Objective: Guidelines adherence in emergency departments (EDs) relies partly on the availability of resources to improve sepsis care and outcomes. Our objective was to assess the management of pediatric septic shock (PSS) in Latin America's EDs and to determine the impact of treatment coordinated by a pediatric emergency specialist (PEMS) versus nonpediatric emergency specialists (NPEMS) on guidelines adherence.Methods: Prospective, descriptive, and multicenter study using an electronic survey administered to PEMS and NPEMS who treat PSS in EDs in 14 Latin American countries. Results:We distributed 2164 surveys with a response rate of 41.5%, of which 22.5% were PEMS. Overall American College of Critical Care Medicine reported guidelines adherence was as follows: vascular access obtained in 5 minutes, 76%; fluid infusion technique, 60%; administering 40 to 60 mL/kg within 30 minutes, 32%; inotropic infusion by peripheral route, 61%; dopamine or epinephrine in cold shock, 80%; norepinephrine in warm shock, 57%; and antibiotics within 60 minutes, 82%. Between PEMS and NPEMS, the following differences were found: vascular access in 5 minutes, 87.1% versus 72.7% (P < 0.01); fluid infusion technique, 72.3% versus 55.9% (P < 0.01); administering 40 to 60 mL/kg within 30 minutes, 42% versus 29% (P < 0.01); inotropic infusion by peripheral route, 75.7% versus 56.3% (P < 0.01); dopamine or epinephrine in cold shock, 87.1% versus 77.3% (P < 0.05); norepinephrine in warm shock, 67.8% versus 54% (P < 0.01); and antibiotic administration within first 60 minutes, 90.1% versus 79.3% (P < 0.01), respectively. Good adherence criteria were followed by 24%. The main referred barrier for sepsis care was a failure in its recognition, including the lack of triage tools. Conclusions:In some Latin American countries, there is variability in self-reported adherence to the evidence-based recommendations for the treatment of PSS during the first hour. The coordination by PEMS support greater adherence to these recommendations.

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Introducción: El pie diabético es una de las complicaciones más graves y frecuentes de la diabetes mellitus, por tal motivo es importante conocer los factores de riesgo que lo desencadenan. Objetivo: Determinar los factores de riesgo asociados a pie diabético en el hospital PNP Luis N. Sáenz, año 2017. Métodos: Estudio observacional, cuantitativo, retrospectivo, analítico, de casos y controles. La muestra la conformó 165 pacientes (55 casos y 110 controles) atendidos en el servicio de endocrinología en el año 2017. Se estudiaron factores de riesgo, modificables y no modificables, asociados al desarrollo de pie diabético; se recogió la información de las historias clínicas mediante una ficha de recolección de datos, la cual fue analizada mediante el programa SPSS versión 25.0 utilizando los modelos estadísticos de Chi cuadrado y el odds ratios con un nivel de significancia menor a 0.05% y un intervalo de confianza de 95%. Resultados: Los factores de riesgo asociados a pie diabético son tiempo de enfermedad (p: 0,000;

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