recuadros, así como ejemplos resueltos que animan a los y las estudiantes a realizar ellos mismos los diferentes ejercicios propuestos con el fin de que puedan aprender resolviéndolos (Learning by doing)