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A Survey of Medical Resuscitation Practices and Resources in Academic Pediatric Emergency Departments
Ashish Shah1, Tanner Heckle2, Katherine Edmunds3,4
1Medical College of Wisconsin, Wauwatosa, WI.
Insights
Pediatric emergency departments lack standardized medical resuscitation programs. This study reveals wide variations in practice, leadership, and quality improvement, highlighting a need for coordinated systems.
Area of Science:
- Pediatric Emergency Medicine
- Resuscitation Science
- Healthcare Systems Analysis
Background:
- Medical resuscitation is more prevalent than trauma in pediatric emergency departments (PEDs).
- Existing pediatric resuscitation programs lack national standardization in clinical care, education, quality improvement (QI), and research.
- This study aimed to assess current structures and resources to inform standardization efforts.
Purpose of the Study:
- To describe current structures and resources for medical resuscitation in pediatric emergency departments.
- To identify gaps in standardization for pediatric medical resuscitation.
- To provide a foundation for developing nationally standardized programs.
Main Methods:
- A survey was administered to physician leaders in pediatric emergency departments (PEDs) affiliated with the Pediatric Emergency Medicine Resuscitation of Children (PEM-ResCue) network.
- The survey assessed clinical practice, education, research, quality assurance (QA), and QI activities, including procedure volumes and leadership support.
- Data on strengths and challenges were collected through structured and open-ended questions.
Main Results:
- Twenty out of 39 centers (51% response rate) participated; most had Pediatric Emergency Medicine fellowships and were level I trauma centers.
- Significant variation was observed in the annual volume of critical procedures like tracheal intubations and chest compressions.
- Formal resuscitation leadership and dedicated FTE support were present in only a few centers, while QA/QI activities were common but inconsistently structured. Research varied from robust to nonexistent.
- Key challenges included limited funding, lack of standardization, and absence of centralized data systems.
Conclusions:
- Pediatric medical resuscitation practices and infrastructure show considerable variability across academic PEDs.
- Notable deficiencies exist in dedicated leadership, standardized education, and consistent QA/QI processes.
- The findings underscore the need for coordinated, standardized systems to improve pediatric medical resuscitation outcomes.
Background:
Medical resuscitation is more common than trauma in pediatric emergency departments (PEDs), yet it lacks nationally standardized programs for clinical care, education, quality improvement (QI), and research. We sought to describe current structures and resources as a step toward standardization.
Methods:
We surveyed PEDs affiliated with the AAP Section on Emergency Medicine Special Interest Group, Pediatric Emergency Medicine Resuscitation of Children (PEM-ResCue). One physician leader per site completed a structured survey spanning clinical practice, education, research, quality assurance (QA), and QI. Items included annual counts of critical procedures (eg, tracheal intubation) and full-time equivalent (FTE) support for resuscitation leadership, plus open-ended questions on strengths and challenges.
Results:
Twenty of 39 centers (51%) responded; 19/20 had Pediatric Emergency Medicine fellowships and 18 were level I trauma centers. Reported annual percenter averages were 79 tracheal intubations, 8 chest tubes, 4 central lines, and 20 chest compression events. Six centers had formal resuscitation leadership roles; 4 of 6 reported dedicated FTE support. Education (17 sites), QA (18), and QI (19) activities were common but varied in structure and frequency. Research activity ranged from robust to none. Reported strengths included video review and interdisciplinary collaboration; challenges included limited funding, lack of standardization, and absence of centralized data systems.
Conclusion:
Across 20 academic PEDs, medical resuscitation practices and infrastructure varied widely, with notable gaps in dedicated leadership and standardized education and QA/QI processes. Findings highlight opportunities to build coordinated, standardized systems for pediatric medical resuscitation.
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