Improved Retention of Chest Compression Psychomotor Skills With Brief "Rolling Refresher" Training.

Introduction: High-quality cardiopulmonary resuscitation (CPR) is critical to improve survival from cardiac arrest. However, cardiopulmonary resuscitation knowledge and psychomotor skill proficiency are transient. We hypothesized that brief, in situ refresher training will improve chest compression (CC) psychomotor skill retention for bedside providers.

Redesign of an Open-System Oxygen Face Mask With Mainstream Capnometer for Children.

Background: Partial pressure of end-tidal carbon dioxide (P ) monitoring in children is important to detect apnea or hypopnea early to intervene before hypoxemia develops. Monitoring P in children without a tracheal tube is challenging. To improve P measurement accuracy in a commercially available mask with a mainstream CO detector, we implemented design changes with deform-and-hold shaping technology and anterior-posterior adjustment of the expiratory gas flow cup.

A pragmatic checklist to identify pediatric ICU patients at risk for cardiac arrest or code bell activation.

Background: In-hospital cardiac arrest is a rare event associated with significant morbidity and mortality. The ability to identify the ICU patients at risk for cardiac arrest could allow the clinical team to prepare staff and equipment in anticipation.

Methods: This pilot study was completed at a large tertiary care pediatric intensive care unit to determine the feasibility of a simple checklist of clinical variables to predict deterioration.

Factors Associated with Adverse Events during Tracheal Intubation in the NICU.

Background: The incidence of adverse tracheal intubation-associated events (TIAEs) and associated patient, practice, and intubator characteristics in the neonatal intensive care unit (NICU) setting are unknown.

Objectives: To determine the incidence of adverse TIAEs and to identify factors associated with TIAEs in the NICU.

Methods: Single-site prospective observational cohort study of infants who were intubated in a level 4 referral NICU between September 1, 2011 and November 30, 2013.

Blood Pressure Directed Booster Trainings Improve Intensive Care Unit Provider Retention of Excellent Cardiopulmonary Resuscitation Skills.

Objectives: Brief, intermittent cardiopulmonary resuscitation (CPR) training sessions, "Booster Trainings," improve CPR skill acquisition and short-term retention. The objective of this study was to incorporate arterial blood pressure (ABP) tracings into Booster Trainings to improve CPR skill retention. We hypothesized that ABP-directed CPR "Booster Trainings" would improve intensive care unit (ICU) provider 3-month retention of excellent CPR skills without need for interval retraining.

2010 American Heart Association recommended compression depths during pediatric in-hospital resuscitations are associated with survival.

Aim: Gaps exist in pediatric resuscitation knowledge due to limited data collected during cardiac arrest in real children. The objective of this study was to evaluate the relationship between the 2010 American Heart Association (AHA) recommended chest compression (CC) depth (≥51 mm) and survival following pediatric resuscitation attempts.

Methods: Single-center prospectively collected and retrospectively analyzed observational study of children (>1 year) who received CCs between October 2006 and September 2013 in the intensive care unit (ICU) or emergency department (ED) at a tertiary care children's hospital.

Simplified dispatcher instructions improve bystander chest compression quality during simulated pediatric resuscitation.

Aim: Cardiopulmonary resuscitation (CPR) quality is associated with survival outcomes after out-of-hospital cardiac arrest. The objective of this study was to evaluate the effectiveness of simplified dispatcher CPR instructions to improve the chest compression (CC) quality during simulated pediatric cardiac arrest in public places.

Methods: Adult bystanders recruited in public places were randomized to receive one of two scripted dispatcher CPR instructions: (1) "Push as hard as you can" (PUSH HARD) or (2) "Push approximately 2 inches" (TWO INCHES).

First quantitative analysis of cardiopulmonary resuscitation quality during in-hospital cardiac arrests of young children.

Aim: The objective of this study is to report, for the first time, quantitative data on CPR quality during the resuscitation of children under 8 years of age. We hypothesized that the CPR performed would often not achieve 2010 Pediatric Basic Life Support (BLS) Guidelines, but would improve with the addition of audiovisual feedback.

Methods: Prospective observational cohort evaluating CPR quality during chest compression (CC) events in children between 1 and 8 years of age.

Pushing harder, pushing faster, minimizing interruptions… but falling short of 2010 cardiopulmonary resuscitation targets during in-hospital pediatric and adolescent resuscitation.

Aim: The objective of this study was to evaluate the effect of instituting the 2010 Basic Life Support Guidelines on in-hospital pediatric and adolescent cardiopulmonary resuscitation (CPR) quality. We hypothesized that quality would improve, but that targets for chest compression (CC) depth would be difficult to achieve.

Methods: Prospective in-hospital observational study comparing CPR quality 24 months before and after release of the 2010 Guidelines.

Forensic analysis of crib mattress properties on pediatric CPR quality--can we balance pressure reduction with CPR effectiveness?

Introduction: Single mode, pressure reduction (PR) crib mattresses are increasingly employed in hospitals to prevent skin injury and infection. However, single mode PR mattresses risk large mattress deflection during CPR chest compressions, potentially leading to inadequate chest compressions.

Hypothesis: New, dual mode PR crib mattress technology provides less mattress deflection during chest compressions (CCs) with similar PR characteristics for prevention of skin injury.

Ability of code leaders to recall CPR quality errors during the resuscitation of older children and adolescents.

Aim: Performance of high quality CPR is associated with improved resuscitation outcomes. This study investigates code leader ability to recall CPR error during post-event interviews when CPR recording/audiovisual feedback-enabled defibrillators are deployed.

Patients And Methods: Physician code leaders were interviewed within 24h of 44 in-hospital pediatric cardiac arrests to assess their ability to recall if CPR error occurred during the event.

Comparison of relative and actual chest compression depths during cardiac arrest in children, adolescents, and young adults.

Aim: Cardiopulmonary resuscitation (CPR) guidelines recommend specific chest compression (CC) target depths for children. We quantitatively describe relative anterior-posterior diameter (APD) depth, actual depth, and force of CCs during real CPR events in children.

Methods: CC depth and force were recorded during real CPR events in children ≥8 years using FDA-approved CC sensor.