Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions

Thousands of children experience a cardiac arrest event in the hospital each year, with more than half of these patients not surviving to hospital discharge. Cardiopulmonary resuscitation (CPR) depth, rate, velocity and percentage of high-quality chest compressions are modifiable factors associated...

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Autores principales:	Matthew Pizzuto, Candice M Ray, Edith Reyes-Alvarado, Kimberly Jackson, David A Turner, Sameer Kamath
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2020
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/66826671d6124f768383837763359721
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spelling	oai:doaj.org-article:66826671d6124f7683838377633597212021-11-11T07:30:07ZCardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions10.1136/bmjoq-2020-0009302399-6641https://doaj.org/article/66826671d6124f7683838377633597212020-10-01T00:00:00Zhttps://bmjopenquality.bmj.com/content/9/4/e000930.fullhttps://doaj.org/toc/2399-6641Thousands of children experience a cardiac arrest event in the hospital each year, with more than half of these patients not surviving to hospital discharge. Cardiopulmonary resuscitation (CPR) depth, rate, velocity and percentage of high-quality chest compressions are modifiable factors associated with improved survival. Therefore, we created a novel and standardised process to track and analyse cardiac arrests in the Duke paediatric intensive care unit (PICU). Our aim was to identify areas for improved American Heart Association (AHA) compliance and implement education and communication-based initiatives to enhance early recognition of at-risk patients leading to improved outcomes. From January 2017 to December 2018, all cardiac arrests in our PICU were tracked, reviewed and presented at monthly morbidity and mortality conference. We used the data to track compliance with AHA guidelines and identify opportunities for improvement. Through these efforts, we established a multidisciplinary cardiac arrest education and review programme. Over the 2-year period, we tracked 45 cardiac arrests, which comprised 2% of all PICU admissions. In 2017, during the first year of development, 16 of 22 arrests (73%) were not reported to code committee members in time for complete review. Of the six cardiac arrests with complete reviews, only 17% followed AHA guidelines. In 2018, all 23 arrest events were communicated and 76% of resuscitations were found to be compliant with AHA guidelines. Survival of patients to discharge was 47% in 2017 and increased to 63% in 2018 with similar percentage of PICU admissions having a cardiac arrest between the 2 years. The primary aim of this project was to establish a multidisciplinary comprehensive cardiac arrest review process. This programme allowed for comprehensive analysis of individual events, promoted quality improvement initiatives and improved consistent delivery of high-quality CPR.Matthew PizzutoCandice M RayEdith Reyes-AlvaradoKimberly JacksonDavid A TurnerSameer KamathBMJ Publishing GrouparticleMedicine (General)R5-920ENBMJ Open Quality, Vol 9, Iss 4 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Matthew Pizzuto Candice M Ray Edith Reyes-Alvarado Kimberly Jackson David A Turner Sameer Kamath Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
description	Thousands of children experience a cardiac arrest event in the hospital each year, with more than half of these patients not surviving to hospital discharge. Cardiopulmonary resuscitation (CPR) depth, rate, velocity and percentage of high-quality chest compressions are modifiable factors associated with improved survival. Therefore, we created a novel and standardised process to track and analyse cardiac arrests in the Duke paediatric intensive care unit (PICU). Our aim was to identify areas for improved American Heart Association (AHA) compliance and implement education and communication-based initiatives to enhance early recognition of at-risk patients leading to improved outcomes. From January 2017 to December 2018, all cardiac arrests in our PICU were tracked, reviewed and presented at monthly morbidity and mortality conference. We used the data to track compliance with AHA guidelines and identify opportunities for improvement. Through these efforts, we established a multidisciplinary cardiac arrest education and review programme. Over the 2-year period, we tracked 45 cardiac arrests, which comprised 2% of all PICU admissions. In 2017, during the first year of development, 16 of 22 arrests (73%) were not reported to code committee members in time for complete review. Of the six cardiac arrests with complete reviews, only 17% followed AHA guidelines. In 2018, all 23 arrest events were communicated and 76% of resuscitations were found to be compliant with AHA guidelines. Survival of patients to discharge was 47% in 2017 and increased to 63% in 2018 with similar percentage of PICU admissions having a cardiac arrest between the 2 years. The primary aim of this project was to establish a multidisciplinary comprehensive cardiac arrest review process. This programme allowed for comprehensive analysis of individual events, promoted quality improvement initiatives and improved consistent delivery of high-quality CPR.
format	article
author	Matthew Pizzuto Candice M Ray Edith Reyes-Alvarado Kimberly Jackson David A Turner Sameer Kamath
author_facet	Matthew Pizzuto Candice M Ray Edith Reyes-Alvarado Kimberly Jackson David A Turner Sameer Kamath
author_sort	Matthew Pizzuto
title	Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
title_short	Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
title_full	Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
title_fullStr	Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
title_full_unstemmed	Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
title_sort	cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions
publisher	BMJ Publishing Group
publishDate	2020
url	https://doaj.org/article/66826671d6124f768383837763359721
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Cardiac arrest in the paediatric intensive care unit: defining the problem and developing solutions

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