Tatiana Cuartas Alvarez

Conocimientos en soporte vital básico y desfribilador externo automático de los monitores de centros deportivos de una zona geográfica del Principado de Asturias

OBJECTIVE A study was conducted to determine the level of knowledge about cardiopulmonary resuscitation and automated external defibrillation (AED) in sport instructors working in public sport centers in Asturias. METHODS A cross-sectional study was conducted on sports instructors in May 2014, by completing a self-administered questionnaire on cardiopulmonary resuscitation and use of AED, with 25 items and four possible answers, only one valid, divided into five categories (emergency medical system in Asturias, initial assessment, circulation,airway and use of AED). Age, gender, work experience as sports instructor, previous training courses, education and training and employment contract were studied as epidemiological variables. RESULTS A total 26 questionnaires (52%) were collected in public sports centers, and 84% of total responses were correct. It should be emphasized that among the wrong answers, 42.30% did not know what was the first action in a cardiac arrest, and 36.62% did not know how to perform a complete cardiopulmonary resuscitation if the person affected had a perioral injury, with 46.15% not knowing how to respond to a cardiac arrest due to drowning. CONCLUSIONS It is recommended to include the management of cardiac arrest in their workplace in the training plans and the continuing education of sports instructors, at least every two years, according to national laws and laws from Asturias, including also training on the use and management of AED.

Terrorismo, salud pública y sistemas sanitarios

Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

The development and features of the Spanish prehospital advanced triage method (META) for mass casualty incidents

This text describes the process of development of the new Spanish Prehospital Advanced Triage Method (META) and explain its main features and contribution to prehospital triage systems in mass casualty incidents. The triage META is based in the Advanced Trauma Life Support (ATLS) protocols, patient’s anatomical injuries and mechanism of injury. It is a triage method with four stages including early identification of patients with severe trauma that would benefit from a rapid evacuation to a surgical facility and introduces a new patient flow by-passing the advanced medical post to improve evacuation. The stages of triage META are: I) Stabilization triage that classifies patients according to severity to set priorities for initial emergency treatment; II) Identifying patients requiring urgent surgical treatment, this is done at the same time than stage I and creates a new flow of patients with high priority for evacuation; III) Implementation of Advanced Trauma Life Support protocols to patients previously classified according to stablished priority; and IV) Evacuation triage, stablishing evacuation priorities in case of lacks of appropriate transport resources. The triage META is to be applied only by prehospital providers with advanced knowledge and training in advanced trauma life support care and has been designed to be implemented as prehospital procedure in mass casualty incidents (MCI).

Preparación del personal sanitario en un área de salud de Asturias altamente industrializada para responder ante un desastre industrial

Fundamento: Para responder a los accidentes industriales, de cara a minimizar sus consecuencias, es necesaria una correcta preparacion del personal sanitario que trabaja en zonas de riesgo. El objetivo de este estudio es establecer el grado de percepcion subjetiva que tienen los profesionales sanitarios sobre su preparacion para actuar en un accidente industrial con multiples victimas, asi como su conocimiento sobre los riesgos industriales propios de la zona. Metodos: Se diseno un cuestionario para medir cinco dimensiones relacionadas con la respuesta ante accidentes industriales (conocimiento tecnicos, conocimientos del Area, habilidades practicas, actitudes y formacion). La muestra estaba formada por todos los medicos y personal de enfermeria de Atencion Primaria del Area y del Servicio de Urgencias del hospital de referencia. Resultados: La tasa de respuesta fue del 61,2%. Los resultados en las cuestiones de cada dimension, con un valor maximo de 4, fueron: Conocimientos tecnicos (µ=1,3; d=0,81); Conocimientos del Area (µ=0,75; d=0,96); Habilidades practicas (µ=0,9; d=0,8); Actitudes (µ=3,25; d=0,73); y Formacion (µ=0,75; d=0,88). Obtienen mejores puntuaciones los trabajadores del servicio de urgencias hospitalario y aquellos con contratos indefinidos o temporales, por encima de los trabajadores con contrato fijo. Conclusiones: Existe un deficit de informacion y de formacion entre los profesionales sanitarios que contrasta con el interes mostrado por subsanar estas carencias. Es necesario establecer un programa de informacion y formacion basica para responder ante desastres industriales en nuestra Area de Salud.