Evaluación sistemática de la actuación de los pediatras ante un caso simulado de taquicardia supraventricular

  1. Oulego Erroz, Ignacio
  2. Rodríguez Núñez, Antonio
  3. Alonso Quintela, Paula
  4. Mora Matilla, María
  5. Iglesias Vázquez, Ana
  6. Fernández Sanmartín, Manuel
  7. Civantos Fuentes, Eva
  8. Sánchez Santos, Luis
Revista:
Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

ISSN: 1695-4033 1696-4608

Año de publicación: 2012

Volumen: 77

Número: 3

Páginas: 165-170

Tipo: Artículo

DOI: 10.1016/J.ANPEDI.2012.01.020 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )

Resumen

Introduction: The aims of this study are to: a) assess the quality in clinical management during a simulated scenario of acute supraventricular tachycardia (SVT) by means of a structured taskbased checklist and to b) detect pitfalls and grey areas where reinforcement in training may be needed. Material and methods: We systematically reviewed SVT simulated scenarios during simulation courses between June 2008 and April 2010. Three scenarios were programmed using SimBaby® simulation system, and included stable SVT (S-SVT), stable progressing to unstable SVT (SU-SVT) and unstable SVT (U-SVT). Scenarios were evaluated by means of an 18-task checklist based on ILCOR international recommendations. Results: A total of 45 scenarios were assessed with the participation of 167 paediatricians, including 15 S-SVT, 25 SU-SVT and 5 U-SVT scenarios. Out of a total of 551 possible tasks, 328 (59.5%) were completed correctly. The mean percentage of correct tasks per scenario was 63.4 (16.7) for S-SVT, 47.8 (20.3) for SU-ST and 38.6 (31) for U-SVT (p = 0.028). There were no signi?cant differences between primary care paediatricians and hospital paediatricians. Most of the participants correctly identi?ed non-sinus rhythm as SVT. However, important pitfalls were observed, including failure to identify haemodynamic instability in 20 out of 43 (48%) cases, an incorrect dose of adenosine in 18 out of 39 (48%), incorrect adenosine administration in 23 out of 39 (59%), and non-recognition of indication to emergent cardioversion in 15 out of 31 (48%). Conclusions: Paediatricians are able to diagnose SVT correctly, but need to improve their skills in treatment. Systematic analysis of clinical performance in a simulated scenario allows the identi?cation of strengths, as well as weak points, where reinforcement is needed.