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Pereira R, Silva EMKD. Interdisciplinary training program for pediatric cardiorespiratory arrest using rapid cycle deliberate practice: A descriptive cross-sectional study. SAO PAULO MED J 2024; 142:e2023271. [PMID: 38896579 PMCID: PMC11185849 DOI: 10.1590/1516-3180.2023.0271.16022024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 02/16/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND cardiorespiratory arrest (CRA) is a severe public health concern, and clinical simulation has proven to be a beneficial educational strategy for training on this topic. OBJECTIVE To describe the implementation of a program for pediatric cardiac arrest care using rapid-cycle deliberate practice (RCDP), the quality of the technique employed, and participants' opinions on the methodology. DESIGN AND SETTING This descriptive cross-sectional study of pre- and post-performance training in cardiopul monary resuscitation (CPR) techniques and reaction evaluation was conducted in a hospital in São Paulo. METHODS Multidisciplinary groups performed pediatric resuscitation in a simulated scenario with RCDP mediated by a facilitator. The study sample included professionals working in patient care. During the simulation, the participants were evaluated for their compliance with the CRA care algorithm. Further, their execution of chest compressions was assessed pre- and post-intervention. RESULTS In total, 302 professionals were trained in this study. The overall quality of CPR measured pre-intervention was inadequate, and only 26% had adequate technique proficiency, whereas it was 91% (P < 0.01) post-intervention. Of the participants, 95.7% responded to the final evaluation and provided positive comments on the method and their satisfaction with the novel simulation. Of these, 88% considered that repetition of the technique used was more effective than traditional simulation. CONCLUSIONS The RCDP is effective for training multidisciplinary teams in pediatric CPR, with an emphasis on the quality of chest compressions. However, further studies are necessary to explore whether this trend translates to differential performances in practical settings.
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Affiliation(s)
- Renata Pereira
- Master's student; Department of Medicine; Universidade Federal de São Paulo (UNIFESP). São Paulo (SP), Brazil
| | - Edina Mariko Koga da Silva
- Associate Professor; Department of Medicine; Universidade Federal de São Paulo (UNIFESP). São Paulo (SP), Brazil
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2
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Fuchs A, Bockemuehl D, Jegerlehner S, Both CP, Cools E, Riva T, Albrecht R, Greif R, Mueller M, Pietsch U. Favourable neurological outcome following paediatric out-of-hospital cardiac arrest: a retrospective observational study. Scand J Trauma Resusc Emerg Med 2023; 31:106. [PMID: 38129894 PMCID: PMC10734091 DOI: 10.1186/s13049-023-01165-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) in children is rare and can potentially result in severe neurological impairment. Our study aimed to identify characteristics of and factors associated with favourable neurological outcome following the resuscitation of children by the Swiss helicopter emergency medical service. MATERIALS AND METHODS This retrospective observational study screened the Swiss Air-Ambulance electronic database from 01-01-2011 to 31-12-2021. We included all primary missions for patients ≤ 16 years with OHCA. The primary outcome was favourable neurological outcome after 30 days (cerebral performance categories (CPC) 1 and 2). Multivariable linear regression identified potential factors associated with favourable outcome (odd ratio - OR). RESULTS Having screened 110,331 missions, we identified 296 children with OHCA, which we included in the analysis. Patients were 5.0 [1.0; 12.0] years old and 61.5% (n = 182) male. More than two-thirds had a non-traumatic OHCA (67.2%, n = 199), while 32.8% (n = 97) had a traumatic OHCA. Thirty days after the event, 24.0% (n = 71) of patients were alive, 18.9% (n = 56) with a favourable neurological outcome (CPC 1 n = 46, CPC 2 n = 10). Bystander cardiopulmonary resuscitation (OR 10.34; 95%CI 2.29-51.42; p = 0.002) and non-traumatic aetiology (OR 11.07 2.38-51.42; p = 0.002) were the factors most strongly associated with favourable outcome. Factors associated with an unfavourable neurological outcome were initial asystole (OR 0.12; 95%CI 0.04-0.39; p < 0.001), administration of adrenaline (OR 0.14; 95%CI 0.05-0.39; p < 0.001) and ongoing chest compression at HEMS arrival (OR 0.17; 95%CI 0.04-0.65; p = 0.010). CONCLUSION In this study, 18.9% of paediatric OHCA patients survived with a favourable neurologic outcome 30 days after treatment by the Swiss helicopter emergency medical service. Immediate bystander cardiopulmonary resuscitation and non-traumatic OHCA aetiology were the factors most strongly associated with a favourable neurological outcome. These results underline the importance of effective bystander and first-responder rescue as the foundation for subsequent professional treatment of children in cardiac arrest.
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Affiliation(s)
- Alexander Fuchs
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010, +41 31 664 14 65, Switzerland.
- Unit for Research in Anaesthesia, Department of Paediatric Anaesthesia, IRCCS, Istituto Giannina Gaslini, Genova, Italy.
- Swiss Air-Ambulance (Rega), Zurich, Switzerland.
| | - Deliah Bockemuehl
- Department of perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Sabrina Jegerlehner
- Department of Emergency Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Christian P Both
- Department of Anaesthesiology, Children's Hospital Zurich, Zurich, Switzerland
| | - Evelien Cools
- Swiss Air-Ambulance (Rega), Zurich, Switzerland
- Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Thomas Riva
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010, +41 31 664 14 65, Switzerland
| | - Roland Albrecht
- Swiss Air-Ambulance (Rega), Zurich, Switzerland
- Department of perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Robert Greif
- University of Bern, Bern, Switzerland
- School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
- European Resuscitation Council (ERC) Research NET, Niel, Belgium
| | - Martin Mueller
- Department of Emergency Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Urs Pietsch
- Swiss Air-Ambulance (Rega), Zurich, Switzerland
- Department of perioperative Intensive Care Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Emergency Medicine, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
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3
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Herrera H, Wood D. Battling Alarm Fatigue in the Pediatric Intensive Care Unit. Crit Care Nurs Clin North Am 2023; 35:347-355. [PMID: 37532388 DOI: 10.1016/j.cnc.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Pediatric intensive care unit nurses can be exposed to hundreds of alarms per patient they care for each shift. The exposure to so many alarms can cause nurses to be desensitized to future alarms and thus increase the time to respond to alarms. This is one of the largest patient safety concerns within health care today. Steps should be taken to mitigate the number of alarms nurses experience so that they can properly respond to actionable alarms.
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Affiliation(s)
- Heather Herrera
- Christus Children's, 333 North, Santa Rosa Street, San Antonio, TX 78207, USA
| | - Danielle Wood
- Duke University Hospital, 104 Lanier Valley Drive, Durham, NC 27703, USA.
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4
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Tamur S, Alasmari RM, Alnemari MA, Altowairgi MA, Altowairqi AH, Alshamrani NM, Aljaid M, Al-Malki S, Khayat A, Alzahrani A, Shams A. Knowledge and Attitudes around First Aid and Basic Life Support of Kindergarten and Elementary School Teachers and Parents in Taif City, Saudi Arabia. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1266. [PMID: 37508763 PMCID: PMC10378546 DOI: 10.3390/children10071266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/05/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND The foremost cause of children's (1-19 year) death is inadvertent injuries. While most of these accidental harms occur at home and school, rapid and suitable parental and teacher intervention is required to increase the chances of a child's survival. Therefore, both parents and teachers of the children in kindergarten and elementary school must be knowledgeable in first aid practice and basic life support (BLS) training. OBJECTIVES In the current study, our ambition is to evaluate the orientation level, knowledge, and attitudes around first aid and BLS training of kindergarten and elementary school teachers and parents in the city of Taif, Makkah region. METHODS A cross-sectional study in Taif, Saudi Arabia, targeted kindergarten and elementary school teachers and parents of students enrolled at these levels. There were 648 participants included in this study. The researchers assessed teachers' and parents' knowledge and attitudes around first aid and BLS using a validated, self-administered online questionnaire. RESULTS The study included 648 participants, including 248 (38.3%) teachers and 400 (61.7%) parents. The socio-demographic analysis showed that 412 (63.6%) are females and 233 (36.5%) are between the ages of 36 and 45 years. Approximately 142 (21.9%) participants reported previous training in the cardiopulmonary resuscitation (CPR) program, though more than half of them (53.5%) had outdated certificates (more than 2 years). The mean total knowledge for our study was 4.6 ± 1.4, with 22.4% of the participants being educated about first aid support and expressing a fair level of CPR foundations. Only a small percentage (2.3%) of the participants exposed a good and adequate theoretical level of knowledge around CPR skills and performance, while most of the contributors unveiled a poor level of knowledge (over 75%). There were no statistically significant differences between parents and teachers (p > 0.05). Finally, numerous participants (85%) appreciated training in the CPR program, and the most common motive was a "wish to avoid unnecessary death". CONCLUSIONS We concluded that a sizable portion of the contributors expressed a lack of proficiency in the fundamental CPR training knowledge and skills, pointing to an alarming public concern. Promisingly, a sizable percentage of participants expressed motivated attitudes toward CPR training. Therefore, additional study and data are required to effectively combat injury, with an emphasis on investigating causes and risk factors, burden and socioeconomic health determinants, community awareness level and desire to contribute, and accessibility for disseminating specific intervention strategies.
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Affiliation(s)
- Shadi Tamur
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | | | | | | | | | | | - Maryam Aljaid
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Sultan Al-Malki
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Abdullah Khayat
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ahmad Alzahrani
- Department of Pediatrics, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Anwar Shams
- Department of Pharmacology, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
- Centre of Biomedical Sciences Research (CBSR), Taif University, P.O. Box 11099, Taif 21974, Saudi Arabia
- High Altitude Research Center, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
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Raschdorf K, Mohseni A, Hogle K, Cheung A, So K, Manouchehri N, Khalili M, Lingawi S, Grunau B, Kuo C, Christenson J, Shadgan B. Evaluation of transcutaneous near-infrared spectroscopy for early detection of cardiac arrest in an animal model. Sci Rep 2023; 13:4537. [PMID: 36941315 PMCID: PMC10027843 DOI: 10.1038/s41598-023-31637-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
Sudden cardiac arrest (SCA) is a leading cause of mortality worldwide. The SCA-to-resuscitation interval is a key determinant of patient outcomes, highlighting the clinical need for reliable and timely detection of SCA. Near-infrared spectroscopy (NIRS), a non-invasive optical technique, may have utility for this application. We investigated transcutaneous NIRS as a method to detect pentobarbital-induced changes during cardiac arrest in eight Yucatan miniature pigs. NIRS measurements during cardiac arrest were compared to invasively acquired carotid blood pressure and partial oxygen pressure (PO2) of spinal cord tissues. We observed statistically significant decreases in mean arterial pressure (MAP) 64.68 mmHg ± 13.08, p < 0.0001), spinal cord PO2 (38.16 mmHg ± 20.04, p = 0.0028), and NIRS-derived tissue oxygen saturation (TSI%) (14.50% ± 3.80, p < 0.0001) from baseline to 5 min after pentobarbital administration. Euthanasia-to-first change in hemodynamics for MAP and TSI (%) were similar [MAP (10.43 ± 4.73 s) vs TSI (%) (12.04 ± 1.85 s), p = 0.3714]. No significant difference was detected between NIRS and blood pressure-derived pulse rates during baseline periods (p > 0.99) and following pentobarbital administration (p = 0.97). Transcutaneous NIRS demonstrated the potential to identify rapid hemodynamic changes due to cardiac arrest in periods similar to invasive indices. We conclude that transcutaneous NIRS monitoring may present a novel, non-invasive approach for SCA detection, which warrants further investigation.
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Affiliation(s)
- Katharina Raschdorf
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
- Department of Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Arman Mohseni
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Kaavya Hogle
- School of Biomedical Engineering (SBME), University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Amanda Cheung
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Kitty So
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Neda Manouchehri
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada
| | - Mahsa Khalili
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - Saud Lingawi
- School of Biomedical Engineering (SBME), University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Brian Grunau
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - Calvin Kuo
- School of Biomedical Engineering (SBME), University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Jim Christenson
- Department of Emergency Medicine, University of British Columbia and St. Paul's Hospital, Vancouver, BC, Canada
| | - Babak Shadgan
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
- Department of Neuroscience, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
- School of Biomedical Engineering (SBME), University of British Columbia, 2222 Health Sciences Mall, Vancouver, BC, V6T 1Z4, Canada.
- Department of Orthopaedics, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
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6
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Suppan L, Jampen L, Siebert JN, Zünd S, Stuby L, Ozainne F. Impact of Two Resuscitation Sequences on Alveolar Ventilation during the First Minute of Simulated Pediatric Cardiac Arrest: Randomized Cross-Over Trial. Healthcare (Basel) 2022; 10:2451. [PMID: 36553975 PMCID: PMC9777645 DOI: 10.3390/healthcare10122451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/22/2022] [Accepted: 12/02/2022] [Indexed: 12/09/2022] Open
Abstract
The International Liaison Committee on Resuscitation regularly publishes a Consensus on Science with Treatment Recommendations, but guidelines can nevertheless differ when knowledge gaps persist. In case of pediatric cardiac arrest, the American Heart Association recommends following the adult resuscitation sequence, i.e., starting with chest compressions. Conversely, the European Resuscitation Council advocates the delivery of five initial rescue breaths before starting chest compressions. This was a superiority, randomized cross-over trial designed to determine the impact of these two resuscitation sequences on alveolar ventilation in a pediatric model of cardiac arrest. The primary outcome was alveolar ventilation during the first minute of resuscitation maneuvers according to the guidelines used. A total of 56 resuscitation sequences were recorded (four sequences per team of two participants). The ERC approach enabled higher alveolar ventilation volumes (370 mL [203−472] versus 276 mL [140−360], p < 0.001) at the cost of lower chest compression fractions (57% [54;64] vs. 66% [59;68], p < 0.001). Although statistically significant, the differences found in this simulation study may not be clinically relevant. Therefore, and because of the importance of overcoming barriers to resuscitation, advocating a pediatric-specific resuscitation algorithm may not be an appropriate strategy.
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Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Faculty of Medicine, University of Geneva, Geneva University Hospitals, 1211 Geneva, Switzerland
| | - Laurent Jampen
- ESAMB-École Supérieure de Soins Ambulanciers, College of Higher Education in Ambulance Care, 1231 Conches, Switzerland; (L.J.); (F.O.)
| | - Johan N. Siebert
- Department of Paediatric Emergency Medicine, Geneva Children’s Hospital, Geneva University Hospitals, 1211 Geneva, Switzerland;
| | - Samuel Zünd
- Service de la Protection et de la Sécurité, 2000 Neuchâtel, Switzerland;
| | - Loric Stuby
- Genève TEAM Ambulances, 1201 Geneva, Switzerland;
| | - Florian Ozainne
- ESAMB-École Supérieure de Soins Ambulanciers, College of Higher Education in Ambulance Care, 1231 Conches, Switzerland; (L.J.); (F.O.)
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Laventhal NT, Barks JDE. Beyond the Clinical Trials: Off-Protocol Therapeutic Hypothermia. Clin Perinatol 2022; 49:137-147. [PMID: 35209996 DOI: 10.1016/j.clp.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mild therapeutic hypothermia has been extensively studied and validated as an effective and safe treatment for term and near-term infants with moderate and severe hypoxic encephalopathy meeting narrow inclusion criteria. Unanswered questions remain about whether cooling treatment can be optimized to improve outcomes even further, and whether it is reasonable to offer treatment to infants excluded from the foundational studies. Consideration of "off-protocol" cooling practices requires methodical review of available evidence and analysis using both a clinical and a research ethical framework.
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Affiliation(s)
- Naomi T Laventhal
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Michigan Medicine-University of Michigan Medical School, 8-621 C.S. Mott Children's Hospital, SPC 4254, 1540 East Hospital Drive, Ann Arbor, MI 48105-4254, USA.
| | - John D E Barks
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Michigan Medicine-University of Michigan Medical School, 8-621 C.S. Mott Children's Hospital, SPC 4254, 1540 East Hospital Drive, Ann Arbor, MI 48105-4254, USA
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8
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Riphagen S, Bird R. Ventilatory management of critically ill children in the emergency setting, during transport and retrieval. Paediatr Anaesth 2022; 32:330-339. [PMID: 34865291 DOI: 10.1111/pan.14358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 01/22/2023]
Abstract
Critical illness in children is uncommon. The acute stabilization and resuscitation of critically ill children remains challenging to even the most experienced operator. Cardiorespiratory illness represents the largest subgroup of diseases causing critical illness and, thus adds a layer of complexity and additional challenge to the safe intubation and establishment of effective ventilation of this group of children. Children have unique physiological and anatomical differences to adults, and present the team involved in their resuscitation and stabilization with challenges exaggerated by critical illness. The consideration of pathophysiological implications of disease and the equipment available during transport and retrieval from the roadside or nonspecialist setting to pediatric intensive care allows the clinician involved in resuscitation, stabilization, and establishment of ventilation to employ targeted strategies to optimize ventilatory success. This review focuses on the types of ventilatory challenges that must be addressed when managing critically ill children in the local settings in which they present, and the resources available to optimize the outcome prior to and during transfer to a higher level of care.
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Affiliation(s)
| | - Ruth Bird
- Hospital for Sick Children, Toronto, Ontario, Canada
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9
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Geerts A, Herbelet S, Borremans G, Coppens M, Christiaens-Leysen E, Van de Voorde P. Five vs. two initial rescue breaths during infant basic life support: A manikin study using bag-mask-ventilation. Front Pediatr 2022; 10:1067971. [PMID: 36582512 PMCID: PMC9792851 DOI: 10.3389/fped.2022.1067971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Children are more likely to suffer a hypoxic-ischaemic cause for cardiac arrest. Early ventilation may provide an advantage in outcome during paediatric cardiopulmonary resuscitation [CPR]. European Resuscitation Council guidelines recommend five initial rescue breaths [IRB] in infants, stemming from the hypothesis that rescuers might need 5 attempts in order to deliver 2 effective ventilations. This study aimed to verify this hypothesis. METHODS Participants (n = 112, convenience sample) were medical students from the Faculty of Medicine and Health Sciences Ghent University, Belgium. Students were divided into duos and received a 15 min just-in-time training regarding the full CPR-cycle using BMV. Participants then performed five cycles of 2-person CPR. The IRB were given by 1-person BMV, as opposed to a 2-persons technique during the further CPR-cycle. Correct ventilations for the infant were defined as tidal volumes measured (Laerdal® Q-CPR) between 20 and 60 ml, with n = 94 participants included in the analysis. The primary outcome consisted of the difference in the % of medical student duos providing at least 2 effective IRB between 2 and 5 attempts. RESULTS Off all duos, 55,3% provided correct volumes during their first 2 initial ventilations. An increase up to 72,4% was noticed when allowing 5 ventilations. The proportional difference between 2 and 5 IRB allowed was thus significant [17,0%, 95% confidence interval (5.4; 28.0)]. CONCLUSION In this manikin study, 5 IRB attempts during infant CPR with BMV increased the success rate in delivering 2 effective ventilations. Besides, students received training emphasizing the need for 5 initial rescue breaths. This study provides evidence supporting European Resuscitation Council guidelines.
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Affiliation(s)
- Anke Geerts
- Department of Basic and Applied Medical Sciences (BAMS), Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Sandrine Herbelet
- Department of Basic and Applied Medical Sciences (BAMS), Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Gautier Borremans
- Department of Basic and Applied Medical Sciences (BAMS), Ghent University, Ghent University Hospital, Ghent, Belgium
| | - Marc Coppens
- Department of Basic and Applied Medical Sciences (BAMS), Ghent University, Ghent University Hospital, Ghent, Belgium
| | | | - Patrick Van de Voorde
- Department of Basic and Applied Medical Sciences (BAMS), Ghent University, Ghent University Hospital, Ghent, Belgium.,Department of Emergency Medicine, Ghent University Hospital, Ghent, Belgium.,Federal Department of Health, EMS Dispatch Centre 112 Flanders, Ghent, Belgium
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10
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Schmucker M, Haag M. Automated Size Recognition in Pediatric Emergencies Using Machine Learning and Augmented Reality: Within-Group Comparative Study. JMIR Form Res 2021; 5:e28345. [PMID: 34542416 PMCID: PMC8491115 DOI: 10.2196/28345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/25/2021] [Accepted: 06/19/2021] [Indexed: 01/26/2023] Open
Abstract
Background Pediatric emergencies involving children are rare events, and the experience of emergency physicians and the results of such emergencies are accordingly poor. Anatomical peculiarities and individual adjustments make treatment during pediatric emergency susceptible to error. Critical mistakes especially occur in the calculation of weight-based drug doses. Accordingly, the need for a ubiquitous assistance service that can, for example, automate dose calculation is high. However, few approaches exist due to the complexity of the problem. Objective Technically, an assistance service is possible, among other approaches, with an app that uses a depth camera that is integrated in smartphones or head-mounted displays to provide a 3D understanding of the environment. The goal of this study was to automate this technology as much as possible to develop and statistically evaluate an assistance service that does not have significantly worse measurement performance than an emergency ruler (the state of the art). Methods An assistance service was developed that uses machine learning to recognize patients and then automatically determines their size. Based on the size, the weight is automatically derived, and the dosages are calculated and presented to the physician. To evaluate the app, a small within-group design study was conducted with 17 children, who were each measured with the app installed on a smartphone with a built-in depth camera and a state-of-the-art emergency ruler. Results According to the statistical results (one-sample t test; P=.42; α=.05), there is no significant difference between the measurement performance of the app and an emergency ruler under the test conditions (indoor, daylight). The newly developed measurement method is thus not technically inferior to the established one in terms of accuracy. Conclusions An assistance service with an integrated augmented reality emergency ruler is technically possible, although some groundwork is still needed. The results of this study clear the way for further research, for example, usability testing.
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Affiliation(s)
- Michael Schmucker
- GECKO Institute, Heilbronn University of Applied Sciences, Heilbronn, Germany
| | - Martin Haag
- GECKO Institute, Heilbronn University of Applied Sciences, Heilbronn, Germany
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