Resuscitation practices in hospitals caring for children: Insights from get with the guidelines-resuscitation

Resuscitation practices in pediatric hospitals have not been compared, and whether practices differ between freestanding pediatric only hospitals and combined hospitals (which care for adults and children) is unknown.

We surveyed hospitals that submit data on pediatric in-hospital cardiac arrest (IHCA) to Get-With-The Guidelines®-Resuscitation, to elicit information on resuscitation practices. Hospitals were categorized as pediatric only and combined hospitals, and rates of resuscitation practices were compared.

Thirty-three hospitals with ≥5 IHCA events between 2017-2019 completed the survey, of which 9 (27.3%) were pediatric only and 24 (72.7%) were combined hospitals. Overall, 18 (54.5%) hospitals used a device to measure chest compression quality, 16 (48.5%) had a staff member monitor chest compression quality, 10 (30.3%) used lanyards or hats to designate code leaders during a resuscitation, 16 (48.5%) routinely conducted code debriefings immediately after a resuscitation, and 7 (21.2%) conducted mock codes at least quarterly with 17 (51.5%) reporting no set schedule. Pediatric only hospitals were more likely to employ a device to measure chest compressions (88.9% vs. 41.7%; P = 0.02), conduct code debriefings always or frequently after resuscitations (77.8% vs. 37.5%, P = 0.04), use lanyards or a hat to designate the code team leader during resuscitations (66.7% vs. 16.7%, P = 0.006), and allow nurses to defibrillate using an AED (77.8% vs. 29.2%, P = 0.01). There were no differences in simulation frequency or other resuscitation practices between the two hospital groups.

Across hospitals caring for children, substantial variation exists in resuscitation practices, with notable differences between pediatric only and combined hospitals.