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PURPOSE OF STUDYTo study the time interval between consecutive shocks in OHCA when ACLS is provided as an indirect indicator of time management during CPR cycles according to 2015 ERC Guidelines.MATERIAL AND METHODSDescriptive, observational, retrospective study.Study period: January 1st 2014 to December 31st 2016. We define event as the presence of ventricular fibrillation (VF) for at least 3 consecutive rhythm analyses.Other studies define CPR cycle time in 120 s, optimal rhythm check time in 4 s, time to charge the defibrillator up to 200J in 7 s and shock delivery and resuming CPR in 1 s; therefore, the optimal time in between shocks is 133 s. We define, for analysis, an optimal time range between 133-146 s. Inclusion criteria: OHCA with one or more events assisted by SAMU-Asturias.Data collected from clinical records and event log from the monitor/defibrillator.Statistical analysis with SPSS Statistics 21 software.RESULTS1706 OHCA registered: 114 meet inclusion criteria, with 127 events and 680 time intervals between shocks.Mean interval between shocks is 134,1 s (SD= 49,9 s).15.9% of intervals between shocks are in the optimal time range.CONCLUSIONS- The optimal time range rate can be considered an indirect indicator of CPR quality.- Most of shocks are delivered in the 2 to 3 min interval.- Our optimal time range rate seems to be very low, though there are no standards to compare with.- Our study shows higher rates of time below the lower limit of the optimal time range.- Time control measures must be implemented during ACLS in OHCA.

PURPOSE OF THE STUDYTo determine the time u201ccall-first shocku201d in OHCA in our units and to study time intervals involved in it: u201ccall-dispatchu201d, u201cdispatch-monitor onu201d, u201cmonitor on-first shocku201d.MATERIAL AND METHODSTo determine the time u201ccall-first shocku201d in OHCA in our units and to study time intervals involved in it: u201ccall-dispatchu201d, u201cdispatch-monitor onu201d, u201cmonitor on-first shocku201d.RESULTS1706 OHCA registered: 126 (7.38%) meet inclusion criteria.Mean interval between call and shock is 14 m 42 s (DS=385 s).Using Tanigawau2019s intervals our findings show:Delay over 13 m is 51,6%, being lower than 9 m in 14.3% of cases.Delays bigger than 20 min are just 13.5%.Mean interval between call and ALS team dispatch is 2 m 15 s (SD=78 s).Mean interval between ALS team dispatch and when the monitor is switched on is 10 m 21 s (SD=343 s).Mean interval between u201cmonitor switched onu201d and the first shock is 2 m 8 s. (SD=68 s).CONCLUSIONS- OHCA have specific difficulties that imply delays in the first shock delivery (patients hard to reach, excess of clothes, unsafe area) that have to be studied. - Our intervals u201ccall-first shocku201d seem to be better than in other published studies.- Interval variability can be due to the absence of a fixed procedure regarding the moment to turn the monitor on in our units.- Rates of time u201cmonitor on-shocku201d higher than two minutes have to be studied further.

PURPOSE OF THE STUDYSudden cardiac arrest during sports is an extremely uncommon event that has a very strong social impact. We aim to study the basic epidemiological characteristics and outcome when life support is performed and compare to those in overall population (OP).MATERIAL AND METHODSDescriptive, retrospective, observational study.Study period: January 1st 2015 to December 31st 2016.Inclusion criteria: OHCA at sports event (Utstein definition) assisted by SAMU-Asturias, regardless of the/treatment: BLS, ACLS or no treatment. Data collected from clinical reports and Utstein based OHCA registry and analysed with SPSS Statistics 21 software.RESULTSOut of 1108 OHCA registered, 7 (0.6%) at sports events. 6 patients (85.7%) male; average age, 48.1 years (s=21.8), being 66.7 (s=16.3) in OP. Witnessed OHCA in 85.7% of cases, being 66.3% in OP. Bystander BLS in 6 patients (85.7%), use of AED in 3 (42.9%), all with shock delivered; in OP use of AED in 159 cases (14.4%), with shock delivered in 46 (28.8% of them). ACLS by an EMS unit in 2 patients, both with initial shockable rhythm, and postresuscitation care, due to return to spontaneous circulation prior to the EMS team arrival, in 1 patient. All 3 were survived events (100%); in OP rate was 25.9% (p=0.01). 100% with hospital discharge: neurological outcome, CPC 1, 2 patients (66.6%), CPC 4, 1 patient (33.3%).CONCLUSIONS- The incidence proves to be extremely low thus limiting the statistical validity of this study.- Trends show high rate of witnessed CA, of bystander CPR and better short-term survival in those with survived event.- Utstein definition does not discriminate organised sport events and casual sports practice.

Fibrinolysis: a needed check up PURPOSE OF THE STUDYUtstein based OHCA registry shows an increase, during 2016, of the use of fibrinolytics in cardiac arrests (OHCA). To determine the conditions of its use, to check compliance with ERC Guidelines and to compare results with those from our previous series. MATERIALS AND METHODSDescriptive, retrospective, observational study of the OHCA assisted by SAMU-Asturias.Study period: July 1st 2013 to December 31st 2016.Inclusion criteria: Patients that received fibrinolytics during ACLS provided by EMS. Patients with suspected acute pulmonary embolism (APE) OHCA, with or without use of fibrinolytics.Data collected from clinical reports and Utstein based OHCA registry.Data analysed with SPSS Statistics 21 software.RESULTSOut of 2251 PC registered, 31 (1.37%) received fibrinolytics during ACLS: 16 before 2016, and 15 in 2016. The increase is statistically significant (p=0.021). 23 patients (74.2%) male: average age, 56.5 years (s=15.3). Table I shows the epidemiological variables studied related to these events.9 (29.0%) survived events, all in 2016: 6 with suspected cardiac etiology, 3 with suspected APE. Average time of return of spontaneous circulation (ROSC) after administration of fibrinolytics: 20.2 min (s=16.7) [2-53]. Discharge with CPC 1-2 in 3 cases (9.7%), witnessed CA of cardiac etiology with initial shockable rhythm.Figure 1 shows CPR times after fibrinolysis in patients without ROSC.Table II shows the management of suspected APE.CONCLUSIONSThere is a higher use of fibrinolytics in OHCA in 2016.Higher use does not reflect in survival rate.Most of fibrinolytics were used in non suspected APE OHCA.Recommended CPR time after administration of fibrinolytics is not accomplished.There seems to be a contagion effect on treatment in OHCA due to suspected APE and OHCA of cardiac etiology, which according to literature is contraindicat

Introducción: Los hospitales son instituciones especialmente sensibles ante las emergencias. Prestan asistencia a los heridos, y tienen alto valor simbólico como lugares que preservan la vida y la seguridad, pero son susceptibles a sufrir una situación crítica, y deben estar preparados para responder a ésta de manera eficaz. Metodología: Comparamos el Plan de Emergencias Interior del Hospital Carmen y Severo Ochoa, vigente desde 1993, con otros dos documentos con enfoques diferenciados: la Norma Básica de Autoprotección, que aporta un marco teórico, y con estándares operativos definidos en el programa Hospitales Seguros de la OMS, dentro del Índice de Seguridad Hospitalaria, que valoran su implantación. Resultados: Este estudio objetiva un plan con muy pocos puntos débiles al compararlo con el primero, pero que no supera los mínimos exigidos por la OMS, al no haber sido implantado correctamente entre el personal del hospital. Conclusiones: Debe mejorarse la implantación del plan para considerar que podría resultar operativo, en caso de tener que ser activado, y de esa manera, el hospital pueda cumplir con las expectativas que la sociedad tiene depositadas en él.

En la presente comunicación se describen las actividades que conforman una propuesta de trabajo en grupo, así como algunos mecanismos que ayudan en el proceso de evaluación. Asimismo, se presentan los resultados obtenidos tras llevar a cabo la propuesta en una asignatura de último curso de una Ingeniería Técnica Informática. Una de las motivaciones de los autores a la hora de diseñar la propuesta, fue la de establecer actividades de grupo cuya realización de forma individual fuese complicado. Además, también se ha tratado de proponer trabajos que no fuera posible realizarlos exclusivamente a base de recopilación de material de la web, junto con labores de “copy/paste”. Un proceso de evaluación periódica del trabajo que se va realizando, supone un buen complemento para que el conjunto de la propuesta tenga éxito y se alcancen los objetivos perseguidos.

El presente trabajo constituye una memoria sobre la experiencia docente que se ha realizado durante el primer cuatrimestre del curso académico 2005/2006 en una asignatura de último curso de la titulación de Ingeniería Técnica Informática de Sistemas, correspondiente a la E.U.I.T. Informática de Gijón. La intención de los autores es poner de manifiesto las medidas concretas adoptadas, los resultados obtenidos, y una posible adaptación de la asignatura de cara a la próxima entrada en vigor del EEES.