• Resuscitation · Jun 2015

    Observational Study

    Videographic assessment of cardiopulmonary resuscitation quality in the pediatric emergency department.

    • Aaron Donoghue, Ting-Chang Hsieh, Sage Myers, Allison Mak, Robert Sutton, and Vinay Nadkarni.
    • Division of Emergency Medicine, Children's Hospital of Philadelphia, PA, United States; Division of Critical Care Medicine, Children's Hospital of Philadelphia, PA, United States; Center for Simulation, Innovation, and Advanced Education, Children's Hospital of Philadelphia, PA, United States. Electronic address: donoghue@email.chop.edu.
    • Resuscitation. 2015 Jun 1;91:19-25.

    ObjectiveTo describe the adherence to guidelines for CPR in a tertiary pediatric emergency department (ED) where resuscitations are reviewed by videorecording.MethodsResuscitations in a tertiary pediatric ED are videorecorded as part of a quality improvement project. Patients receiving CPR under videorecorded conditions were eligible for inclusion. CPR parameters were quantified by retrospective review. Data were described by 30-s epoch (compression rate, ventilation rate, compression:ventilation ratio), by segment (duration of single providers' compressions) and by overall event (compression fraction). Duration of interruptions in compressions was measured; tasks completed during pauses were tabulated.Results33 children received CPR under videorecorded conditions. A total of 650 min of CPR were analyzed. Chest compressions were performed at <100/min in 90/714 (13%) of epochs; 100-120/min in 309/714 (43%); >120/min in 315/714 (44%). Ventilations were 6-12 breaths/min in 201/708 (23%) of epochs and >12/min in 489/708 (70%). During CPR without an artificial airway, compression:ventilation coordination (15:2) was done in 93/234 (40%) of epochs. 178 pauses in CPR occurred; 120 (67%) were <10s in duration. Of 370 segments of compressions by individual providers, 282/370 (76%) were <2 min in duration. Median compression fraction was 91% (range 88-100%).ConclusionsCPR in a tertiary pediatric ED frequently met recommended parameters for compression rate, pause duration, and compression fraction. Hyperventilation and failure of C:V coordination were very common. Future studies should focus on the impact of training methods on CPR performance as documented by videorecording.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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