Rescuers' characteristics associated with the correct chest compression during cardiopulmonary resuscitation.

AIM: To analyse the caregivers' physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR). METHODS: An observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models. RESULTS: Two hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR = 3.03; 95% CI 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI .87-.99) and grip strength (OR: .94; 95% CI .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil. CONCLUSIONS: The caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.

Características de los reanimadores asociadas a la correcta compresión torácica durante la reanimación cardiopulmonar / Rescuers’ characteristics associated with the correct chest compression during cardiopulmonary resuscitation

Objetivos: Analizar las características físicas, antropométricas y formativas de los reanimadores asociadas a la correcta compresión y reexpansión torácica durante la reanimación cardiopulmonar. Metodología: Estudio observacional prospectivo. Profesionales y estudiantes sanitarios de urgencias y cuidados críticos realizaron 2min de compresiones torácicas sobre un maniquí. Se evaluó la profundidad y la presión residual tras las compresiones, y se estudió su asociación a diferentes variables (físicas, antropométricas y formativas) mediante la creación de modelos de regresión logística. Resultados: Participaron 238 voluntarios. Que el reanimador tuviese una experiencia previa en menos de 6 reanimaciones cardiopulmonares (OR: 3,03; IC 95%: 1,2-7,63) se asoció a una mayor probabilidad de no lograr una profundidad adecuada en las compresiones. Una mayor estatura (OR: 0,93; IC 95%: 0,87-0,99) y fuerza de aprehensión (OR: 0,94; IC 95%: 0,89-0,99) fueron condiciones que actuaron como factores predisponentes a la ejecución de una técnica correcta. Ninguna característica se asoció a la adecuación de la reexpansión torácica. Conclusiones: La experiencia previa del reanimador es el factor más fuertemente asociado a la correcta ejecución de las compresiones torácicas. En menor medida, también influye la estatura y la fuerza del tren superior del profesional. No se han identificado factores asociados a la adecuación de la reexpansión torácica tras las compresiones.(AU)

Aim: To analyse the caregivers’ physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR). Methods: An observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models. Results: Two hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR: 3.03; CI 95%: 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI: .87-.99) and grip strength (OR: .94; 95% CI: .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil. Conclusions: The caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.(AU)

Rescuers' characteristics associated with the correct chest compression during cardiopulmonary resuscitation. / Características de los reanimadores asociadas a la correcta compresión torácica durante la reanimación cardiopulmonar.

AIM: To analyse the caregivers' physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR). METHODS: An observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models. RESULTS: Two hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR: 3.03; CI 95%: 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI: .87-.99) and grip strength (OR: .94; 95% CI: .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil. CONCLUSIONS: The caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.

Knowledge of appropriate foods and beverages needed for weight loss and diet of patients in an Obesity Clinic.

BACKGROUND/OBJECTIVE: Knowledge does not automatically translate into behaviour change. This study examined the relationship between knowledge of appropriate foods and beverages needed for weight loss and the diet of patients seeking weight management. SUBJECTS/METHODS: A cross-sectional study of 104 consecutive first-time patients (55 women and 49 men) seeking weight management, with a mean age of 37.3 ± 11.8 years and a BMI of 44.9 ± 9.4 kg/m(2), was carried out; 67.3% of these patients had a BMI of 40 kg/m(2) or greater. Patients were told to design a detailed weight-loss diet that they would recommend to a person with the same characteristics (recommended diet or RD) as themselves and asked whether the RD was similar to their own. Consumed diet (CD) was assessed by a different dietitian through a 24-h diet recall. Estimated energy requirement (EER), energy content of RD and CD and number of fruit, vegetable, cereal and sweetened-beverage portions were calculated. Statistical differences were assessed through the Pearson's correlation and the Wilcoxon's rank-sum tests. RESULTS: RD and CD were 1104 ± 243 and 1976 ± 708 kcal for women and 1254 ± 287 and 2743 ± 1244 kcal for men, with statistical differences for both genders (P<0.001). Energy content of the RD was lower than the EER in men and women (P<0.001); CD was lower than the EER in women (P=0.033). Number of fruit/vegetable portions was lower in CD than in the RD in women (P<0.001), whereas cereal and sweetened-beverage portions were higher in CD than in the RD in both genders (P<0.001). RD was not followed by 46.1% of the patients. CONCLUSIONS: Patients with obesity seeking care have knowledge of the appropriate dietary strategies needed for weight loss, but do not translate it into practice. Treatment approaches should include tools that help patients to implement their nutrition knowledge.

Efectividad del uso de predictores de vía aérea difícil en el área de urgencias / Usefulness of difficult airway predictors in the emergency department

Objetivos: Determinar la efectividad del uso de predictores en el manejo de la vía aérea en el área de urgencias y el valor pronóstico de algunos predictores de vía aérea difícil. Método: Se realizó un estudio descriptivo, observacional, en el área de urgencias durante un periodo de 14 meses. La muestra estuvo constituida por pacientes con necesidad de control de la vía aérea, en los cuales se analizó la probabilidad de vía aérea difícil mediante la aplicación de los test de Mallampati, Cormack Lehane y Distancia Esternomentoniana. Se determinó su valor predictivo, sensibilidad y especificidad de manera independiente y combinados. Resultados: Se detectaron 137 pacientes, y en ellos la IOT se realizó en menos de 3 intentos en el 79,5% y en el 92,3% en 5 o menos minutos. En 98 pacientes pudo analizarse a priori la probabilidad de encontrar una vía aérea difícil. El test de Mallampati tuvo un valor predictivo positivo de 100%, el de Cormack Lehane de 87,5%, y la Distancia Esternomentoniana de 66,6%, mientras que la sensibilidad fue del 100, 77,7y 98,8%, respectivamente, y la especificiadad fue del 100, 85,7 y 96,0%, respectivamente. No hubo diferencias de género en la aparición de vía aérea difícil. Conclusiones: El test de Mallampati tuvo un mayor valor predictivo, sensibilidad y especificidad. El carácter de la vía aérea fue predicho mayoritariamente (AU)

Objective: To determine the usefulness of difficult airway predictors in the emergency department and the prognosticvalue of some of these predictors. Methods: A descriptive, observational study was carried out in the emergency department over a period of 14 months. We studied patients who required intubation to establish an airway, assessing the likelihood of difficult airway by Mallampati score, Cormack-Lehane classification, and sternomental distance and calculating the predictive value, sensitivity, and specificity of these variables by themselves and in combination. Results: We identified 137 patients requiring orotracheal intubation, which was successful in fewer than 3 attempts in 79.5% and in 5 minutes or less in 92.3%. In 98 patients we were able to assess the likelihood of difficult airway inadvance. The positive predictive value was 100% for the Mallampati score (sensitivity, 100%; specificity, 77.7%), 87.5%for the Cormack-Lehane classification (sensitivity, 98.8%; specificity, 100%), and 66.6% for the sternomental distance(sensitivity 85.7%; specificity, 96.0%). No gender-related differences in the incidence of difficult airway were observed. Conclusions: The Mallampati score had the best predictive value, sensitivity, and specificity. The difficulty of an airway could usually be predicted (AU)