• Adam Cheng, Jonathan P Duff, David Kessler, Nancy M Tofil, Jennifer Davidson, Yiqun Lin, Jenny Chatfield, Linda L Brown, Elizabeth A Hunt, and International Network for Simulation-based Pediatric Innovation Research and Education (INSPIRE) CPR.
• Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, KidSIM-ASPIRE Research Program, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada. Electronic address: chenger@me.com.
• Resuscitation. 2018 Nov 1; 132: 33-40.

AimTo determine if integrating a trained CPR Coach into resuscitation teams can improve CPR quality during simulated pediatric cardiopulmonary arrest (CPA).MethodsWe conducted a multicenter, prospective, randomized trial. An 18-minute simulated CPA scenario was run for resuscitation teams comprised of CPR-certified professionals from four International Network for Simulation-based Pediatric Innovation, Research & Education (INSPIRE) institutions. Forty teams (200 participants) were randomized to having a trained CPR Coach vs. no CPR Coach. CPR Coaches were responsible for providing real-time verbal feedback of CPR performance to compressors. All teams utilized CPR feedback technology. We report the proportion of overall excellent CPR, proportion of chest compressions (CC) with depth 50-60 mm, the proportion of CC with rate 100-120 per minute, CC fraction, and pre-, post-, and peri-shock pause duration.ResultsCPR coached teams compared with teams without a CPR Coach resulted in an absolute improvements in overall excellent CPR by 31.8% (95% CI, 17.7, 35.9; p < 0.001), mean CC depth compliance by 31.5% (15.7, 47.4; p < 0.001), mean CC depth by 4.6 mm (1.6, 7.5; p < 0.001), mean CC fraction by 5.4% (0.2, 10.6; p = 0.04), and mean pre-, post- and peri-shock pause duration by -2.7 s (-5.1, -0.4; p = 0.02), -1.0 s (-1.8, -0.2; p = 0.01); and -3.8 (-6.6, -1.0; p = 0.008), respectively. Changes in mean CC rate compliance and mean CC rate were not statistically significant.ConclusionsIn the presence of CPR feedback technology, the integration of a trained CPR coach into resuscitation teams enhances CPRquality metrics associated with improved survival outcomes from pediatric cardiac arrest.Copyright © 2018 Elsevier B.V. All rights reserved.

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