Adam Cheng1, Elizabeth A Hunt2, David Grant3, Yiqun Lin4, Vincent Grant5, Jonathan P Duff6, Marjorie Lee White7, Dawn Taylor Peterson8, John Zhong9, Ronald Gottesman10, Stephanie Sudikoff11, Quynh Doan12, Vinay M Nadkarni13, Linda Brown, Frank Overly, Ilana Bank, Farhan Bhanji, David Kessler, Nancy Tofil, Jennifer Davidson, Mark Adler, Alex Bragg, Kimberly Marohn, Nicola Robertson, Jordan Duval-Arnould, Hubert Wong, Aaron Donoghue, Jenny Chatfield, Nnenna Chime. 1. University of Calgary, KidSim-ASPIRE Research Program, Division of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8. Electronic address: chenger@me.com. 2. Johns Hopkins University School of Medicine, Charlotte R. Bloomberg Children's Center, Division of Pediatric Anesthesiology and Critical Care Medicine, 1800 Orleans Street/Room 6321, Baltimore, MD 21287, USA. Electronic address: ehunt@jhmi.edu. 3. Bristol Royal Hospital for Children, University Hospitals Bristol, Paul O'Gorman Building, Upper Maudin St, Bristol BS2 8BJ, UK. Electronic address: david.grant@nhs.net. 4. KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8. Electronic address: jeffylin@hotmail.com. 5. KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8. Electronic address: vinceinfrance@gmail.com. 6. Stollery Children's Hospital, University of Alberta, 8215 112 St NW, Edmonton, AB, Canada T6G 2L9. Electronic address: jon.duff@albertahealthservices.ca. 7. Pediatric Simulation Center, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Ave, S., Birmingham, AL 35233, USA. Electronic address: mlwhite@peds.uab.edu. 8. Pediatric Simulation Center, Children's of Alabama, University of Alabama at Birmingham, 1600 7th Ave, S., Birmingham, AL 35233, USA. Electronic address: dtpeterson@uab.edu. 9. Children's Medical Center of Dallas, UT Southwestern Medical Center, 1935 Medical District Dr, Dallas, TX 75235, USA. Electronic address: john.zhong@childrens.com. 10. Montreal Children's Hospital, McGill University, 2300 Tupper St, Montreal, QC, Canada H3H 1P3. Electronic address: ronald.gottesman@mcgill.ca. 11. Yale-New Haven Health, Yale Medical School, 730 Howard Ave, New Haven, CT 06519, USA. Electronic address: Stephanie.sudikoff@ynhh.org. 12. British Columbia Children's Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, Canada V6H 3V4. Electronic address: qdoan@cw.bc.ca. 13. The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: nadkarni@email.chop.edu.
Abstract
AIM: The variability in quality of CPR provided during cardiac arrest across pediatric institutions is unknown. We aimed to describe the degree of variability in the quality of CPR across 9 pediatric institutions, and determine if variability across sites would be affected by Just-in-Time CPR training and/or visual feedback during simulated cardiac arrest. METHODS: We conducted secondary analyses of data collected from a prospective, multi-center trial. Participants were equally randomized to either: (1) No intervention; (2) Real-time CPR visual feedback during cardiac arrest or (3) Just-in-Time CPR training. We report the variability in median chest compression depth and rate across institutions, and the variability in the proportion of 30-s epochs of CPR meeting 2010 American Heart Association guidelines for depth and rate. RESULTS: We analyzed data from 528 epochs in the no intervention group, 552 epochs in the visual feedback group, and 525 epochs in the JIT training group. In the no intervention group, compression depth (median range 22.2-39.2mm) and rate (median range 116.0-147.6 min(-1)) demonstrated significant variability between study sites (p<0.001). The proportion of compressions with adequate depth (0-11.5%) and rate (0-60.5%) also varied significantly across sites (p<0.001). The variability in compression depth and rate persisted despite use of real-time visual feedback or JIT training (p<0.001). CONCLUSION: The quality of CPR across multiple pediatric institutions is variable. Variability in CPR quality across institutions persists even with the implementation of a Just-in-Time training session and visual feedback for CPR quality during simulated cardiac arrest.
RCT Entities:
AIM: The variability in quality of CPR provided during cardiac arrest across pediatric institutions is unknown. We aimed to describe the degree of variability in the quality of CPR across 9 pediatric institutions, and determine if variability across sites would be affected by Just-in-Time CPR training and/or visual feedback during simulated cardiac arrest. METHODS: We conducted secondary analyses of data collected from a prospective, multi-center trial. Participants were equally randomized to either: (1) No intervention; (2) Real-time CPR visual feedback during cardiac arrest or (3) Just-in-Time CPR training. We report the variability in median chest compression depth and rate across institutions, and the variability in the proportion of 30-s epochs of CPR meeting 2010 American Heart Association guidelines for depth and rate. RESULTS: We analyzed data from 528 epochs in the no intervention group, 552 epochs in the visual feedback group, and 525 epochs in the JIT training group. In the no intervention group, compression depth (median range 22.2-39.2mm) and rate (median range 116.0-147.6 min(-1)) demonstrated significant variability between study sites (p<0.001). The proportion of compressions with adequate depth (0-11.5%) and rate (0-60.5%) also varied significantly across sites (p<0.001). The variability in compression depth and rate persisted despite use of real-time visual feedback or JIT training (p<0.001). CONCLUSION: The quality of CPR across multiple pediatric institutions is variable. Variability in CPR quality across institutions persists even with the implementation of a Just-in-Time training session and visual feedback for CPR quality during simulated cardiac arrest.
Authors: Jorge López; Sarah N Fernández; Rafael González; María J Solana; Javier Urbano; Blanca Toledo; Jesús López-Herce Journal: PLoS One Date: 2017-11-30 Impact factor: 3.240
Authors: Adam Cheng; David Kessler; Ralph Mackinnon; Todd P Chang; Vinay M Nadkarni; Elizabeth A Hunt; Jordan Duval-Arnould; Yiqun Lin; Martin Pusic; Marc Auerbach Journal: Adv Simul (Lond) Date: 2017-02-28
Authors: Francesco Corazza; Deborah Snijders; Marta Arpone; Valentina Stritoni; Francesco Martinolli; Marco Daverio; Maria Giulia Losi; Luca Soldi; Francesco Tesauri; Liviana Da Dalt; Silvia Bressan Journal: JMIR Mhealth Uhealth Date: 2020-10-01 Impact factor: 4.773
Authors: Debora Almeida; Carol Clark; Michael Jones; Phillip McConnell; Jonathan Williams Journal: Scand J Trauma Resusc Emerg Med Date: 2020-09-10 Impact factor: 2.953