Abstract
Objective
To describe the adherence to guidelines for CPR in a tertiary pediatric emergency
department (ED) where resuscitations are reviewed by videorecording.
Methods
Resuscitations in a tertiary pediatric ED are videorecorded as part of a quality improvement
project. Patients receiving CPR under videorecorded conditions were eligible for inclusion.
CPR parameters were quantified by retrospective review. Data were described by 30-s
epoch (compression rate, ventilation rate, compression:ventilation ratio), by segment
(duration of single providers’ compressions) and by overall event (compression fraction).
Duration of interruptions in compressions was measured; tasks completed during pauses
were tabulated.
Results
33 children received CPR under videorecorded conditions. A total of 650 min of CPR were analyzed. Chest compressions were performed at <100/min in 90/714
(13%) of epochs; 100–120/min in 309/714 (43%); >120/min in 315/714 (44%). Ventilations
were 6–12 breaths/min in 201/708 (23%) of epochs and >12/min in 489/708 (70%). During
CPR without an artificial airway, compression:ventilation coordination (15:2) was
done in 93/234 (40%) of epochs. 178 pauses in CPR occurred; 120 (67%) were <10 s in duration. Of 370 segments of compressions by individual providers, 282/370 (76%)
were <2 min in duration. Median compression fraction was 91% (range 88–100%).
Conclusions
CPR in a tertiary pediatric ED frequently met recommended parameters for compression
rate, pause duration, and compression fraction. Hyperventilation and failure of C:V
coordination were very common. Future studies should focus on the impact of training
methods on CPR performance as documented by videorecording.
Keywords
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Article info
Publication history
Published online: March 21, 2015
Accepted:
March 13,
2015
Received in revised form:
March 3,
2015
Received:
December 31,
2014
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2015.03.007.
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
