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Implementation of resuscitation committees in Canary Islands Health Service (Canary Islands, Spain)
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Abstracts / Resuscitation 85S (2014) S15–S121
CA, health technicians, Emergency Medical System, Red Cross and experts. 2009–2010: consensus meetings (videoconferencing or face to face) to design the main recording sheet according to the Utstein style. 2011: Training and test the record sheet by doctors during 3 months in outpatient and inpatient services. Modification and final closure of the registration model. 2012–2013: Beginning of the use of the registry; computerization by Web applications or new developments in electronic health records software. Integration of different applications to manage a standard record. 2014: creation of standard evaluation panel for analysis. Access to computerized record of 100% of the public health system. Publication of rules for compulsory registration. Results: It has achieved a unique model of care record for inhospital and out-of-hospital CA. Current coverage of the database would record more than 80% events. There is a low registration level, mainly due to incomplete or not filling the information and/or misinterpretation of some items record. Conclusions: The standard record of CA is an homogeneous tool for all health professionals, especially useful in a fragmented territory. Computerization will analyze efficiently health care for the CA in order to develop improvement measures and reassess in health services. http://dx.doi.org/10.1016/j.resuscitation.2014.03.295 AP247 “A lesson for Life-Un Ora per la Vita”: Resuscitation for schoolchildren and young people Rommel Jadaan 1,∗ , Elisa Cobalchini 2 , Aurelio Tommasi 1 1 EMS 118 I.M.E.T Onlus, Crespano del Grappa (TV), Italy 2 Member of Civil Protection, Nove (VI), Italy
Purpose of the study: The aim of the study that was realized in primary schools and youth organizations in the Province of Vicenza-Italy was to demonstrate the capability skills as well as the positive attitude and constructive behavior of children and young people (5–18 years) towards Hands-Only Reanimation and their capability to reproduce these skills after 12 months. Materials and methods: In one class lesson (45 min) the theory of Cardiac Arrest followed by the “four steps of resuscitation” were explained (10 min): (1) Call and Shake the patient, (2) Control Consciousness (Dolorous stimulus on the stern), (3) Emergency Service Call, (4) Start chest compression. The rest of the lesson (30 min) they were repeatedly trained and questions that occurred answered and discussed. At the end a questionnaire was distributed asking them to draw about what they learned observed and felt during the theoretical and practical parts of the lesson. A manikin, we used Anne (Laerdal) or an adult volunteer for the theoretical part and Mini Anne (Laerdal) or mattresses, cushions or class seats for the practical part. A Self-made man-big model of a telephone to simulate the emergency call. Results: The skills of Hands-Only Reanimation where easily accepted by the 7170 children and young people between 5 and 18 year old involved in this study. The attitude of the children towards their role as First responders using the Hands-only Reanimation method was very positive. Their constructive behavior towards their “responsibility” to be able to Act: “to help saving lives” was highly appreciated by them.
Conclusion: Teaching and training the Hands-Only Reanimation technique is simple and highly accepted and appreciated by children and young people. Our simple method showed to be very efficient in encouraging children and young people to overcome barriers that may block them from assisting, as well as it showed efficiency being able to be reproduced after 12 months. http://dx.doi.org/10.1016/j.resuscitation.2014.03.296 AP248 Implementation of resuscitation committees in Canary Islands Health Service (Canary Islands, Spain) Enrique Martín Sánchez 1,∗ , Miguel Ángel Hernández Rodríguez 2 , Juan José Cáceres Agra 4 , Federico Segura Villalobos 4 , Nieves González Bravo 3 , Isabel Llorca Alonso 7 , Rubén Sangüesa Molina 5 , Jesús Andrés Álvarez Fernández 8 , Juan Francisco Cabrera Torres 6 , Xerach Arteaga Rodríguez 5 1 Servicio de Urgencias Canario (SUC), Las Palmas, Spain 2 DIrección General de Programas Asistenciales Scs, Sta. Cruz de Tenerife, Spain 3 Complejo Hospitalario Universitario de Canarias, Sta. Cruz de Tenerife, Spain 4 Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain 5 Complejo Hospitalario Universitario Ntra. Sra. de la Candelaria, Sta. Cruz de Tenerife, Spain 6 Servicio de Urgencias Canario (SUC), Sta. Cruz de Tenerife, Spain 7 Gerencia Atención Primaria Gran Canaria, Las Palmas, Spain 8 Hospital Universitario de Getafe, Madrid, Spain
Introduction: The public health assistance network in the Canary Islands covers 2,113,345 people and over 10 million visitors every year. This service includes 9 hospitals, 105 health areas in Primary Health Care (PHC) and an Emergency Medical System (EMS). The creation of Resuscitation Committees (RC) is a relevant recommendation of the International Liaison Committee on Resuscitation (ILCOR). Objective: To strengthen the cardiac arrest (CA) quality of care by publication of a recommendations document to advise the creation, development and functioning of RC in each of the manager teams of the Canarian Public Health Service. Material and methods: 2008: establishment of the Working Group “GERCAN” with representatives of major scientific societies in adult and pediatric CA, health technicians, Emergency Medical System (EMS), Red Cross and experts. 2009–2010: consensus meetings (videoconferencing or face to face) to create a draft document including objectives, interdisciplinary composition, members election, duties, responsibilities and main activities to do. 2011: Preliminary version of the document was sent to reviewers from hospitals, PHC and EMS, in order to improve, update and ends the final version. 2012-2013: publication and dissemination of the document. Gradual creation of RC. Results: A support tool for implementation of RC has been published. Document is open to all manager teams and professionals. Until December 2013, 9 RC have been implemented in hospitals and PHC, accounting for 75% of the target for all the Canary Islands Public Health Service.
Abstracts / Resuscitation 85S (2014) S15–S121
Conclusions: Creation of RC has been supported by this document, acting as an agreed and interdisciplinary tool. The RC will be responsible for coordinating actions (cardiac arrest registry, training, organization, counseling, etc.) in order to improve CA quality of care in the Canary Islands. http://dx.doi.org/10.1016/j.resuscitation.2014.03.297 AP249 The resuscitative management of pulmonary haemorrhage Purpose of the study: The poster presentation is regarding the management of pulmonary haemorrhage from the point of view of an anaesthetist taken from an airway, breathing and circulation format. It is a daunting situation which can leave even the most experienced of anaesthetists unsure how to proceed and what is the best method for the course of resuscitation and treatment. There is currently no consensus guidelines on how to manage these life threatening situations which can leave the patient in severe extremis and often leads to cardiac arrest from either severe airway,
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breathing or circulatory dysfunction. The overall end prognosis is generally poor. The purpose of this poster is to highlight this rare and interesting presenting problem and show the importance of early recognition and consideration of the options available. Materials and method: Having been involved in several of these situations with varying degrees of success – some potential management of the resuscitative phase have been proposed. There are a multitude of differential diagnosis which may be important in the early resuscitative phase but these can often be unknown. Due to the rarity of this condition trials in this would be unlikely Results: Although it is unclear to an extent what interventions would be most useful – this is a collective bundle as well as a set of options that one can consider and is partially dependent on the actual cause if that is known or a site of the primary problem suspected. Conclusion: Putting some of these interventions together may lead to a successful outcome as the primary respiratory and circulatory injury will be reduced, plus there would be clear attempts to avoid the cardiac arrest situation in this relatively unfamiliar situation. http://dx.doi.org/10.1016/j.resuscitation.2014.03.298
Abstracts / Resuscitation 85S (2014) S15–S121
CA, health technicians, Emergency Medical System, Red Cross and experts. 2009–2010: consensus meetings (videoconferencing or face to face) to design the main recording sheet according to the Utstein style. 2011: Training and test the record sheet by doctors during 3 months in outpatient and inpatient services. Modification and final closure of the registration model. 2012–2013: Beginning of the use of the registry; computerization by Web applications or new developments in electronic health records software. Integration of different applications to manage a standard record. 2014: creation of standard evaluation panel for analysis. Access to computerized record of 100% of the public health system. Publication of rules for compulsory registration. Results: It has achieved a unique model of care record for inhospital and out-of-hospital CA. Current coverage of the database would record more than 80% events. There is a low registration level, mainly due to incomplete or not filling the information and/or misinterpretation of some items record. Conclusions: The standard record of CA is an homogeneous tool for all health professionals, especially useful in a fragmented territory. Computerization will analyze efficiently health care for the CA in order to develop improvement measures and reassess in health services. http://dx.doi.org/10.1016/j.resuscitation.2014.03.295 AP247 “A lesson for Life-Un Ora per la Vita”: Resuscitation for schoolchildren and young people Rommel Jadaan 1,∗ , Elisa Cobalchini 2 , Aurelio Tommasi 1 1 EMS 118 I.M.E.T Onlus, Crespano del Grappa (TV), Italy 2 Member of Civil Protection, Nove (VI), Italy
Purpose of the study: The aim of the study that was realized in primary schools and youth organizations in the Province of Vicenza-Italy was to demonstrate the capability skills as well as the positive attitude and constructive behavior of children and young people (5–18 years) towards Hands-Only Reanimation and their capability to reproduce these skills after 12 months. Materials and methods: In one class lesson (45 min) the theory of Cardiac Arrest followed by the “four steps of resuscitation” were explained (10 min): (1) Call and Shake the patient, (2) Control Consciousness (Dolorous stimulus on the stern), (3) Emergency Service Call, (4) Start chest compression. The rest of the lesson (30 min) they were repeatedly trained and questions that occurred answered and discussed. At the end a questionnaire was distributed asking them to draw about what they learned observed and felt during the theoretical and practical parts of the lesson. A manikin, we used Anne (Laerdal) or an adult volunteer for the theoretical part and Mini Anne (Laerdal) or mattresses, cushions or class seats for the practical part. A Self-made man-big model of a telephone to simulate the emergency call. Results: The skills of Hands-Only Reanimation where easily accepted by the 7170 children and young people between 5 and 18 year old involved in this study. The attitude of the children towards their role as First responders using the Hands-only Reanimation method was very positive. Their constructive behavior towards their “responsibility” to be able to Act: “to help saving lives” was highly appreciated by them.
Conclusion: Teaching and training the Hands-Only Reanimation technique is simple and highly accepted and appreciated by children and young people. Our simple method showed to be very efficient in encouraging children and young people to overcome barriers that may block them from assisting, as well as it showed efficiency being able to be reproduced after 12 months. http://dx.doi.org/10.1016/j.resuscitation.2014.03.296 AP248 Implementation of resuscitation committees in Canary Islands Health Service (Canary Islands, Spain) Enrique Martín Sánchez 1,∗ , Miguel Ángel Hernández Rodríguez 2 , Juan José Cáceres Agra 4 , Federico Segura Villalobos 4 , Nieves González Bravo 3 , Isabel Llorca Alonso 7 , Rubén Sangüesa Molina 5 , Jesús Andrés Álvarez Fernández 8 , Juan Francisco Cabrera Torres 6 , Xerach Arteaga Rodríguez 5 1 Servicio de Urgencias Canario (SUC), Las Palmas, Spain 2 DIrección General de Programas Asistenciales Scs, Sta. Cruz de Tenerife, Spain 3 Complejo Hospitalario Universitario de Canarias, Sta. Cruz de Tenerife, Spain 4 Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas, Spain 5 Complejo Hospitalario Universitario Ntra. Sra. de la Candelaria, Sta. Cruz de Tenerife, Spain 6 Servicio de Urgencias Canario (SUC), Sta. Cruz de Tenerife, Spain 7 Gerencia Atención Primaria Gran Canaria, Las Palmas, Spain 8 Hospital Universitario de Getafe, Madrid, Spain
Introduction: The public health assistance network in the Canary Islands covers 2,113,345 people and over 10 million visitors every year. This service includes 9 hospitals, 105 health areas in Primary Health Care (PHC) and an Emergency Medical System (EMS). The creation of Resuscitation Committees (RC) is a relevant recommendation of the International Liaison Committee on Resuscitation (ILCOR). Objective: To strengthen the cardiac arrest (CA) quality of care by publication of a recommendations document to advise the creation, development and functioning of RC in each of the manager teams of the Canarian Public Health Service. Material and methods: 2008: establishment of the Working Group “GERCAN” with representatives of major scientific societies in adult and pediatric CA, health technicians, Emergency Medical System (EMS), Red Cross and experts. 2009–2010: consensus meetings (videoconferencing or face to face) to create a draft document including objectives, interdisciplinary composition, members election, duties, responsibilities and main activities to do. 2011: Preliminary version of the document was sent to reviewers from hospitals, PHC and EMS, in order to improve, update and ends the final version. 2012-2013: publication and dissemination of the document. Gradual creation of RC. Results: A support tool for implementation of RC has been published. Document is open to all manager teams and professionals. Until December 2013, 9 RC have been implemented in hospitals and PHC, accounting for 75% of the target for all the Canary Islands Public Health Service.
Abstracts / Resuscitation 85S (2014) S15–S121
Conclusions: Creation of RC has been supported by this document, acting as an agreed and interdisciplinary tool. The RC will be responsible for coordinating actions (cardiac arrest registry, training, organization, counseling, etc.) in order to improve CA quality of care in the Canary Islands. http://dx.doi.org/10.1016/j.resuscitation.2014.03.297 AP249 The resuscitative management of pulmonary haemorrhage Purpose of the study: The poster presentation is regarding the management of pulmonary haemorrhage from the point of view of an anaesthetist taken from an airway, breathing and circulation format. It is a daunting situation which can leave even the most experienced of anaesthetists unsure how to proceed and what is the best method for the course of resuscitation and treatment. There is currently no consensus guidelines on how to manage these life threatening situations which can leave the patient in severe extremis and often leads to cardiac arrest from either severe airway,
S121
breathing or circulatory dysfunction. The overall end prognosis is generally poor. The purpose of this poster is to highlight this rare and interesting presenting problem and show the importance of early recognition and consideration of the options available. Materials and method: Having been involved in several of these situations with varying degrees of success – some potential management of the resuscitative phase have been proposed. There are a multitude of differential diagnosis which may be important in the early resuscitative phase but these can often be unknown. Due to the rarity of this condition trials in this would be unlikely Results: Although it is unclear to an extent what interventions would be most useful – this is a collective bundle as well as a set of options that one can consider and is partially dependent on the actual cause if that is known or a site of the primary problem suspected. Conclusion: Putting some of these interventions together may lead to a successful outcome as the primary respiratory and circulatory injury will be reduced, plus there would be clear attempts to avoid the cardiac arrest situation in this relatively unfamiliar situation. http://dx.doi.org/10.1016/j.resuscitation.2014.03.298