SAS - Centro de Emergencias Sanitarias 061 - Málaga

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Why Use Aprepitant Only as a Cough Suppressant in Lung Cancer When at Higher Doses it Could Also Exert an Antitumor Action?
(2022-05-13) Muñoz, Miguel; Muñoz, Miguel E; Morell, Ferran; Coveñas, Rafael
Cross-cultural adaptation and psychometric validation of a Spanish version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire.
(2022-04-21) de Juan-Roldán, Jose Ignacio; Castillo-Jimena, Marcos; González-Hevilla, Alba; Sánchez-Sánchez, Clara; García-Ruiz, Antonio J; Gavilán-Moral, Enrique
Successful deprescribing depends largely on factors related to the patient. The revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire was developed with the objective of evaluating the beliefs and attitudes of older adults and caregivers towards deprescribing. The present study was designed to validate a Spanish version of the rPATD questionnaire, both the versions for older adults and for caregivers, through a qualitative validation phase and the analysis of its psychometric properties. Cross-sectional validation study. Primary care settings in Málaga (Spain). A sample of 120 subjects (60 patients with polypharmacy and 60 caregivers of patients with polypharmacy) were enrolled in the study. In the qualitative validation stage, the rPATD questionnaire was translated/back-translated and subjected to a cross-cultural adaptation to evaluate its face validity and feasibility. Next, its psychometric properties were assessed. Confirmatory factor analysis was used to evaluate construct validity. Internal consistency was determined using Cronbach's alpha test. Criterion validity through pre-established hypotheses from the Beliefs about Medicines Questionnaire (BMQ) Specific-Concerns Scale, and test-retest reliability were analysed. Confirmatory factor analysis verified the four-factor structure of the original rPATD questionnaire, with items loading into four factors: involvement, burden, appropriateness and concerns about stopping. The Cronbach's alpha coefficient of the factors ranged from 0.683 to 0.879. The burden, appropriateness and concerns about stopping factors were significantly correlated with the BMQ Specific-Concerns Score, except for the concerns about stopping factor in the older adults' version. The consistency of the items between administration times (test-retest reliability) showed weighted Cohen's kappa values ranging from moderate (>0.4) to very good (>0.8). The Spanish version of the rPATD questionnaire is a feasible, valid and reliable instrument to evaluate attitudes towards deprescribing in Spanish-speaking patients and caregivers.
NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care.
(2022-05-04) Sánchez-Almagro, César Pedro; Romero-Sánchez, José Manuel; White-Ríos, Melanie; González Del Pino, Carlos Antonio; Paloma-Castro, Olga
To determine the prevalence of NANDA International nursing diagnoses in the coping/stress tolerance domain and their linkages to Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions in the pre-hospital emergency care setting. Retrospective descriptive study of electronic record review. Eight thousand three hundred three episodes recorded during the year 2019 were recovered from the electronic health records of a public emergency care agency. The prevalence of NANDA International nursing diagnosis, Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions was determined. A cross-tabulation analysis was performed to determine the linkages. Data were accessed in November 2020. NANDA International nursing diagnoses Anxiety (00146) and Fear (00148) represented more than 90% of the diagnoses recorded in the domain. Anxiety level (1211) and emotional support (5270) were the most recorded Nursing Outcomes Classification outcomes and Nursing Interventions Classification interventions, with almost 20% and 5% of total records, respectively. The linkage between nursing diagnosis Anxiety (00146), outcome Anxiety level (1211) and intervention Anxiety reduction (5820) was the most recorded with slightly more than 3% of the total. Eight different NANDA International nursing diagnoses in the coping/stress tolerance domain were recorded. Nursing Outcomes Classification outcomes were selected aimed mainly at psychological well-being and Nursing Interventions Classification interventions to support coping. In general, linkages were aimed to provide emotional support, physical well-being, information, education and safety. This study showed that pre-hospital emergency care nurses diagnose and treat human responses in the coping/stress tolerance domain. Expert consensus-based linkages may be complemented by the results of this study, increasing the levels of evidence of both individualized and standardized care plans for critical patients assisted by pre-hospital emergency care nurses.
Influence of prehospital response times in the survival of trauma patients in Navarre
(Gobierno de navarra, 2016-01-01) Luque Gutierrez, M.; Lopez Rebollo, E.; [Luque Gutierrez, M.] Empresa Publ Emergencias Sanitarias Andalucia, Carretera Ronda,226-6a Planta, Almeria 04005, Spain; [Lopez Rebollo, E.] Empresa Publ Emergencias Sanitarias Andalucia, Carretera Ronda,226-6a Planta, Almeria 04005, Spain
Mobile platform for treatment of stroke: A case study of tele-assistance
(Sage publications inc, 2016-09-01) Torres Zenteno, Arturo Henry; Fernandez, Francisco; Palomino-Garcia, Alfredo; Moniche, Francisco; Escudero, Irene; Dolores Jimenez-Hernandez, M.; Caballero, Auxiliadora; Escobar-Rodriguez, German; Parra, Carlos; [Torres Zenteno, Arturo Henry] Everis, Seville, Spain; [Fernandez, Francisco] Everis, Seville, Spain; [Palomino-Garcia, Alfredo] Virgen del Rocio Univ Hosp, Clin Neurosci Unit, Seville, Spain; [Moniche, Francisco] Virgen del Rocio Univ Hosp, Clin Neurosci Unit, Seville, Spain; [Escudero, Irene] Virgen del Rocio Univ Hosp, Clin Neurosci Unit, Seville, Spain; [Dolores Jimenez-Hernandez, M.] Virgen del Rocio Univ Hosp, Clin Neurosci Unit, Seville, Spain; [Caballero, Auxiliadora] Publ Co Healthcare Emergencies EPES, Seville, Spain; [Escobar-Rodriguez, German] Virgen del Rocio Univ Hosp, Technol Innovat Grp, Seville, Spain; [Parra, Carlos] Virgen del Rocio Univ Hosp, Technol Innovat Grp, Seville, Spain; Network for Innovation in Medical Technologies and Health (Red ITEMAS in Spanish))
This article presents the technological solution of a tele-assistance process for stroke patients in acute phase in the Seville metropolitan area. The main objective of this process is to reduce time from symptom onset to treatment of acute phase stroke patients by means of telemedicine, regarding mobility between an intensive care unit ambulance and an expert center and activating the pre-hospital care phase. The technological platform covering the process has been defined following an interoperability model based on standards and with a focus on service-oriented architecture focus. Messaging definition has been designed according to the reference model of the CEN/ISO 13606, messages content follows the structure of archetypes. An XDS-b (Cross-Enterprise Document Sharing-b) transaction messaging has been designed according to Integrating the Healthcare Enterprise profile for archetype notifications and update enquiries.This research has been performed by a multidisciplinary group. The Virgen del Rocio University Hospital acts as Reference Hospital and the Public Company for Healthcare as mobility surroundings.
EuReCa ONE-27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe (vol 105, pg 188, 2016)
(Elsevier ireland ltd, 2016-12-01) Graesner, Jan-Thorsten; Lefering, Rolf; Koster, Rudolph W.; Masterson, Siobhan; Boettiger, Bernd W.; Herlitz, Johan; Wnent, Jan; Tjelmeland, Ingvild B. M.; Ortiz, Fernando Rosell; Maurer, Holger; Baubin, Michael; Mols, Pierre; Hadzibegovic, Irzal; Ioannides, Marios; Skulec, Roman; Wissenberg, Mads; Salo, Ari; Hubert, Herve; Nikolaous, Nikolaos I.; Loczi, Gerda; Svavarsdottir, Hildigunnur; Semeraro, Federico; Wright, Peter J.; Clarens, Carlo; Pijls, Ruud; Cebula, Grzegorz; Correia, Vitor Gouveia; Cimpoesu, Diana; Raffay, Violetta; Trenkler, Stefan; Markota, Andrej; Stroemsoee, Anneli; Burkart, Roman; Perkins, Gavin D.; Bossaert, Leo L.; EuReCa ONE Collaborators; [Correia, Vitor Gouveia] Univ Hosp Schleswig Holstein, Dept Anaesthesiol & Intens Care Med, Kiel, Germany; [Graesner, Jan-Thorsten] Univ Hosp Schleswig Holstein, Inst Emergency Med, Kiel, Germany; [Wnent, Jan] Univ Hosp Schleswig Holstein, Inst Emergency Med, Kiel, Germany; [Lefering, Rolf] Univ Witten Herdecke, Cologne, Germany; [Koster, Rudolph W.] Acad Med Ctr, Amsterdam, Netherlands; [Masterson, Siobhan] Natl Univ Ireland Galway, Galway, Ireland; [Boettiger, Bernd W.] Univ Hosp Cologne, Cologne, Germany; [Herlitz, Johan] Univ Boras, Sahlgrenska Univ Hosp, Boras, Sweden; [Tjelmeland, Ingvild B. M.] Norwegian Natl Advisory Unit Prehosp Emergency Me, Oslo, Norway; [Ortiz, Fernando Rosell] Empresa Publ Emergencias Sanitarias, Almeria, Spain; [Maurer, Holger] Univ Hosp Schleswig Holstein, Dept Anaesthesiol & Intens Care Med, Campus Lubeck, Lubeck, Germany; [Baubin, Michael] Univ Innsbruck Hosp, Innsbruck, Austria; [Mols, Pierre] Univ Libre Bruxelles, Ctr Hosp Univ St Pierre, Brussels, Belgium; [Hadzibegovic, Irzal] Josip Juraj Strossmayer Univ, Med Fac Osijek, Osijek, Croatia; [Ioannides, Marios] Nicosia Gen Hosp, Nicosia, Cyprus; [Skulec, Roman] Emergency Med Serv Cent Bohemian Reg, Kladno, Czech Republic; [Skulec, Roman] Univ JE Purkyne, Masaryk Hosp Usti Nad Labem, Usti Nad Labem, Czech Republic; [Wissenberg, Mads] Univ Copenhagen, Emergency Med Serv Copenhagen, Copenhagen, Denmark; [Salo, Ari] Univ Helsinki, Dept Emergency Med, Emergency Med Serv, Helsinki, Finland; [Salo, Ari] Helsinki Univ Hosp, Helsinki, Finland; [Hubert, Herve] Univ Lille, Lille, France; [Nikolaous, Nikolaos I.] Konstantopouleio Gen Hosp, Athens, Greece; [Loczi, Gerda] Hlth Care Centers Csongrad Cty Hodmezovasarhely M, Mako, Hungary; [Svavarsdottir, Hildigunnur] Univ Akureyri, Akureyri Hosp, Akureyri, Iceland; [Semeraro, Federico] AUSL Bologna, Osped Maggiore Carlo Alberto Pizzardi, Bologna, Italy; [Wright, Peter J.] Hlth Serv Execut Ballyshannon, Ballyshannon, Ireland; [Clarens, Carlo] Luxembourg Resuscitat Council, Luxembourg, Luxembourg; [Pijls, Ruud] Maastricht Univ, Maastricht, Netherlands; [Cebula, Grzegorz] Jagiellonian Univ, Krakow, Poland; [Correia, Vitor Gouveia] Serv Emergencia Med Reg SEMER EMIR, Oporto, Portugal; [Cimpoesu, Diana] Univ Med & Pharm Gr T Popa, Iasi, Romania; [Cimpoesu, Diana] Univ Cty Hosp Sf Spiridon, Iasi, Romania; [Raffay, Violetta] Municipal Inst Emergency Med Novi Sad, Novi Sad, Serbia; [Trenkler, Stefan] Safarik Univ, Kosice, Slovakia; [Markota, Andrej] Univ Med Ctr Maribor, Maribor, Slovenia; [Stroemsoee, Anneli] Malardalens Univ, Vasteras, Sweden; [Burkart, Roman] Fdn Ticino Cuore, Breganzona, Switzerland; [Perkins, Gavin D.] Univ Warwick, Coventry, W Midlands, England; [Perkins, Gavin D.] Heart England NHS Fdn Trust, Coventry, W Midlands, England; [Bossaert, Leo L.] Univ Antwerp, Dept Med & Hlth Sci, Antwerp, Belgium; National Institute for Health Research
Methodology of Specialist Physicians Training: From Traditional to e-Learning.
(2020-10-21) Chaves, Juan; Lorca-Marín, Antonio A; Delgado-Algarra, Emilio José
Different studies show that mixed methodology can be effective in medical training. However, there are no conclusive studies in specialist training on advanced life support (ALS). The main objective of this research is to determine if, with mixed didactic methodology, which includes e-learning, similar results are produced to face-to-face training. The method used was quasi-experimental with a focus on efficiency and evaluation at seven months, in which 114 specialist doctors participated and where the analysis of the sociodemographic and pre-test variables points to the homogeneity of the groups. The intervention consisted of e-learning training plus face-to-face workshops versus standard. The results were the performance in knowledge and technical skills in cardiac arrest scenarios, the perceived quality, and the perception of the training. There were no significant differences in immediate or deferred performance. In the degree of satisfaction, a significant difference was obtained in favour of the face-to-face group. The perception in the training itself presented similar results. The main limitations consisted of sample volume, dropping out of the deferred tests, and not evaluating the transfer or the impact. Finally, mixed methodology including e-learning in ALS courses reduced the duration of the face-to-face sessions and allowed a similar performance.
Giant cell arteritis: is the clinical spectrum of the disease changing?
(2019-07-29) González-Gay, Miguel Á; Ortego-Jurado, Miguel; Ercole, Liliana; Ortego-Centeno, Norberto
Giant cell arteritis is a vasculitis of large and middle-sized arteries that affects patients aged over 50 years. It can show a typical clinical picture consisting of cranial manifestations but sometimes nonspecific symptoms and large-vessel involvement prevail. Prompt diagnosis and treatment is essential to avoid irreversible damage. There has been an increasing knowledge on the occurrence of the disease without the typical cranial symptoms and its close relationship and overlap with polymyalgia rheumatica, and this may contribute to reduce the number of underdiagnosed patients. Although temporal artery biopsy is still the gold-standard and temporal artery ultrasonography is being widely used, newer imaging techniques (FDG-PET/TAC, MRI, CT) can be of valuable help to identify giant cell arteritis, in particular in those cases with a predominance of extracranial large-vessel manifestations. Giant cell arteritis is a more heterogeneous condition than previously thought. Awareness of all the potential clinical manifestations and judicious use of diagnostic tests may be an aid to avoid delayed detection and consequently ominous complications.
Effect of Trans-Nasal Evaporative Intra-arrest Cooling on Functional Neurologic Outcome in Out-of-Hospital Cardiac Arrest: The PRINCESS Randomized Clinical Trial.
(2019) Nordberg, Per; Taccone, Fabio Silvio; Truhlar, Anatolij; Forsberg, Sune; Hollenberg, Jacob; Jonsson, Martin; Cuny, Jerome; Goldstein, Patrick; Vermeersch, Nick; Higuet, Adeline; Jiménes, Francisco Carmona; Ortiz, Fernando Rosell; Williams, Julia; Desruelles, Didier; Creteur, Jacques; Dillenbeck, Emelie; Busche, Caroline; Busch, Hans-Jörg; Ringh, Mattias; Konrad, David; Peterson, Johan; Vincent, Jean-Louis; Svensson, Leif
Therapeutic hypothermia may increase survival with good neurologic outcome after cardiac arrest. Trans-nasal evaporative cooling is a method used to induce cooling, primarily of the brain, during cardiopulmonary resuscitation (ie, intra-arrest). To determine whether prehospital trans-nasal evaporative intra-arrest cooling improves survival with good neurologic outcome compared with cooling initiated after hospital arrival. The PRINCESS trial was an investigator-initiated, randomized, clinical, international multicenter study with blinded assessment of the outcome, performed by emergency medical services in 7 European countries from July 2010 to January 2018, with final follow-up on April 29, 2018. In total, 677 patients with bystander-witnessed out-of-hospital cardiac arrest were enrolled. Patients were randomly assigned to receive trans-nasal evaporative intra-arrest cooling (n = 343) or standard care (n = 334). Patients admitted to the hospital in both groups received systemic therapeutic hypothermia at 32°C to 34°C for 24 hours. The primary outcome was survival with good neurologic outcome, defined as Cerebral Performance Category (CPC) 1-2, at 90 days. Secondary outcomes were survival at 90 days and time to reach core body temperature less than 34°C. Among the 677 randomized patients (median age, 65 years; 172 [25%] women), 671 completed the trial. Median time to core temperature less than 34°C was 105 minutes in the intervention group vs 182 minutes in the control group (P Among patients with out-of-hospital cardiac arrest, trans-nasal evaporative intra-arrest cooling compared with usual care did not result in a statistically significant improvement in survival with good neurologic outcome at 90 days. ClinicalTrials.gov Identifier: NCT01400373.
[Use of the mobile application of Salud Responde for the optimisation of health resources].
(2019-04-17) Cubillas Mercado, Juan José; Quero Haro, Manuel; Ramos Rodriguez, Maria Belén; Ramos, Maria Isabel; Lopez, Wilfredo; Gonzalez Conejo, José Maria
EuReCa ONE-27 Nations, ONE Europe, ONE Registry: A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe.
(2016-06-16) Gräsner, Jan-Thorsten; Lefering, Rolf; Koster, Rudolph W; Masterson, Siobhán; Böttiger, Bernd W; Herlitz, Johan; Wnent, Jan; Tjelmeland, Ingvild B M; Ortiz, Fernando Rosell; Maurer, Holger; Baubin, Michael; Mols, Pierre; Hadžibegović, Irzal; Ioannides, Marios; Škulec, Roman; Wissenberg, Mads; Salo, Ari; Hubert, Hervé; Nikolaou, Nikolaos I; Lóczi, Gerda; Svavarsdóttir, Hildigunnur; Semeraro, Federico; Wright, Peter J; Clarens, Carlo; Pijls, Ruud; Cebula, Grzegorz; Correia, Vitor Gouveia; Cimpoesu, Diana; Raffay, Violetta; Trenkler, Stefan; Markota, Andrej; Strömsöe, Anneli; Burkart, Roman; Perkins, Gavin D; Bossaert, Leo L; EuReCa ONE Collaborators
The aim of the EuReCa ONE study was to determine the incidence, process, and outcome for out of hospital cardiac arrest (OHCA) throughout Europe. This was an international, prospective, multi-centre one-month study. Patients who suffered an OHCA during October 2014 who were attended and/or treated by an Emergency Medical Service (EMS) were eligible for inclusion in the study. Data were extracted from national, regional or local registries. Data on 10,682 confirmed OHCAs from 248 regions in 27 countries, covering an estimated population of 174 million. In 7146 (66%) cases, CPR was started by a bystander or by the EMS. The incidence of CPR attempts ranged from 19.0 to 104.0 per 100,000 population per year. 1735 had ROSC on arrival at hospital (25.2%), Overall, 662/6414 (10.3%) in all cases with CPR attempted survived for at least 30 days or to hospital discharge. The results of EuReCa ONE highlight that OHCA is still a major public health problem accounting for a substantial number of deaths in Europe. EuReCa ONE very clearly demonstrates marked differences in the processes for data collection and reported outcomes following OHCA all over Europe. Using these data and analyses, different countries, regions, systems, and concepts can benchmark themselves and may learn from each other to further improve survival following one of our major health care events.
[Factors associated with prehospital delay in men and women with acute coronary syndrome].
(2016-04-30) Daponte-Codina, A; Bolívar-Muñoz, J; Sánchez-Cantalejo, E; Mateo-Rodríguez, I; Babio, G; Romo-Avilés, N; Rosell-Ortiz, F; Grupo de Estudio de Género Y Enfermedades Cardiovasculares (GENCAR)
To identify factors associated with prehospital delay in people who have had an acute coronary syndrome. Using a survey we studied patients admitted due to acute coronary syndrome in the 33 Andalusian public hospitals, obtaining information about different types of variables: socio-demographic, contextual,clinical, perception, action, and transportation.Multivariate logistic regression models were applied to calculate the odds ratios for the delay. Of the 1,416 patients studied, more than half had a delay of more than an hour. This is associated to distance to the hospital and means of transport: when the event occurs in the same city,using the patient's own means of transport increases the delay, odds ratio = 1.51 (1.02 to 2.23); if the distance is 1 to 25 kilometers from the hospital,there is no difference between the patient's own means of transport and an ambulance, odds ratio =1.41 and odds ratio =1.43 respectively; and when the distance exceeds 25 kilometers transport by ambulance means more delay, odds ratio = 3.13 and odds ratio = 2.20 respectively. Also, typical symptoms reduce delay amongst men but increase amongst women. Also, not caring and waiting for the resolution of symptoms, seeking health care other than a hospital or emergency services, previous clinical history, being away from home, and having an income under 1,500 euros, all increase delay. Respiratory symptoms reduce delay. Prehospital delay times do not meet health recommendations. The physical and social environment,in addition to clinical, perceptual and attitudinal factors, are associated with this delay.
[Use of customer relationship management to improve healthcare for citizens. The 24h Andalusian Health Service: Healthline].
(2016-02-18) Quero, Manuel; Ramos, María Belén; López, Wilfredo; Cubillas, Juan José; González, José María; Castillo, José Luis
Salud Responde (in English: Healthline) is a Health Service and Information Centre of the taxpayer-funded Andalusian Health System (AHS) that offers a Telephone Health Advisory Service called SA24h, among other services. The main objective of SA24h is to inform and advise citizens on health issues and the available health resources of the AHS. SA24h has a Customer Relationship Management information technology tool that organises information at various levels of specialization. Depending on the difficulty of the query, the citizen is attended by professionals with distinct profiles, providing a consensual response within the professionals working within Salud Responde or within other healthcare levels of the AHS. SA24h provided responses to 757,168 patient queries from late 2008 to the end of 01/12/2015. A total of 9.38% of the consultations were resolved by the non-health professionals working at Salud Responde. The remaining 84.07% were resolved by health staff. A total of 6.5% of users were referred to accident and emergency facilities while 88.77% did not need to attend their general practitioner within the next 24hours, thus avoiding unnecessary visits to health care facilities.
Initial complications and factors related to prehospital mortality in acute myocardial infarction with ST segment elevation.
(BMJ Publishing Group,, 2014-07-25) Rosell-Ortiz, Fernando; Mellado-Vergel, Francisco J; Fernández-Valle, Patricia; González-Lobato, Ismael; Martínez-Lara, Manuela; Ruiz-Montero, María M; Romero-Morales, Francisco; Vivar Díaz, Itziar; García-Alcántara, Angel; García del Águila, Javier; [Rosell-Ortiz,F; Fernández-Valle,P; González-Lobato, I; Martínez-Lara,M; Ruiz-Montero,MM; Romero-Morales,F; Vivar Díaz,I; García del Águila,J] 1Empresa Pública de Emergencias Sanitarias de Andalucía. Andalusian Health Ministry, Andalucía, Spain. [Mellado-Vergel,FJ] Department of Urgencias, Hospital el Toyo, Almería, Spain. [García-Alcántara,A] Intensive Care Unit, Hospital Clínico, Málaga, Spain; Project funded by (1) Public Health Emergency Service Enterprise of Andalusia, Spain (Andalusian Public Health System, public funding). (2) A research grant from ‘Fundación Progreso y Salud’ (Andalusian Research Agency, Spain, public funding). (3) Collaboration of a limited research grant from Boehringer Ingelheim Spain.
OBJECTIVE Hospital mortality in myocardial infarction ST-elevation myocardial infarction has decreased in recent years, in contrast to prehospital mortality. Our objective was to determine initial complications and factors related to prehospital mortality in patients with acute myocardial infarction with ST segment elevation (STEMI). METHODS Observational study based on a prospective continuous register of patients of any age attended by out-of-hospital emergency teams in Andalusia between January 2006 and June 2009. This includes patients with acute coronary syndrome-like symptoms whose initial ECG showed ST elevation or presumably new left bundle branch block (LBBB). Epidemiological, prehospital data and final diagnostic were recorded. The study included all patients with STEMI on the register, without age restrictions. Forward stepwise logistic regression analysis was performed to control for confounders. RESULTS A total of 2528 patients were included, 24% were women. Mean age 63.4±13.4 years; 16.7% presented atypical clinical symptoms. Initial complications: ventricular fibrillation (VF) 8.4%, severe bradycardia 5.8%, third-degree atrial-ventricular (AV) block 2.4% and hypotension 13.5%. Fifty-two (2.1%) patients died before reaching hospital. Factors associated with prehospital mortality were female sex (OR 2.36, CI 1.28 to 4.33), atypical clinical picture (OR 2.31, CI 1.21 to 4.41), hypotension (OR 4.95, CI 2.60 to 9.20), LBBB (OR 4.29, CI 1.71 to 10.74), extensive infarction (ST elevation in ≥5 leads) (OR 2.53, CI 1.28 to 5.01) and VF (OR 2.82, CI 1.38 to 5.78). CONCLUSIONS A significant proportion of patients with STEMI present early complications in the prehospital setting, and some die before reaching hospital. Prehospital mortality was associated with female sex and atypical presentation, as pre-existing conditions, and hypotension, extensive infarction, LBBB and VF on emergency team attendance.
Adecuación de la medicación cardiovascular en los diabéticos tipo 2 de Torrejoncillo (Cáceres) según los criterios STOP/STAR.
(Elsevier, 2015-01) Baquero-Barroso, María José; Fernández Del Valle, Patricia; Palomo Cobos, Luis; Domínguez-Felipe, Francisco Javier; [Baquero-Barroso,MJ; Domínguez-Felipe,FJ] Centro de Salud de Torrejoncillo, Torejoncillo, Cáceres, España. [Fernández del Valle,P] Unidad de Investigación, Empresa Pública de Emergencias Sanitarias, Sevilla, España. [Palomo Cobos,L] Centro de Salud Zona Centro, Cáceres, España; Financiación Proyecto de Investigación DIAB06/2012 «Detección y control de factores de riesgo y complicaciones vasculares en los pacientes diabéticos de la zona de salud de Torrejoncillo(Cáceres)». Fundación para la Formación y la Investigación de los Profesionales de Salud de Extremadura.
La polimedicación se incrementa con la edad y es un motivode creciente preocupación por sus consecuencias indesea-bles. Pero, por otro lado, se necesita prevenir las frecuentescomplicaciones cardiovasculares que padecen los diabéti-cos tipo 2 (DM2), muchos de ellos ancianos, en ocasionesa˜nadiendo más medicamentos apropiados. Entre los instru-mentos para calificar la adecuación de los tratamientosadministrados, recientemente se han propuesto los deno-minados criterios STOP/STAR.
Prescripción enfermera en el contexto de las urgencias y emergencia
(Enferurg, 2009-06) Valenzuela Rodríguez, Antonio J.; Cámara Anguita, Sixto; [Valenzuela Rodríguez,AJ] DCCU(Baena). Distrito Sanitario Córdoba-Sur. Servicio Andaluz de Salud (SAS). [Cámara Anguita, S] Empresa Pública de Emergencias Sanitarias (EPES 061). SP Jaén.
El área de las urgencias y emergencias, asistidas desde cualquiera de los niveles y entornos asistenciales plantea, si cabe, unos modelos de trabajo y formas en que la colaboración entre profesionales y el trabajo en Equipo hacen de la prescripción enfermera, muchas veces farmacológica, una necesidad legislada atendiendo a la mayor evidencia científica y a través de algoritmos de actuación internacionalmente aceptados. Posibilitando a la enfermera actuar acorde a estos conceptos y fuera de toda “duda y sospecha” de ilegalidad. Haciéndose necesario un consenso y desarrollo formativo y acorde a la especialización y diferenciación profesional en esta área y como argumentos que despejen cuantas dudas aún este asunto sigue encerrando sin ningún sentido y en muchos sectores.
Continuidad De Cuidados y Comunicación interniveles entre equipos de emergencias sanitarias y Atención Primaria.
(Enferurg, 2008-12) Cámara Anguita, Sixto; Valenzuela Rodríguez, Antonio Jesús; [Cámara Anguita,S] Empresa Pública de Emergencias Sanitarias Andalucía, Servicio Provincial 061 de Jaén. [Valenzuela Rodríguez, AJ] Dispositivo de Cuidados Críticos y Urgencias de Atención Primaria, Servicio Andaluz de Salud.
La incorporación progresiva de las enfermeras a los equipos de emergencias extrahospitalarios, dotan a éstos de un aspecto holístico en la esfera de los cuidados. Y ello, no es posible sin atender a las posibilidades de continuidad de cuidados y comunicación con el resto de niveles asistenciales. Todos los esfuerzos en este sentido, y asumidos como intervenciones propias de enfermería: “Derivación” (Nic 8100) e “Intercambio de información de cuidados de salud” (Nic 7960), son el marco conceptual de este trabajo, cuyos objetivos son cuantificar y exponer las actuaciones en esta línea llevadas a cabo por los profesionales de enfermería de los Equipos de Emergencias.

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