Análisis de la interferencia inducida en el electrocardiograma y señal de impedancia por compresiones torácicas sobre un maniquí.

[EN]This paper presents a project within that research field. The project consists on the development of an experimental environment comprised by a sensorized practice manikin and a management software system. Manikin model allows the simulation of cardiac arrest episodes on laboratory settings. The management software system adds the capacity to compute and analyze the characteristics of the artifact induced on the electrocardiogram and the thoracic impedance signals by chest compressions during cardiopulmonary resuscitation due to variations of the electrode-skin interface. The main reason for choosing this kind of model is the impossibility to use real people because of the risk of thoracic injuries during chest compression. Moreover, this platform could be used for training in reanimation techniques for real situations. Even laypeople with minimal training can perform cardiopulmonary resuscitation. This can reduce the response time to an emergency while the healthcare personnel arrives, which is key to improve outcomes, since with every minute the chances of survival decrease approximately 10%. It is not necessary to have medical knowledge to perform cardiopulmonary resuscitation, which could increase chances of survival for a patient with an early reanimation since In this context, this paper details the technique solution for the manikin sensorisation to acquire the electrocardiogram, the impedance signal measured between the defibrillation pads placed on the patient’s chest, the compression depth, the compression force and the acceleration experienced by the chest in the three orthogonal axes. Moreover, it is possible to inject a previously recorded electrocardiogram signal.

Cálculo de la profundidad de la compresión durante la resucitación cardiopulmonar administrada sobre colchón.

[ES]En este trabajo se estudia la precisión de un nuevo método de cálculo de la profundidad de las compresiones torácicas, a partir de las señales obtenidas de dos acelerómetros, cuando la reanimación cardiopulmonar es realizada sobre un colchón blando.

Plan de Marketing Fisioterapia BE GOOD

El objetivo del presente documento es definir y presentar el Plan de Marketing asociado a una empresa basada en una propuesta empresarial. La empresa a la que se va a hacer referencia en dicho Plan es un centro fisioterapéutico que se denominará “Be Good”. La clínica fisioterapia “Be Good”, se situará en la calle “Villa de Plencia” localizada en el municipio de Getxo y nacerá con el objetivo de ofrecer un servicio de calidad dirigido a la cura y prevención de lesiones músculo-esqueléticas, afecciones respiratorias, patologías neurológicas y, en general, a la satisfacción de cualquier tipo de persona que solicite sus servicios. Aunque existan diferentes metodologías, para llevar a cabo el Plan de Marketing se ha decidido seguir el procedimiento propuesto por José María Sainz de Vicuña (2013). Por medio de la metodología seleccionada, el Plan de Marketing descrito en el presente documento tratará de mejorar la eficacia en la toma de decisiones que influyan en la empresa. Adicionalmente, se actuará de medio para el logro de los objetivos planteados a continuación. Por último, facilitará y optimizará la comunicación interna de la empresa de cara a disponer de procesos de evaluación y control más eficientes responsabilizando al área de marketing de los resultados obtenidos.

Evaluation of Fentanyl Disposition and Effects in Newborn Piglets as an Experimental Model for Human Neonates

Background: Fentanyl is widely used off-label in NICU. Our aim was to investigate its cerebral, cardiovascular and pulmonary effects as well as pharmacokinetics in an experimental model for neonates. Methods: Fentanyl (5 mu g/kg bolus immediately followed by a 90 minute infusion of 3 mu g/kg/h) was administered to six mechanically ventilated newborn piglets. Cardiovascular, ventilation, pulmonary and oxygenation indexes as well as brain activity were monitored from T = 0 up to the end of experiments (T = 225-300 min). Also plasma samples for quantification of fentanyl were drawn. Results: A "reliable degree of sedation" was observed up to T = 210-240 min, consistent with the selected dosing regimen and the observed fentanyl plasma levels. Unlike cardiovascular parameters, which were unmodified except for an increasing trend in heart rate, some of the ventilation and oxygenation indexes as well as brain activity were significantly altered. The pulmonary and brain effects of fentanyl were mostly recovered from T = 210 min to the end of experiment. Conclusion: The newborn piglet was shown to be a suitable experimental model for studying fentanyl disposition as well as respiratory and cardiovascular effects in human neonates. Therefore, it could be extremely useful for further investigating the drug behaviour under pathophysiological conditions.

A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation

nterruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies.