Pauses in compressions during pediatric CPR: Opportunities for improving CPR quality
| Autor: | Alexis B. Sandler, Niall H. Cochrane, Turaj Vazifedan, Ryan R Keane, Benjamin T. Kerrey, Aaron Donoghue, Sage R. Myers, Karen J. O'Connell, Paul C. Mullan |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatric emergency medicine.medical_specialty Resuscitation Time Factors Adolescent medicine.medical_treatment Video Recording Heart Massage 030204 cardiovascular system & hematology Emergency Nursing 03 medical and health sciences 0302 clinical medicine medicine Humans Cardiopulmonary resuscitation Child health care economics and organizations Guideline adherence business.industry Infant Newborn Single pulse Infant 030208 emergency & critical care medicine Quality Improvement Cardiopulmonary Resuscitation Child Preschool Emergency medicine Emergency Medicine Female Guideline Adherence Cpr quality Emergency Service Hospital Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | Resuscitation. 145:158-165 |
| ISSN: | 0300-9572 |
| Popis: | Minimizing pauses in chest compressions during cardiopulmonary resuscitation (CPR) is recommended by the American Heart Association (AHA) and is associated with improved patient outcomes. We studied the quality of pediatric CPR performed in a tertiary pediatric emergency department (ED) with a focus on pauses in chest compressions.We conducted an observational study of CPR quality in two pediatric EDs using video review during pediatric cardiac arrest. Events were reviewed for AHA guideline adherence. Parameters of CPR performance were described according to individual compressor segment. Pauses in compressions were analyzed for duration and pause activities.From a 30-month period, 81 cardiac arrests were analyzed, including 1003 individual compressor segments and 900 pauses. Median chest compression fraction was 91%, with a median pause duration of 4 s (IQR 2, 10); 22% of pauses were prolonged (10 s). Pulse checks occurred in 23% of pauses; 62% were prolonged. Checking a single pulse site (p 0.001) and having fingers ready pre-pause (p = 0. 001) were associated with significantly shorter pause duration. Pause duration was correlated with the number of pause tasks (r = 0.559, p 0.001). "Coordinated pauses" (pulse check, rhythm check and compressor change) were rare (6%) and long in duration (19 s; IQR 11, 30).Prolonged pauses in chest compressions occurred frequently during CPR and were associated with pulse checks and multiple simultaneous tasks. Checking a single pulse site with fingers ready on the pulse site pre-pause could decrease pause duration and improve CPR quality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect