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Analysis of CPR quality by individual providers in the pediatric emergency department.
Metadata
Journalresuscitation4.215Date
2020 Jun 04
4 months ago
Type
Research Support, Non-U.S. Gov't
Journal Article
Volume
2020-08 / 153 : 37-44
Author
Donoghue AJ 1, Myers S 2, Kerrey B 3, Sandler A 4, Keane R 5, Watanabe I 6, Hanna R 2, Abbadessa MK 7, Frey M 3, O'Connell K 8
Affiliation
  • 2. Division of Critical Care Medicine, Department of Anesthesia and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
  • 3. Division of Emergency Medicine, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH, United States.
  • 4. The George Washington School of Medicine and Health Sciences, Washington, DC, United States.
  • 5. Duke University School of Medicine, Durham, NC, United States.
  • 6. Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
  • 7. Division of Emergency Medicine, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
  • 8. Division of Emergency Medicine, Department of Pediatrics, The George Washington School of Medicine and Health Sciences, Washington, DC, United States.
Doi
PMIDMESH
Abstract
OBJECTIVES: To describe chest compression (CC) quality by individual providers in two pediatric emergency departments (EDs) using video review and compression monitor output during pediatric cardiac arrests.
METHODS: Prospective observational study. Patients <18 yo receiving CC for >1 min were eligible. Data was collected from video review and CC monitor device in a synchronized fashion and reported in 'segments' by individual providers. Univariate comparison by age (<1 yo, 1-8 yo, >8 yo) was performed by chi-square testing for dichotomous variables ('high-quality' CPR) and nonparametric testing for continuous variables (CC rate and depth). Univariate comparison of ventilation rate (V) was made between segments with an advanced airway versus without.
RESULTS: 524 segments had data available; 42/524 (8%) met criteria for 'high-quality CC'. Patients >8 yo had more segments meeting criteria (18% vs. 2% and 0.5%; p < 0.001). Segments compliant for rate were less frequent in <1 yo (17% vs. 24% vs. 27%; p = 0.03). Segments compliant for depth were less frequent in <1 year olds and 1-8 year olds (5% and 9% vs. 20%, p < 0.001.) Mean V for segments with an advanced airway was higher than with a natural airway (24 ± 18 vs. 14 ± 10 bpm, p < 0.001). Hyperventilation was more prevalent in CPR segments with an advanced airway (66% vs. 32%, p < 0.001).
CONCLUSIONS: CC depth is rarely guideline compliant in infants. Hyperventilation is more prevalent during CPR periods with an advanced airway in place. Measuring individual provider CPR quality is feasible, allowing future studies to evaluate the impact of CPR training.
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Resuscitationresuscitation
Metadata
LocationIreland
FromELSEVIER IRELAND LTD

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