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Measuring the Quality of Cardiopulmonary Resuscitation in the Emergency Department at a Quaternary Children's
Lucas Falco1, Zebulon Timmons2, Ted Swing1
1From the Department of Pediatric Emergency Medicine, Phoenix Children's Hospital, Phoenix, AZ.
Insights
Pediatric cardiopulmonary resuscitation (CPR) in an emergency department met chest compression rate and fraction goals. However, compression depth fell short for younger children, highlighting a critical area for improvement in pediatric cardiac arrest care.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Resuscitation Science
Background:
- High-quality cardiopulmonary resuscitation (CPR) is vital for pediatric survival during cardiac arrest.
- Optimal CPR performance during care transitions in pediatric emergency departments (PEDs) is challenging.
- Survival rates for out-of-hospital pediatric cardiac arrest remain critically low.
Purpose of the Study:
- To evaluate the quality of pediatric cardiopulmonary resuscitation (CPR) against American Heart Association (AHA) guidelines.
- To assess CPR performance in a pediatric emergency department at a quaternary children's hospital.
Main Methods:
- Retrospective analysis of pediatric cardiac arrest data.
- Data collected from a free-standing children's hospital emergency department.
- Evaluation of 23 pediatric CPR events for patients under 18 years.
Main Results:
- Median chest compression (CC) fraction was 85%, exceeding the AHA goal of 80% for all age groups.
- Average CC rate was 112 compressions per minute.
- CC depth met AHA targets for patients 8-18 years but fell below recommendations for those younger than 8 years, especially infants.
Conclusions:
- Chest compression fraction and rate met AHA targets in all pediatric age groups studied.
- Chest compression depth was suboptimal for pediatric patients younger than 8 years.
- Improving CC depth, particularly in infants, is crucial for enhancing pediatric CPR quality and outcomes.
Aim Of Study:
The aim of this study was to evaluate the quality of cardiopulmonary resuscitation (CPR) as it relates to American Heart Association (AHA) guidelines during cardiac arrests in a pediatric emergency department at a quaternary children's hospital.
Background And Objectives:
High-quality CPR increases the likelihood of survival from pediatric out-of-hospital cardiac arrest. However, optimal performance of high-quality CPR during transition of care between prehospital and pediatric emergency department providers is challenging, and survival without comorbidities remains extremely low for out-of-hospital cardiac arrest.
Methods:
This was a retrospective study of data collected from a free-standing children's hospital emergency department and level 1 trauma center.
Results:
There were 23 pediatric CPR events for subjects younger than 18 years in the emergency department during the time of the study. Median chest compression (CC) fraction was 85% overall with the AHA goal of 80%. Compliance with this recommendation was achieved in all age groups. The CC rate averaged 112 for the entire sample. Median depth was 2.06 cm in subjects younger than 1 year, 3.95 cm in subjects 1 year old to younger than 8 years, and 5.33 cm in subjects 8 years old to younger than 18 years. These compression depth rates fell below the AHA recommendations, with the exception of those 8 years and older.
Conclusions:
In our study, CC fraction and CC rate were found to meet AHA targets for all age groups, whereas CC depth only met AHA targets for the 8- to 18-year-old group. The most difficult parameter was CC depth for the group of subjects younger than 1 year.
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