Pauses in compressions during pediatric CPR : Opportunities for improving CPR quality
Copyright © 2019 Elsevier B.V. All rights reserved..
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
| Errataetall: |
CommentIn: Resuscitation. 2019 Dec;145:192-193. - PMID 31539613 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:145 |
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| Enthalten in: |
Resuscitation - 145(2019) vom: 30. Dez., Seite 158-165 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
O'Connell, Karen J [VerfasserIn] |
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| Links: |
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| Themen: |
CPR |
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| Anmerkungen: |
Date Completed 24.09.2020 Date Revised 24.09.2020 published: Print-Electronic CommentIn: Resuscitation. 2019 Dec;145:192-193. - PMID 31539613 Citation Status MEDLINE |
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| doi: |
10.1016/j.resuscitation.2019.08.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 245 | 1 | 0 | |a Pauses in compressions during pediatric CPR |b Opportunities for improving CPR quality |
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| 500 | |a Date Revised 24.09.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Resuscitation. 2019 Dec;145:192-193. - PMID 31539613 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier B.V. All rights reserved. | ||
| 520 | |a OBJECTIVE: 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 | ||
| 520 | |a METHODS: 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 | ||
| 520 | |a RESULTS: 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) | ||
| 520 | |a CONCLUSIONS: 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 | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 650 | 4 | |a Cardiopulmonary resuscitation | |
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| 650 | 4 | |a Resuscitation | |
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| 700 | 1 | |a Cochrane, Niall H |e verfasserin |4 aut | |
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| 700 | 1 | |a Donoghue, Aaron J |e verfasserin |4 aut | |
| 700 | 1 | |a Kerrey, Benjamin T |e verfasserin |4 aut | |
| 700 | 1 | |a Myers, Sage R |e verfasserin |4 aut | |
| 700 | 1 | |a Vazifedan, Turaj |e verfasserin |4 aut | |
| 700 | 1 | |a Mullan, Paul C |e verfasserin |4 aut | |
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