Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management. Part I.

The Airway Management section of the Spanish Society of Anesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), and the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) present the Guide for the comprehensive management of difficult airway in adult patients. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations, and optimization in the progression of strategies application to preserve adequate alveolar oxygenation in order to enhance safety and the quality of care. The document provides evidence-based recommendations, theoretical-educational tools, and implementation tools, mainly cognitive aids, applicable to airway management in the fields of anesthesiology, critical care, emergencies, and prehospital medicine. For this purpose, an extensive literature search was conducted following PRISMA-R guidelines and was analyzed using the GRADE methodology. Recommendations were formulated according to the GRADE methodology. Recommendations for sections with low-quality evidence were based on expert opinion through consensus reached via a Delphi questionnaire.

Spanish Society of Anesthesiology, Reanimation and Pain Therapy (SEDAR), Spanish Society of Emergency and Emergency Medicine (SEMES) and Spanish Society of Otolaryngology, Head and Neck Surgery (SEORL-CCC) Guideline for difficult airway management. Part II.

The Airway Management section of the Spanish Society of Anesthesiology, Resuscitation, and Pain Therapy (SEDAR), the Spanish Society of Emergency Medicine (SEMES), and the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC) present the Guide for the comprehensive management of difficult airway in adult patients. Its principles are focused on the human factors, cognitive processes for decision-making in critical situations, and optimization in the progression of strategies application to preserve adequate alveolar oxygenation in order to enhance safety and the quality of care. The document provides evidence-based recommendations, theoretical-educational tools, and implementation tools, mainly cognitive aids, applicable to airway management in the fields of anesthesiology, critical care, emergencies, and prehospital medicine. For this purpose, an extensive literature search was conducted following PRISMA-R guidelines and was analyzed using the GRADE methodology. Recommendations were formulated according to the GRADE methodology. Recommendations for sections with low-quality evidence were based on expert opinion through consensus reached via a Delphi questionnaire.

Validez del Sistema de Triaje Manchester en la predicción del volumen de transportes e ingresos en un servicio de urgencias de un hospital comarcal / Validation of the Manchester Triage System for predicting a regional hospital’s emergency service hospital admissions and transfer volume

Objetivo: Analizar la relación entre el Sistema de Triaje de Manchester (STM) y los ingresos y traslados desde el servicio de urgencias (SU) y descripción de los tiempos de respuesta según niveles de triaje. Método: Estudio observacional y descriptivo unicéntrico mediante revisión de los datos anónimos disponibles en los sistemas SIHGA y ALERT del SU en el año 2010.Resultados: Cuanto más baja es la prioridad de asistencia establecida por el MTS, menores también el índice de ingreso y menor la utilización del transporte sanitario (p < 0,001).Los tiempos de pretriaje no alcanzan el estándar, los de triaje son muy uniformes y se observa variabilidad en los resultados de los tiempos de respuesta facultativa. Conclusiones: Se observa asociación entre los niveles de triaje y el tanto por ciento de ingresos y transportes, que resulta estadísticamente significativa para los niveles de mayor gravedad, especialmente en adultos (AU)

Objectives: To analyze relations between Manchester Triage System (MTS) classifications and hospital admissions and transfer volume. To describe response times according to triage level. Methods: Descriptive, observational study of a single hospital’s emergency service. Anonymous case information was extracted from the admissions, transfer, and triage records of Hospital Comarcal do Salnés in Pontevedra, Spain. Results: Lower MTS categories had lower hospital admission rates and generated fewer emergency transfers (P<.001).Pretriage delays did not reach the level considered standard and triage times were very stable. We detected variability in times until an attending physician saw the patient. Conclusions: We detected a relationship between triage level and both admission rates and use of emergency transport services. Especially in adults, the rates were significantly higher for higher MTS categories (AU)

Valoración de la eficacia de un blog de medicina de urgencias como medio de comunicación / An Emergency Medicine blog utility as a communications tool: efficacy assessment

Objetivos: En 2006 SEMES Galicia aprobó la creación de un blog de medicina de urgencias, adaptándose a las nuevas tendencias en comunicación. Después de un año realizó un estudio para determinar el interés que despertaba, cuyos objetivos fueron, entre otros, analizar su frecuentación, el grado de fidelidad, el porcentaje de abandono desde la misma página de acceso y la relación entre el número de artículos publicados y su frecuentación. Material y método: Se realizaron estudios descriptivos, analíticos y de correlación para determinar la frecuentación, la fidelidad, el porcentaje de abandono desde la página de acceso y la distribución geográfica de los lectores, así como la relación entre los artículos publicados y las visitas recibidas. Se utilizaron los programas Google Analytics y el SPSS 12.0 for Windows. Resultados: A lo largo del año creció la frecuentación del blog cada mes y pasó de una única página vista en el mes de enero a 3.800 en diciembre. El 93% de las visitas procedieron de España, sobre todo de Galicia (50%). La fidelidad fue media, alta o muy alta en el 49%. Cuando la página de acceso al blog era la principal, el 52% no lo abandonaba y se visitaban otras secciones. La frecuentación del blog estaba directamente relacionada con el número de artículos publicados (r = 0,9, p < 0,01). Conclusiones: El interés por el blog ha crecido a lo largo del año. La mayoría de nuestros visitantes fueron fieles, pues repitieron sus visitas, y leyeron otras secciones además de la página principal. La frecuentación del blog estuvo directamente relacionada con el número de artículos publicados. El 93% de visitas procedieron de España. El blog SEMES Galicia es un poderoso y barato medio de comunicación (AU)

Aims and purpose: In 2006, SEMES Galicia approved the creation of an Emergency Medicine blog considering the more recent trends in communications. One year later, a study has been carried out to assess the interest level achieved. A number of aspects were analysed, such as, among others, the number of visits, degree of fidelity, dropout rate from the main access page and the relationship between the number of articles published and the number of visits. Material and methods: Descriptive, analytical and correlation studies were performed for the assessment of the number of visits, fidelity, dropout rate and geographical distribution of the readership. The relationship between the number of articles published and the number of visits to the blog was also examined. The Google Analytics and SPSS 12.0 for Windows software packages were used for the analyses. Results: The number of visits increased monthly over the year, from just one page visited in January to 3,800 in December. Spain was the origin of 93% of the visits, with Galicia occupying the first place (50%). The degree of fidelity was classed as medium, high or very high in 49% of the visits. When the accessed page was the home page 52% of the visitors did not drop out and visited several other sections of the blog. The level of frequentation was clearly related to the number of articles published (r = 0.9; p<0.01). Conclusions: The interest on this blog has increased throughout the year studied. Most visitors evidenced a high degree of fidelity, repeating visits and accessing several other sections besides the home page. The number of visits was also directly related to the number of articles published. Visits originated all over the world but mainly in Spain (93%). The SEMES Galicia blog is a powerful and non-expensive communications tool (AU)