Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Borns, Julia; Ersch, Jörg; Dobrovoljac, Milana; Staubli, Georg; Brotschi, Barbara

doi:10.1097/pec.0000000000001403

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…In our study, we use one device to analyze CC quality. We also used video recordings to asses pediatric resuscitation management and to detect errors or omissions during resuscitation because previous studies showed that it is a useful tool for this purpose 24 .…”

Section: Discussionmentioning

confidence: 99%

Quality of chest compressions during pediatric resuscitation with 15:2 and 30:2 compressions-to-ventilation ratio in a simulated scenario

Manrique

González

Iguiñiz

et al. 2020

Sci Rep

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The main objetive was to compare 30:2 and 15:2 compression-to-ventilation ratio in two simulated pediatric cardiopulmonary resuscitation (cpR) models with single rescuer. the secondary aim was to analyze the errors or omissions made during resuscitation. A prospective randomized parallel controlled study comparing 15:2 and 30:2 ratio in two manikins (child and infant) was developed. The CPR was performed by volunteers who completed an basic CPR course. Each subject did 4 CPR sessions of 3 minutes each one. Depth and rate of chest compressions (CC) during resuscitation were measured using a Zoll Z series defibrillator. Visual assessment of resuscitation was performed by an external researcher. A total of 26 volunteers performed 104 CPR sessions. Between 54-62% and 44-53% of CC were performed with an optimal rate and depth, respectively, with no significant differences. No differences were found in depth or rate of CC between 15:2 and 30:2 compression-to-ventilation ratio with both manikins. In the assessment of compliance with the ERC CPR algorithm, 69.2-80.8% of the subjects made some errors or omissions during resuscitation, the most frequent was not asking for help and not giving rescue breaths. the conclusions were that a high percentage of cc were not performed with optimal depth and rate. errors or omissions were frequently made by rescuers during resuscitation.Pediatric cardiac arrest (CA) is an important health problem since it has high mortality (52-80%) and a large proportion of survivors suffer from permanent and severe neurologic disability (poor outcome in 20-50%) 1-4 . Previous studies have shown that optimizing maneuvers of cardiopulmonary resuscitation (CPR) in children could improve survival and prognosis 4,5 . Nevertheless, many studies documented that CPR is often not optimally performed 6,7 .The 2015 European Resuscitation Council (ERC) guidelines recommend a synchronized 15:2 compression-to-ventilation ratio during basic pediatric CPR 1,8,9 . However, there is not a strong evidence to indicate the best compression-to-ventilation ratio in pediatric CPR 10,11 . Firstly, maintaining an adequate ventilation is crucial during CPR in children because pediatric CA is primarily caused by respiratory failure 2 . The 15:2 ratio delivers more ventilations whereas the 30:2 ratio delivers more chest compressions (CC). In the other hand, different recommendations for the compression-to-ventilation ratio between children (15:2 ratio) and adults (30:2 ratio) could increase the errors or omissions and impair learning. In adult simulation models 12-14 , there are different studies that compare the quality of CC in both compression-to-ventilation ratio. However, only one study conducted in pediatric models, but it was developed by volunteers with pediatric advanced life support (PALS) accreditation 15 . In our knowledge, there are no previous studies comparing the quality of CC between 15:2 and 30:2 compression-to-ventilation ratio during pediatric CPR conducted by volunteers training in basic life support.with ...

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Section: Discussionmentioning

confidence: 99%

Quality of chest compressions during pediatric resuscitation with 15:2 and 30:2 compressions-to-ventilation ratio in a simulated scenario

Manrique

González

Iguiñiz

et al. 2020

Sci Rep

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“…Interestingly, using a method of audio‐video recording, transcribing ten highly complex operations and then identifying deviations by majority consensus of a multidisciplinary team, a mean of one deviation every 79 min during complex procedures has been reported. Similarly, using videos, a statistically significant correlation between accurate handover and adherence to guidelines was found in an advanced trauma paediatric resuscitation bay.…”

Section: Resultsmentioning

confidence: 89%

“…One study was excluded from further analysis because of low outcome and analysis scores ( Appendix S2 , supporting information). Thus, 20 studies showing good internal and external validity remained, and were used for in‐depth analysis.…”

Section: Resultsmentioning

confidence: 99%

Prospective methods for identifying perioperative risk-assessment methods for patient safety over 20 years: a systematic review

Heideveld-Chevalking

Calsbeek²,

Hofland

et al. 2019

BJS Open

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Background Serious preventable surgical events still occur despite considerable efforts to improve patient safety. In addition to learning from retrospective analyses, prospective risk‐assessment methods may help to decrease preventable events further by targeting perioperative hazards. The aim of this systematic review was to assess the methods used to identify perioperative patient safety risks prospectively, and to describe the risk areas targeted, the quality characteristics and feasibility of methods. Methods MEDLINE, Embase, CINAHL and Cochrane databases were searched, adhering to PRISMA guidelines. All studies describing the development and results of prospective methods to identify perioperative patient safety risks were included and assessed on methodological quality. Exclusion criteria were interventional studies, studies targeting one specific issue, studies reporting on structural factors relating to fundamental hospital items, and non‐original or case studies. Results The electronic search resulted in 16 708 publications, but only 20 were included for final analysis, describing five prospective risk‐assessment methods. Direct observation was used in most studies, often in combination. Direct (16 studies) and indirect (4 studies) observations identified (potential) adverse events (P)AEs, process flow disruptions, poor protocol compliance and poor practice performance. (Modified) Healthcare Failure Mode and Effect Analysis (HFMEA™) (5 studies) targeted potential process flow disruption failures, and direct (P)AE surveillance (3 studies) identified (P)AEs prospectively. Questionnaires (3 studies) identified poor protocol compliance, surgical flow disturbances and patients' willingness to ask questions about their care. Overall, quality characteristics and feasibility of the methods were poorly reported. Conclusion The direct (in‐person) observation appears to be the primary prospective risk‐assessment method that currently may best help to target perioperative hazards. This is a reliable method and covers a broad spectrum of perioperative risk areas.

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“…By contrast, p-OHCA accounts for a further 7037 children brought to United States PEDs each year [1]. Variable adherence to resuscitation algorithms is commonly observed and can hinder optimal trauma and CPR care, thus jeopardizing patient outcome and survival [60][61][62][63][64]. In addition to the technical skills of individual rescuers, shared mental non-technical skills at the team level such as SA, collective team interaction patterns, leadership, and dynamic decision-making affect adherence to algorithms and hence the outcome of resuscitation care [22,65].…”

Section: Discussionmentioning

confidence: 99%

Impact of a shared decision-making mHealth tool on caregivers’ team situational awareness, communication effectiveness, and performance during pediatric cardiopulmonary resuscitation: study protocol of a cluster randomized controlled trial

Ehrler

Sahyoun

Manzano

et al. 2021

Trials

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Background Effective team communication, coordination, and situational awareness (SA) by team members are critical components to deliver optimal cardiopulmonary resuscitation (CPR). Complexity of care during CPR, involvement of numerous providers, miscommunication, and other exogenous factors can all contribute to negatively influencing patient care, thus jeopardizing survival. We aim to investigate whether an mHealth supportive tool (the Interconnected and Focused Mobile Apps on patient Care Environment [InterFACE]) developed as a collaborative platform to support CPR providers in real-time and share patient-centered information would increase SA during pediatric CPR. Methods We will conduct a prospective, cluster randomized controlled trial by groups of 6 participants in a tertiary pediatric emergency department (33,000 consultations/year) with pediatric physicians and nurses. We will compare the impact of the InterFACE tool with conventional communication methods on SA and effective team communication during a standardized pediatric in-hospital cardiac arrest and a polytrauma high-fidelity simulations. Forty-eight participants will be randomized (1:1) to consecutively perform two 20-min video-recorded scenarios using either the mHealth tool or conventional methods. The primary endpoint is the SA score, measured with the Situation Awareness Global Assessment Technique (SAGAT) instrument. Enrollment will start in late 2020 and data analysis in early 2021. We anticipate that the intervention will be completed by early 2021 and study results will be submitted in mid 2021 for publication. Discussion This clinical trial will assess the impact of a collaborative mHealth tool on increasing situational awareness and effective team communication during in-hospital pediatric resuscitation. As research in this area is scarce, the results generated by this study may become of paramount importance in improving the care of children receiving in-hospital CPR, in the era of increasing communication technology. Trial registration ClinicalTrials.gov NCT04464603. Registered on 9 July 2020.

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Video Recordings to Analyze Preventable Management Errors in Pediatric Resuscitation Bay

Cited by 5 publications

References 14 publications

Quality of chest compressions during pediatric resuscitation with 15:2 and 30:2 compressions-to-ventilation ratio in a simulated scenario

Quality of chest compressions during pediatric resuscitation with 15:2 and 30:2 compressions-to-ventilation ratio in a simulated scenario

Prospective methods for identifying perioperative risk-assessment methods for patient safety over 20 years: a systematic review

Impact of a shared decision-making mHealth tool on caregivers’ team situational awareness, communication effectiveness, and performance during pediatric cardiopulmonary resuscitation: study protocol of a cluster randomized controlled trial

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