ObjectiveHypertensive emergencies are potentially life threatening and require prompt blood pressure control with intravenous agents. Preparation of intravenous infusions is time consuming. Usefulness of sublingual nitroglycerin in this setting is not known. We aimed to assess the benefit of sublingual nitroglycerin as a bridge to IV therapy. In a clinical audit in an emergency department, patients presenting with hypertensive emergencies requiring intravenous nitroglycerin were administered single spray of sublingual nitroglycerin awaiting commencement of intravenous infusion. Blood pressure was monitored every 5 min to observe the degree and speed of reduction.ResultsThirty-seven patients met the selection criteria. Mean age was 65.8 years (SD 7.04), and 29 were males (88.4%). Mean values of systolic, diastolic and mean blood pressures on admission were 217, 137, 163 mmHg. At 5 and 10 min after sublingual nitroglycerin, mean reduction of mean arterial blood pressure by 12.3 and 16.3% was achieved. Only 2 patients (5.4%) showed an overcorrection of blood pressure. Minimum of 15 min were required to set up a nitroglycerin intravenous infusion. Sublingual nitroglycerin spray allows rapid blood pressure control in hypertensive emergencies and is a useful bridge during the time to prepare intravenous infusion.

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This study looked at secondary care utilization metrics as an effectiveness indicator of Clozapine initiation in 77 patients over the following year compared to the year prior to initiation. It was found that there was a marginal drop in psychiatric bed utilization, alongside reduced crisis team use. Medical and psychiatric outpatient use increased, as did physical health interventions. Overall, compared with costs over the year preceding Clozapine initiation, an estimated saving per patient of £3,867 ($5,065) was achieved.

Most studies show that cardiopulmonary resuscitation (CPR) skills deteriorate in the first three to six months after initial training. Automated external, defibrillator (AED) skills are retained for longer than isolated BLS skills. There is some evidence that shorter and more frequent training than standard (2 years), can potentially increase BLS competences and reduce the deterioration of expertise. In Hospital de Torrevieja we developed a program for training all staff in BLS and defibrillation, consisting of on line theory, online exam and a 2 hour practical course, every 2 years. We want to assess the knowledgements retained according to the department, and the timing of last learning undertaken. Materials and methodsWe conducted a survey regarding cardiac arrest in order to assess knowledge and subjective impression, in a total of 123 people, including physicians (P), nursing (N), clinic assistants (CA), and administrative staff (AS). We made three groups: ResultsWe show the results for the correct answer, (and timing of last training).

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