C. Arnaud

Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-based Study

Objectives: To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. Design: Randomized controlled study. Setting: Children’s hospital at a tertiary care academic medical center. Subjects: Forty-two first-year pediatric residents. Interventions: Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin. During the second evaluation, the residents in the Google Glass group were allowed to seek help from a remote intensivist at any time by activating real-time video communication. The residents in the control group were asked to provide usual care. Measurements and Main Results: The main outcome measures were the proportion of time for which the manikin received no ventilation (no-blow fraction) or no compression (no-flow fraction). In the first evaluation, overall no-blow and no-flow fractions were 74% and 95%, respectively. During the second evaluation, no-blow and no-flow fractions were similar between the two groups. Insufflations were more effective (p = 0.04), and the technique (p = 0.02) and rate (p < 0.001) of chest compression were more appropriate in the Google Glass group than in the control group. Conclusions: Real-time video communication between the first responder and a remote intensivist through Google Glass did not decrease no-blow and no-flow fractions during the first 5 minutes of a simulated pediatric cardiopulmonary arrest but improved the quality of the insufflations and chest compressions provided.

SFP PC-50 - Apport de la simulation dans la formation aux urgences pédiatriques.

Objectif Formation des equipes soignantes (medicales et paramedicales) des urgences pediatriques, a la prise en charge de l’arret cardiaque de l’enfant, en conditions reelles. Materiel et methodes Utilisation du materiel des urgences et d’un mannequin haute fidelite Simbabyinstalle dans une chambre aux lits porte. Composition d’equipe soignante proche de l’effectif de garde (1 medecin senior, 1 interne, 2 infirmieres, 1 aide soignante). Questionnaires anonymes avant et apres simulation. Resultats principaux 68 personnes ont participe a la formation (41 paramedicaux et 27 medecins). Avant simulation, la capacite a prendre en charge un arret cardiaque, en equipe, est ressentie a 5,88 et apres simulation a 7,88 (echelle de 1–10). La formation est jugee utile a l’apprentissage du travail d’equipe (9,32 sur une echelle de 1–10). Des difficultes, organisationnelles et de materiel, mises en evidence ont pu etre corrigees. Conclusion La simulation, en conditions reelles, permet l’amelioration de la prise en charge, en equipe, d’une situation rare mais grave. Le succes de cette formation, bien vecue par les equipes soignantes et ressentie comme realiste, a encourage son developpement dans les services d’hematologie et de pneumologie pediatriques.

Traitement des plaies « simples » : choix des différentes sutures

The suture, when possible, is the best method to close a simple wound. It must be preceded by debridement and performed with great care. A rigorous technique applied in the best possible environment is necessary but not always sufficient to achieve a good cosmetic result.