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Healthcare Provider Characteristics and Cardiopulmonary Resuscitation Quality During Infant Resuscitation: A
Mona Khattab1, Karin Frisell, Ralph MacKinnon
1From the Division of Neonatology (M.K.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Department of Anesthesiology (K.F.), Mälarsjukhuset Hospital; Department of Anesthesiology (K.F.), Mälarsjukhuset/Karolinska Institutet, Eskilstuna, Sweden; Faculty of Biology, Medicine and Health (R.M.), The University of Manchester; Faculty of Health, Psychology, and Social Care (R.M.), Manchester Metropolitan University; Department of Paediatric Anaesthesia (R.M.), Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK; Division of Emergency Medicine (T.C.), Children's Hospital Los Angeles, University of Southern California, Los Angeles, CA; Division of Cardiac Critical Care (T.R.), Department of Pediatrics, Medical City Children's Hospital, Dallas, TX; NHS Harefield Trust (L.L.), Health Education England (HEE), London, UK; Division of Critical Care (N.T.), Children's Hospital Alabama, University of Alabama, Tuscaloosa, AL; Division of Emergency Medicine (K.F., A.S.), Department of Pediatrics, SSM Health Cardinal Glennon Children's Hospital, St Louis University School of Medicine, St Louis, MO; Golden Valley Health Centers (C.G.), Modesto, CA; Department of Pediatrics and Emergency Medicine (C.G., M.A.), Yale University School of Medicine, New Haven, CT; Department of Research and Innovation (D.A.), Manchester University NHS Foundation Trust, Manchester, UK; Abigail Wexner Research Institute (M.M.-C.); and Division of Critical Care Medicine and Biostatistics Resource (M.M.-C.), Nationwide Children's Hospital, Columbus, OH.
Insights
Healthcare provider characteristics like age and height impact infant cardiopulmonary resuscitation (CPR) quality. While most providers met median guidelines, individual adherence was low, suggesting a need for provider-specific CPR training.
Area of Science:
- Medical Education
- Emergency Medicine
- Pediatric Resuscitation
Background:
- Adult cardiopulmonary resuscitation (CPR) quality is influenced by healthcare provider anthropometrics.
- The impact of provider characteristics on infant CPR performance remains largely unexamined.
- Understanding these factors is crucial for optimizing resuscitation techniques in vulnerable populations.
Purpose of the Study:
- To investigate the relationship between healthcare provider characteristics and simulated infant CPR performance.
- To identify specific provider attributes affecting CPR quality in an infant model.
- To assess CPR performance degradation over a 2-minute period.
Main Methods:
- 127 healthcare providers from 4 international hospitals performed simulated single-rescuer infant CPR.
- Performance was evaluated against 2015 American Heart Association guidelines using a feedback device.
- Multivariate analyses correlated provider demographics, anthropometrics, and training with CPR metrics.
Main Results:
- While median compression and ventilation parameters met guidelines, individual adherence was low (52% compressions, 20% ventilations).
- Older age correlated with higher ventilation volumes; shorter height correlated with deeper chest compressions.
- Neonatal intensive care unit providers performed shallower compressions; no significant sex or BMI differences were found.
Conclusions:
- Specific healthcare provider characteristics are associated with variations in infant CPR quality.
- Findings suggest a need for CPR guidelines tailored to provider attributes, not solely patient factors.
- Minimal performance degradation was observed over the 2-minute simulation period.
Introduction:
Healthcare providers' anthropometric characteristics can adversely affect adult cardiopulmonary resuscitation (CPR) performance quality. However, their effects on infant CPR are unknown. We aimed to determine any relationships between healthcare provider characteristics (anthropomorphic, demographics, training, occupational data) and simulated infant CPR performance at multiple international sites. Our secondary aim was to examine provider's CPR performance degradation.
Methods:
Providers from 4 international hospitals performed 2 minutes of single-rescuer simulated infant CPR using 2015 American Heart Association Basic Life Support criteria with guidance from a real-time visual performance feedback device. Providers' characteristics were collected, and the simulator collected compression and ventilation data. Multivariate analyses examined the entire 2 minutes and performance degradation.
Results:
Data from 127 participants were analyzed. Although median values for all compression variables (depth, rate, lean) and ventilation volume were within guideline target ranges, when looking at individuals, only 52% chest compressions and 20% ventilations adhered to the American Heart Association guidelines. Age was found to be independently associated with ventilation volume (direct-relationship), and height was associated with chest compression lean (shorter participant-deeper lean). No significant differences were noted based on sex or body mass index. Neonatal intensive care unit participants were noted to perform shallower chest compressions (P < 0.001). Overall, there was minimal evidence of performance degradation over 2 minutes.
Conclusions:
Isolated provider characteristics were noted among a diverse cohort of healthcare providers that may affect the CPR quality on a simulated infant. Understanding the relationships between provider characteristics and CPR quality could inform future infant CPR guidelines customized for the provider and not just the patient.
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