Recomendaciones de expertos sobre el material del carro y mochila de reanimación cardiopulmonar pediátrica y neonatal

Cardio-respiratory arrest (CPA) is infrequent in children, but it can occur in any place and at any time. This fact means that every health care facility must always have the staff and material ready to resuscitate a child. These recommendations are the consensus of experts of the Spanish Paediatric and Neonatal Resuscitation Group on the material and medication for paediatric and neonatal resuscitation and their distribution and use.CPR trolleys and backpacks must include the essential material to quickly and efficiently perform a paediatric CPR. At least one CPR trolley must be available in every Primary Care facility, Paediatric Intensive Care Unit, Emergency Department, and Pre-hospital Emergency Areas, as well as in paediatric wards, paediatric ambulatory areas, and radiology suites. This trolley must be easily accessible and exclusively include the essential items to perform a CPR and to assist children (from newborns to adolescents) who present with a life-threatening event. Such material must be familiar to all healthcare staff and also include the needed spare parts, as well as enough drug doses. It must also be re-checked periodically.The standardisation and unification of the material and medication of paediatric CPR carts, trolleys, and backpacks, as well as the training of the personnel in their use are an essential part of the paediatric CPR.     

Novedades en las recomendaciones de reanimación cardiopulmonar pediátrica

Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation.This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation. The Spanish Paediatric Cardiopulmonary Resuscitation recommendations, developed by the Spanish Group of Paediatric and Neonatal Resuscitation, are an adaptation of the European recommendations, and will be used for training health professionals and the general population in resuscitation.This article highlights the main changes from the previous 2010 recommendations on prevention of cardiac arrest, the diagnosis of cardiac arrest, basic life support, advanced life support and post-resuscitation care, as well as reviewing the algorithms of treatment of basic life support, obstruction of the airway and advanced life support.     

Adaptación de las recomendaciones internacionales en estabilización y reanimación neonatal 2015

The International Liaison Committee on Resuscitation (ILCOR) recommendations provide a universal guide of measures to support the transition and resuscitation of newborn after their birth. This guide is expected to be adapted by local groups or committees on resuscitation, according to their own circumstances.The objective of this review is to analyse the main changes, to discuss several of the controversies that have appeared since 2010, and contrasting with other national and international organisations, such as European Resuscitation Council (ERC), American Heart Association (AHA), or the Australian-New Zealand Committee on Resuscitation (ANZCOR). Thus, the Neonatal Resuscitation Group of the Spanish Society of Neonatology (GRN-SENeo) aims to give clear answers to many of the questions when different options are available, generating the forthcoming recommendations of our country to support the transition and/or resuscitation of a newborn after birth, safely and effectively.     

Recomendaciones sobre el diagnóstico y tratamiento de la infección urinaria

Urinary tract infection (UTI) is defined as the growth of microorganisms in a sterile urine culture in a patient with compatible clinical symptoms. The presence of bacteria without any symptoms is known as asymptomatic bacteriuria, and does not require any treatment. In neonates and infants, fever is the guiding sign to suspecting a UTI. Classic urinary tract symptoms become more important in older children. Urine cultures collected before starting antibiotics is always required for diagnosis. Clean-catch (midstream) specimens should be collected for urine culture. In the case of non-toilet-trained children, specimens must be obtained by urinary catheterisation, or suprapubic puncture in neonates and infants. Specimens collected by urine bag should not be used for urine culture. There are no significant differences in the clinical evolution and prognosis between oral versus short intravenous followed by oral antibiotic. Empirical antibiotic therapy should be guided by local susceptibility patterns. Second-generation cephalosporin (children under 6 years) and fosfomycin trometamol (over 6 years), are the empiric therapy recommended in this consensus. In the case of pyelonephritis, recommended antibiotic treatment are third-generation cephalosporins (outpatient care) or, if admission is required, aminoglycosides. Ampicillin should be added in infants less than 3 months old. Antibiotic de-escalation should be always practiced once the result of the urine culture is known.     

Versión española del NAKQ. Adaptación transcultural y análisis de fiabilidad y validez

IntroductionThe Newcastle Asthma Knowledge Questionnaire for parents of children with asthma (NAKQ) has proven to be a valid instrument for asthma knowledge assessment of patients and their parents. The widespread use of the SRS-22 in non-English-speaking countries requires its transcultural adaptation. Our objective was to obtain a version of the NAKQ questionnaire adapted to Spanish and to analyze its validity and reliability.Material and methodsThe Spanish version was obtained by using the forward/back-translation method with expert, bilingual translators. The questionnaire was administered to 157 parents with high knowledge (n=78) and low knowledge (n=79) of asthma. The differences in the number of answers between both groups were analyzed with the χ² test. Internal consistency was determined with Cronbach's alpha coefficient and test–retest reliability with the tau-b of Kendall correlation coefficient, and kappa statistics.ResultsAt the end of the process, 23 of the 31 items were classified as of total equivalence and eight ase of moderate equivalence. The mean score of parents high knowledge was 23±2.94 and the mean score of parents low knowledge was 16.84±2.56. The difference between the two groups was statistically significant (p<0.001). The overall Cronbach's alpha coefficient of the questionnaire was 0.72, the Kendall's tau-b 0,8573 was significant (p=0.01) and the kappa index showed good or very good consistency in more than half of the items.ConclusionsThe Spanish version of the NAKQ has proven to be acceptable and culturally equivalent to the original version and it has a good degree of consistency, validity and reliability.     

Conocimiento y actitudes sobre los primeros auxilios y soporte vital básico de docentes de Educación Infantil y Primaria y los progenitores

ObjectiveThe aim of this study was to evaluate the knowledge of first aid (FA) of primary and pre-school teachers and the parents of children in these education stages.MethodsA questionnaire already used in previous publications was employed and consisted of 4 sections: 1) general information; 2) assessment of FA knowledge; 3) questions about FA, and 4) attitudes about FA. The questionnaire was sent by e-mail in Google Forms format to different education centres of the Autonomous Community of Galicia. The centres were asked to send them to the school staff and parents of the pupils so that they could be completed.ResultsA total of 470 questionnaires were analysed (177 teachers; 242 parents and 51 teachers with children). More than half (268, 57%) of the participants stated to have knowledge of FA. In the case of the teachers, a relationship was found between having this information and teaching these contained in the classroom (P = .008). Only 4 participants managed to arrange the basic life support sequence, and none of them correctly answered the questions on cardiopulmonary resuscitation. More than 95% of the sample considered it necessary to include FA in the school curriculum and in the study plans of degrees destined for teacher training.ConclusionsThe majority of teachers and parents had training in FA, although none of them responded correctly to the questions related to basic life support. The inclusion of these contents in school curricula would be recommendable, but it requires training the teaching staff beforehand. The inclusion of these contents in university study plans should be a measure to take into account.     

Recomendaciones sobre el perfil de competencias y estándares del sistema de traslado neonatal en España

The first hours of life of a sick or premature newborn are crucial for its prognosis and therefore delivery should take place in a center prepared for that degree of complexity. When this condition is not met, the newborn must be transferred in an optimal and safe way to the center that can offer the necessary care. The training, staffing, organization and coordination of the neonatal transport team are essential to guarantee a safe transfer. Being aware of the interest and the advances that are currently taking place in this area of pediatrics, the Standards Commission and the Neonatal Transport Commission of the Spanish Society of Neonatology have prepared this document. In it, both the provision of human and material resources necessary as well as the bases of clinical stabilization in transport to carry out the neonatal transfer in a safe way and proportionate to the needs of the critical newborn have been exhaustively reviewed and detailed.