Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions.

Area of Science:

• Pediatric Critical Care Medicine
• Quality Improvement Science
• Cardiovascular Resuscitation

Background:

• Hospitalized children experience cardiac arrest, with survival rates below 50% to discharge.
• High-quality cardiopulmonary resuscitation (CPR) is crucial for improving survival outcomes.
• Standardized tracking and analysis of cardiac arrests are needed to identify improvement opportunities.

Purpose of the Study:

• To establish a novel, standardized process for tracking and analyzing cardiac arrests in a pediatric intensive care unit (PICU).
• To identify areas for enhanced compliance with American Heart Association (AHA) guidelines.
• To implement educational and communication initiatives to improve early recognition and patient outcomes.

Main Methods:

• A multidisciplinary cardiac arrest education and review program was developed and implemented from January 2017 to December 2018.
• All cardiac arrests within the PICU were tracked, reviewed, and presented at monthly conferences.
• Data were used to monitor compliance with AHA guidelines and identify areas for improvement.

Main Results:

• Over 2 years, 45 cardiac arrests were tracked, representing 2% of PICU admissions.
• In 2017, only 17% of reviewed cardiac arrests complied with AHA guidelines.
• In 2018, compliance increased to 76%, and survival to discharge rose from 47% to 63%.

Conclusions:

• A multidisciplinary cardiac arrest review process enhances the analysis of individual events.
• This program promotes quality improvement initiatives and consistent delivery of high-quality CPR.
• Implementing standardized review processes can significantly improve pediatric cardiac arrest outcomes.