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Objective: The European Paediatric Life Support (EPLS) provider course aims at training doctors and nurses in the efficient and prompt management of cardiopulmonary arrest in children. EPLS is a 2-day European Resuscitation Council course, involving the teaching of theoretical knowledge and practical skills. The aim of the study was to evaluate the retention of theoretical knowledge and certain skills of EPLS providers 4 months after the course., Materials and Methods: In total, 80 doctors and nurses who attended three EPLS provider courses, from May 2012 to December 2012, were asked to participate in the study and only 50 responded positively. Demographic data (age, sex, occupation) of the participants were collected. The European Resuscitation Council-approved EPLS written test was used to assess theoretical knowledge right after the course and after 4 months. The retention of certain skills (airway opening, bag-mask ventilation, chest compressions) was also examined., Results: The theoretical knowledge decreased significantly (P<0.001) 4 months after the course. Age, sex and occupational status (medical or nursing profession) had no effect in theoretical knowledge retention. Interestingly, certain skills such as the application of airway opening manoeuvres and effective bag-mask ventilation were retained 4 months after the course, whereas chest compression skill retention significantly declined (P=0.012)., Conclusion: According to our findings, theoretical knowledge of the EPLS course uniformly declines, irrespective of the provider characteristics, whereas retention of certain skills is evident 4 months after the course.

Summary: Aims: Considerable variability in (paediatric) trauma care has been reported. We wanted to audit current practice in Flanders (Belgium). Methods: The PENTA network prospectively collected data on paediatric trauma patients in a representative sample of Flemish hospitals during 2005. All cases with an ISS≥13 and sufficient data availability were withheld for panel evaluation (n =92). Two trained experts reviewed the medical care provided in the first hours after trauma, based on available evidence and existing universal guidelines. ‘Defaults’ were only withheld as such if there was 100% consensus. At random, about 25% of cases were also reviewed by two other experts in order to assess interobserver variability. Results: In the 92 cases, 264 defaults were recognised. 25.4% of all defaults were thought to have a direct impact on the individual patient''s outcome. Specific difficulties were observed with, e.g. cervical spine management (18/82 relevant cases), pCO2 and global respiratory management (38/92), fluid management (29/92) and analgesia (27/89). The agreement between the two panels was good for defaults identified (crude agreement 74.8%), yet only fair for the presumed impact on outcome (crude agreement 58.3%). Conclusions: We audited paediatric trauma care in Flanders and identified several problem areas (often in basic areas of paediatric life support). The inherent degree of interobserver variability does not diminish the importance of these findings. More performance-based teaching and timely recertification may have a positive impact on the quality of the care delivered. [Copyright &y& Elsevier]

Summary: Aim: The Glasgow Coma Scale (GCS) is not always easy to score and its reliability has been questioned. In adults the GCS Motor score has proven a valuable alternative, as it is easier to assess yet shows similar predictive capacity for outcome. We wanted to test the non-inferiority of the Glasgow Coma Motor score GCS-M versus the Total score GCS-T for predicting outcome in children. Materials and methods: As part of the Flemish paediatric trauma registry (PENTA) we collected data on 96 consecutive children (0–18 years) with moderate to severe traumatic brain injury. Outcome was evaluated using a three level ordinal scale: [normal to mild disability, moderate to severe disability and death]. A number of proportional odds models were fitted for various choices of predictive variables (GCS-T, GCS-M, age, sex, and injury severity score ISS). For each model we calculated Somers’D xy rank correlation and NagelKerke''s R 2 N index, both measures of the predictive performance of the model. Results: All children had an injury to the brain that resulted in a hospital stay of more than 48h. Half of them had a “best” initial GCS of 15; 60%, a Motor score of 6. The median Injury Severity Score ISS was 16. Outcome was ‘normal to mild’ in 79 children, ‘moderate to severe’ in 7, and ‘death’ in 10. D xy values were 0.983 for the model with the Motor score and 0.972 for that with the total GCS, indicating excellent predictive performance for both. R 2 N indices were 0.862 and 0.813, respectively. Overall the difference between all models was small. Conclusion: The GCS Motor subscore was shown to have at least the same predictive ability for outcome as the total GCS. It is our opinion that the total GCS is unnecessarily complicated (especially in children). Using the Motor score alone will improve scoring compliance and statistical performance. We do not believe that the reduction in number of potential scores from 13 to 6 would decrease the descriptive capacity significantly, since clinical algorithms typically group values of the total GCS into five or fewer ranges. [Copyright &y& Elsevier]

This European Resuscitation Council (ERC) Guidelines for Resuscitation 2018 update is focused on the role of antiarrhythmic drugs during advanced life support for cardiac arrest with shock refractory ventricular fibrillation/pulseless ventricular tachycardia in adults, children and infants. This update follows the publication of the International Liaison Committee on Resuscitation (ILCOR) 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations (CoSTR). The ILCOR CoSTR suggests that any beneficial effects of amiodarone or lidocaine are similar. This ERC update does not make any major changes to the recommendations for the use of antiarrhythmic drugs during advanced life support for shock refractory cardiac arrest. [ABSTRACT FROM AUTHOR]