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Community-acquired pneumonia is common in pediatric age. The objective of this work is to present a medical practice guideline, which helps addressing elements on diagnosis, epidemiology, etiology, risk factors, classification and management of children with community-acquired pneumonia. In the environment which is the context to this Guide, diagnosis and treatment, in most cases, is carried out in the primary care level, with a high incidence rate. Although very few patients require hospital care, the etiological diagnosis and the optimization of antibiotic treatment remain difficult challenges to overcome.

Foundation: the comprehensive visit to the family contributes achieving the actions and the specific functions declared in the Program of the Family Doctor and Nurse in Cuba. It must be executed by basic health teams in each of the doctor's offices. Objective: to propose a methodological guide for the comprehensive visit to the family by the members of the basic health team. Methods: this research responds to a development project and was carried out from March to September 2018. The nominal group technique was applied with the participation of experts (postgraduate methodologists from different areas and municipalities of the province) following the established stages: list preparation, list presentation, voting and assessment and debate of the results achieved with the contribution of all the members of the group. The inclusion of individual trials was achieved until arriving to a consensus in the proposals. Results: the guide provides the steps to follow in the comprehensive visit to the family, among which stand out: characteristics, state of health, material, hygienic-sanitary and epidemiological conditions, family scheme, family functioning, etc., including a joint action doctor-family plan, to solve the problems detected.Conclusion: the methodological guide for developing the comprehensive visit to the family by the basic team members contributes to the achievement of main basic action with the required quality, fulfilling the proposed objectives in the Program of the Family Doctor and Nurse.

Fundamento: la parada cardiaca primaria es un problema de salud mundial y una de sus soluciones es disponer, tanto la población como los profesionales de la salud, de conocimientos en reanimación cardiopulmocerebral. El proyecto para la formación e investigación en apoyo vital en emergencias y desastres puede ser un marco académico para lograrlo. Objetivo: actualizar, para el proyecto, las guías y estrategia docente para la enseñanza del socorrismo. Métodos: taller nacional realizado en julio del 2018 en Cienfuegos, con 13 expertos y cuatro informantes clave. Se utilizaron la técnica de tormenta de ideas y de grupo nominal, cuestionario semiestructurado y revisión documental previa. Resultados: se proponen para la enseñanza del socorrismo tanto en el pregrado como el posgrado: los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se definió la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusiones: las propuestas académicas para el curso “Apoyo vital socorrista” permiten el abordaje de la enseñanza de los primeros auxilios tanto a la población como a grupos especializados de socorristas.

Fundamento: en situaciones de desastres, cuando el número de enfermos o lesionados es alto y los recursos limitados, la atención médica precisa de cambios de estructura y procesos si se quiere salvar un número elevado de personas. El personal de salud debe estar entrenado para enfrentar esta situación cada vez más frecuente. El “Proyecto para la formación e investigación en apoyo vital en emergencias y desastres” puede ser un marco académico para lograrlo. Objetivo: actualizar, para el proyecto, las guías y estrategia docente para la enseñanza del apoyo vital ante víctimas múltiples. Métodos: taller nacional realizado el 10-11 de julio del 2018 en Cienfuegos, con 13 expertos y cuatro informantes clave. Se utilizaron la técnica de tormenta de ideas y de grupo nominal, cuestionario semiestructurado y revisión documental previa. Resultados: se proponen para la enseñanza del apoyo vital en situaciones de desastres, tanto en el pregrado como el posgrado: los objetivos, aspectos didácticos, estrategia docente, contenidos, alcance, habilidades a desarrollar, futuras investigaciones y áreas para la colaboración interinstitucional. Se definió la estructura de un curso prototipo para la enseñanza del tema y las principales consideraciones para su ejecución. Conclusiones: las propuestas académicas para el curso “Apoyo vital avanzado ante víctimas múltiples” permiten la preparación de los profesionales de la salud para brindar asistencia médica en situaciones de desastres, con escasos recursos y en ambientes complejos.

Foundation: Primary cardiac failure is a worldwide Health problem and one of its solutions is to count on health professionals and the population in general with knowledge in cardio-pulmonary-cerebral resuscitation. The project for the training and research in life support in emergencies and disasters may be an academic framework to achieve it. Objective: to update, for the project, the teaching guides and strategy for first aids. Methods: national workshop developed in July 2018 in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming, and nominal group, semi-structured questionnaire and documentary review were used. Results: it is proposed for teaching first aids to undergraduate students and postgradutes as well: the objectives, specific aspects, teaching strategy, contents, scope, skills to develop, future research, and areas for inter-institutional collaboration. Conclusion: academic proposals for the course “Life Support” allows approaching treaching first aids to the population and specialized groups as well.

Foundation: in disaster situations, when the number of patients or injured is high and the resources are limited, medical care requires changes of structures and processes if it is aimed to save most of the persons involved. Health personnel should be trained to face this situation becoming more frequent each time. Objective: to update, for the project, the guidelines and strategies for teaching life support in the presence of mass casualty. Methods: national workshop developed in July 10th and 11th in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming and nominal group, semi-structured and previous documentary review. Results: objectives, specific aspects, teaching strategy, contents, scope of the abilities, skills to develop, future research, and areas for inter-institutional collaboration were proposed for teaching life support in situations of disaster. Conclusion: academic proposals for the course “Life support in the presence of mass casualty¨ allow preparing health professionals to offer medical assistance in situations of disasters with limited resources in complex environments.

Community-acquired pneumonia is common in pediatric age. The objective of this work is to present a medical practice guideline, which helps addressing elements on diagnosis, epidemiology, etiology, risk factors, classification and management of children with community-acquired pneumonia. In the environment which is the context to this Guide, diagnosis and treatment, in most cases, is carried out in the primary care level, with a high incidence rate. Although very few patients require hospital care, the etiological diagnosis and the optimization of antibiotic treatment remain difficult challenges to overcome. [ABSTRACT FROM AUTHOR]

Foundation: the comprehensive visit to the family contributes achieving the actions and the specific functions declared in the Program of the Family Doctor and Nurse in Cuba. It must be executed by basic health teams in each of the doctor's offices. Objective: to propose a methodological guide for the comprehensive visit to the family by the members of the basic health team. Methods: this research responds to a development project and was carried out from March to September 2018. The nominal group technique was applied with the participation of experts (postgraduate methodologists from different areas and municipalities of the province) following the established stages: list preparation, list presentation, voting and assessment and debate of the results achieved with the contribution of all the members of the group. The inclusion of individual trials was achieved until arriving to a consensus in the proposals. Results: the guide provides the steps to follow in the comprehensive visit to the family, among which stand out: characteristics, state of health, material, hygienic-sanitary and epidemiological conditions, family scheme, family functioning, etc., including a joint action doctor-family plan, to solve the problems detected. Conclusion: the methodological guide for developing the comprehensive visit to the family by the basic team members contributes to the achievement of main basic action with the required quality, fulfilling the proposed objectives in the Program of the Family Doctor and Nurse. [ABSTRACT FROM AUTHOR]

Foundation: in disaster situations, when the number of patients or injured is high and the resources are limited, medical care requires changes of structures and processes if it is aimed to save most of the persons involved. Health personnel should be trained to face this situation becoming more frequent each time. Objective: to update, for the project, the guidelines and strategies for teaching life support in the presence of mass casualty. Methods: national workshop developed in July 10th and 11th in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming and nominal group, semi-structured and previous documentary review. Results: objectives, specific aspects, teaching strategy, contents, scope of the abilities, skills to develop, future research, and areas for inter-institutional collaboration were proposed for teaching life support in situations of disaster. Conclusion: academic proposals for the course "Life support in the presence of mass casualty" allow preparing health professionals to offer medical assistance in situations of disasters with limited resources in complex environments. [ABSTRACT FROM AUTHOR]

Foundation: Primary cardiac failure is a worldwide Health problem and one of its solutions is to count on health professionals and the population in general with knowledge in cardio-pulmonary-cerebral resuscitation. The project for the training and research in life support in emergencies and disasters may be an academic framework to achieve it. Objective: to update, for the project, the teaching guides and strategy for first aids. Methods: national workshop developed in July 2018 in Cienfuegos, with 13 experts and four key informers. The techniques of brain storming, and nominal group, semi-structured questionnaire and documentary review were used. Results: it is proposed for teaching first aids to undergraduate students and postgradutes as well: the objectives, specific aspects, teaching strategy, contents, scope, skills to develop, future research, and areas for inter-institutional collaboration. Conclusion: academic proposals for the course "Life Support" allows approaching treaching first aids to the population and specialized groups as well. [ABSTRACT FROM AUTHOR]

Background: The appropriate anesthetic management of the obstetric patient with heart disease, either congenital or acquired, poses a complex problem to the anesthesiologist, whose scientific knowledge and clinical experience are deeply challenged. Objective: To outline a clinical practice guidelines for the management of obstetric patients with heart disease. Methods: A qualitatively approached study with a descriptive and exploratory projection was conducted in such a way that the qualitative and quantitative methodologies were complemented. The following scientific methods were used: document analysis, observation, expert criteria and surveys to specialists. Results: The theoretical systematization allowed evidencing that the difficulties in managing obstetric patients with heart disease constitute a challenge to the practice of the anesthesiologist. In this sense, the specialist must master the anatomy and physiology of the obstetric patient and the particularities of each pregnancy-related heart disease and its anesthetic management. A clinical practice guidelines for the anesthetic management of the obstetric patient with heart disease was designed. It was developed from a needs assessment in the practice of the anesthesiology and resuscitation specialist. Conclusions: The appropriate implementation of the present guidelines should result in a more efficient anesthetic management of the obstetric patient with heart disease.

Fundamento: el adecuado manejo anestésico de la paciente obstétrica que presenta cardiopatía, ya sea congénita o adquirida, plantea un problema complejo al anestesiólogo, reta sus conocimientos científicos y su experiencia clínica en toda profundidad. Objetivo: diseñar una guía de práctica clínica para la asistencia a la paciente obstétrica con cardiopatía. Métodos: estudio con enfoque cualitativo, alcance descriptivo y exploratorio, en el que se complementó la metodología cualitativa y cuantitativa. Dentro de los métodos científicos se utilizaron: el análisis documental, la observación, criterio de expertos y encuesta a especialistas. Resultados: la sistematización teórica permitió evidenciar, que la dificultad en el asistencia a la paciente obstétrica con cardiopatía constituye un reto para el modo de actuación del anestesiólogo. En este sentido, deberá dominar toda la anatomía y fisiología de la paciente obstétrica, así como las particularidades de cada cardiopatía relacionada con el embarazo y su manejo anestésico. Se diseñó una guía de práctica clínica para el manejo anestésico de la paciente obstétrica con cardiopatía, que se elaboró a partir de un diagnóstico de necesidades en el modo de actuación del especialista en anestesiología y reanimación. Conclusiones: la implementación adecuada de esta guía deberá hacer más eficiente el manejo anestésico de la paciente obstétrica con cardiopatía.