Quality of cardio-pulmonary resuscitation (CPR) during paediatric resuscitation training: Time to stop the blind leading the blind |
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| Authors: | Muhammad Arshid Tsz-Yan Milly Lo Fiona Reynolds |
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| Institution: | 1. Department of Neurology, Mayo Clinic, Rochester, MN, United States;2. Division of Epilepsy, Department of Neurology, Mayo Clinic, Rochester, MN, United States;3. Division of Neurocritical Care, Department of Neurology, Mayo Clinic, Rochester, MN, United States;4. Division of Biomedical Statistics and Informatics, Department of Neurology, Mayo Clinic, Rochester, MN, United States;5. Division of Cardiovascular Diseases, Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States;6. Department of Internal Medicine, Mayo Clinic, Rochester, MN, United States;7. Division of Epilepsy, Department of Neurology, Mayo Clinic, AZ, United States;1. Clinic of Internal Medicine I, University Hospital of Jena, Erlanger Allee 101, Germany;2. Clinic of Neurology, University Hospital of Jena, Erlanger Allee 101, Germany;3. Clinic of Neurology, General Hospital Altenburg, Am Waldessaum 10, Germany;4. Clinic of Neurology, Helios Klinikum Wuppertal, University Witten/ Herdecke, Heusnerstraße 40, Germany;1. Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, KidSIM-ASPIRE Research Program, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada;2. Stollery Children’s Hospital, University of Alberta, Canada;3. Columbia University College of Physicians and Surgeons, United States;4. Children’s of Alabama, University of Alabama at Birmingham, United States;5. KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, University of Calgary, Canada;6. Hasbro Children’s Hospital, Alpert Medical School of Brown University, United States;7. Johns Hopkins University School of Medicine, United States;1. The Children''s Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States;2. The Children''s Hospital of Philadelphia, Center for Simulation, Advanced Education, and Innovation, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States |
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| Abstract: | AimsRecent evidence suggested that the quality of cardio-pulmonary resuscitation (CPR) during adult advanced life support training was suboptimal. This study aimed to assess the CPR quality of a paediatric resuscitation training programme, and to determine whether it was sufficiently addressed by the trainee team leaders during training.MethodsCPR quality of 20 consecutive resuscitation scenario training sessions was audited prospectively using a pre-designed proforma. A consultant intensivist and a senior nurse who were also Advanced Paediatric Life Support (APLS) instructors assessed the CPR quality which included ventilation frequency, chest compression rate and depth, and any unnecessary interruption in chest compressions. Team leaders’ response to CPR quality and elective change of compression rescuer during training were also recorded.ResultsAirway patency was not assessed in 13 sessions while ventilation rate was too fast in 18 sessions. Target compression rate was not achieved in only 1 session. The median chest compression rate was 115 beats/min. Chest compressions were too shallow in 10 sessions and were interrupted unnecessarily in 13 sessions. More than 50% of training sessions did not have elective change of the compression rescuer. 19 team leaders failed to address CPR quality during training despite all team leaders being certified APLS providers.ConclusionsThe quality of CPR performance was suboptimal during paediatric resuscitation training and team leaders-in-training had little awareness of this inadequacy. Detailed CPR quality assessment and feedback should be integrated into paediatric resuscitation training to ensure optimal performance in real life resuscitations. |
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