A retrospective analysis was performed of 1637 questionnaires among students of immediate pediatric life support (IPLS) courses. All theory and practice classes and organization and methods received an average score higher than 8.5 except for the schedule and time devoted to developing contents. All parameters evaluating instructors' skills received a score higher than 9. Participants requested more time to practice and for course adaptation to their specific professionals needs. IPLS courses are highly valued by students. The duration of IPLS practice sessions should be increased and the course should be adapted to the specific professional needs of participants.

Due to the complexity and characteristics of their patients, neonatal units are risk areas for the development of adverse events (AE). For this reason, there is a need to introduce and implement some tools and strategies that will help to improve the safety of the neonatal patient. Safety check-lists have shown to be a useful tool in other health areas but they are not sufficiently developed in Neonatal Units.A quasi-experimental prospective study was conducted on the design and implementation of the use of a checklist and evaluation of its usefulness for detecting incidents. The satisfaction of the health professionals on using the checklist tool was also assessed.The compliance rate in the neonatal intensive care unit (NICU) was 56.5%, with 4.03 incidents per patient being detected. One incident was detected for every 5.3 checklists used. The most frequent detected incidents were those related to medication, followed by inadequate alarm thresholds, adjustments of the monitors, and medication pumps.The large majority (75%) of the NICU health professionals considered the checklist useful or very useful, and 68.75% considered that its use had managed to avoid an AE. The overall satisfaction was 83.33% for the professionals with less than 5 years working experience, and 44.4% of the professionals with more than 5 years of experience were pleased or very pleased.The checklists have shown to be a useful tool for the detection of incidents, especially in NICU, with a positive assessment from the health professionals of the unit.Las unidades neonatales, por su complejidad y las características de los pacientes, son áreas de riesgo para el desarrollo de eventos adversos (EA); de ahí surge la necesidad de implantar e implementar herramientas y estrategias que permitan mejorar la seguridad del paciente neonatal. Las listas de verificación de seguridad (LVS) han demostrado ser una herramienta útil en otras áreas sanitarias, pero están poco estudiadas en neonatología.Estudio prospectivo cuasiexperimental. Diseño e implantación del uso de LVS y valoración de su utilidad para la detección de incidentes, así como valoración de la satisfacción con el uso de esta herramienta por parte del personal sanitario.En la unidad de cuidados intensivos neonatales (UCIN) el cumplimiento fue del 56,5%. Se detectaron 4,03 incidentes por cada paciente ingresado. Para detectar un incidente fue necesario realizar 5,3 LVS. Los incidentes más frecuentes fueron los relacionados con medicación, seguidos por los ajustes inadecuados de las alarmas de monitores y bombas de infusión.El 75% del personal consideró la LVS útil o muy útil y el 68,75%, que la LVS había conseguido evitar algún EA. En cuanto al grado de satisfacción global, se sentían satisfechos o muy satisfechos con la LVS el 83,33% de las personas con menos de 5 años de experiencia frente al 44,4% del personal con más de 5 años de experiencia.Las LVS han demostrado ser una herramienta útil para la detección de incidentes, especialmente en la UCIN, con una valoración positiva por parte del personal de la unidad.

espanolEste articulo resume las recomendaciones europeas de reanimacion cardiopulmonar (RCP) pediatricas, destacando los principales cambios e intenta animar a los profesionales a actualizar y mantener sus conocimientos y habilidades en RCP pediatrica. Las recomendaciones europeas del ano 2015 mantienen el mismo algoritmo de actuacion en la RCP basica y avanzada pediatrica. Los cambios mas significativos son: en la prevencion de la parada cardiaca (PC), los ninos con enfermedad febril sin signos de shock no deben recibir de forma rutinaria expansiones de fluidos porque un volumen excesivo puede empeorar el pronostico. En la RCP basica se recomienda que la administracion de la respiracion dure alrededor de 1 segundo, para unificar las recomendaciones con las del adulto. En las compresiones toracicas el esternon debe deprimirse por lo menos un tercio del diametro toracico anteroposterior. En el nino, la mayoria de las PC tienen ritmos no desfibrilables y en ellos la secuencia coordinada de ventilacion y compresiones toracicas y administracion de adrenalina es el tratamiento esencial. La via intraosea, sobre todo en los lactantes, puede ser el acceso vascular de primera eleccion. En el tratamiento de la taquicardia supraventricular, cuando se realice cardioversion como tratamiento, se recomienda utilizar una dosis inicial de 1 J/kg (antes se recomendaba 0,5 J/kg). En los cuidados postresucitacion tras la recuperacion de la circulacion espontanea, se deben tomar medidas para evitar la fiebre, teniendo como objetivo conseguir la normotermia ya desde el ambito extrahospitalario. EnglishThis summary of the European guidelines for pediatric cardiopulmonary resuscitation (CPR) emphasizes the main changes and encourages health care professionals to keep their pediatric CPR knowledge and skills up to date. Basic and advanced pediatric CPR follow the same algorithm in the 2015 guidelines. The main changes affect the prevention of cardiac arrest and the use of fluids. Fluid expansion should not be used routinely in children with fever in the abuse of signs of shock because too high a volume can worsen prognosis. Rescue breaths should last around 1 second in basic CPR, making pediatric recommendations consistent with those for adults. Chest compressions should be at least as deep as one-third the anteroposterior diameter of the thorax. Most children in cardiac arrest lack a shockable rhythm, and in such cases a coordinated sequence of breaths, chest compressions, and administration of adrenalin is essential. An intraosseous canula may be the first choice for introducing fluids and medications, especially in young infants. In treating supraventricular tachycardia with cardioversion, an initial dose of 1 J/kg is currently recommended (vs the dose of 0.5 J/kg previously recommended). After spontaneous circulation is recovered, measures to control fever should be taken. The goal is to reach a normal temperature even before arrival to the hospital.

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.

OBJECTIVESThis summary of the European guidelines for pediatric cardiopulmonary resuscitation (CPR) emphasizes the main changes and encourages health care professionals to keep their pediatric CPR knowledge and skills up to date. Basic and advanced pediatric CPR follow the same algorithm in the 2015 guidelines. The main changes affect the prevention of cardiac arrest and the use of fluids. Fluid expansion should not be used routinely in children with fever in the abuse of signs of shock because too high a volume can worsen prognosis. Rescue breaths should last around 1 second in basic CPR, making pediatric recommendations consistent with those for adults. Chest compressions should be at least as deep as one-third the anteroposterior diameter of the thorax. Most children in cardiac arrest lack a shockable rhythm, and in such cases a coordinated sequence of breaths, chest compressions, and administration of adrenalin is essential. An intraosseous canula may be the first choice for introducing fluids and medications, especially in young infants. In treating supraventricular tachycardia with cardioversion, an initial dose of 1 J/kg is currently recommended (vs the dose of 0.5 J/kg previously recommended). After spontaneous circulation is recovered, measures to control fever should be taken. The goal is to reach a normal temperature even before arrival to the hospital.

Therapeutic hypothermia improves outcome after perinatal asphyxia. The Ages and Stages Questionnaire is a screening tool to detect neurodevelopmental delay. In this study we examined the outcome of patients with perinatal asphyxia (defined as Apgar score <5 at 10 min, or continued need for resuscitation, or pH < 7.00 in umbilical cord or within one hour after birth) with and without therapeutic hypothermia treatment at the age of four years.Cohort study of patients with perinatal asphyxia admitted to the Neonatal Intensive Care Units of the VU University Medical Center, Amsterdam and the Wilhelmina Children's Hospital, Utrecht in the year 2008. Parents were asked to fill out the 48 months Ages and Stages Questionnaire (ASQ). In Wilhelmina Children's Hospital treatment with therapeutic hypothermia was implemented in 2008, in the VU University Medical Center in 2009, providing a historical cohort.Twenty-three questionnaires were evaluated. Response rate of questionnaires for the VU Medical Center was 63% (n = 10) and Wilhelmina's Childrens Hospital 93% (n = 13). No significant differences were found in the mean scores between both groups. However, the untreated group scored more frequently under the −2 SD threshold. In the fine motor skills domain the difference was statistically significant (p = 0.031). In the treated group no patients developed cerebral palsy and in the untreated group two patients developed cerebral palsy.In this study patients treated with hypothermia tend to have a better neurodevelopmental outcome. No significant differences were found between the two groups, apart from the fine motor skills.

Chest compression is a standard recommendation during cardiopulmonary resuscitation (CPR). However, chest compression cannot be effectively applied under certain situations, such as chest wall deformity, rib fracture, or hemopneumothorax. An alternative method, abdominal compression, was reported to achieve better resuscitation outcomes in these patients.A prospective study was performed in adult patients with cardiac arrest and anticipated ineffective chest compression (thoracic trauma, chest deformity, rib fracture, and hemopneumothorax). Active abdominal lifting and compression cardiopulmonary resuscitation was used. Primary outcome was success rate of restoration of spontaneous circulation (ROSC). Secondary outcomes included heart rate (HR), mean arterial pressure (MAP), pulse oximetry saturation (SpO2), arterial blood pH value, arterial oxygen pressure (PaO2), and arterial carbon dioxide tension (PaCO2), which were measured during the periods of pre-CPR, CPR, and 30 min post-ROSC.A total of 35 patients were enrolled into the study. Five of them had ROSC (14.3%), which was statistically significantly higher than that (0%) reported in the 2015 Advanced Cardiovascular Life Support manual. HR, MAP, and SpO2 during CPR were also statistically significantly higher during CPR when compared to the period of pre-CPR period (HR 58 versus 0 beats/min, P < 0.01; MAP 25 versus 0 mm Hg, P < 0.01; SpO2 0.68 versus 0.48%, P < 0.01). In post-ROSC period, HR was statistically significantly higher than that during pre-CPR period (121 versus 0 best/min, P < 0.01).Active abdominal lifting and compression cardiopulmonary resuscitation could reach better resuscitation outcomes in certain cardiac arrest patients.

Purpose of the study: Knowing the characteristics and outcomes of pediatric Out-of-Hospital and Emergency Department Cardiac Arrest (CA).