Abstract P55: Brief Bedside CPR Skill Debriefing and Automated Corrective Feedback During Simulated Pediatric Cardiac Arrest
Introduction: Rescuers have difficulty delivering high quality CPR. Defibrillator automated corrective feedback and code team debriefing have improved CPR quality and outcomes in adult studies.
Hypothesis: Bedside CPR skill debriefing and defibrillator automated feedback will improve CPR guideline compliance of pediatric BLS in-hospital providers.
Methods: This prospective interventional trial randomized pediatric BLS in-hospital providers to one of three brief (<120s) bedside skill review programs to evaluate CPR quality improvements during 60s epochs of simulated pediatric arrest. Interventional arms were:
Instructor Only Debriefing;
Automated Defibrillator Feedback Only; and
Instructor Debriefing Assisted by Automated Feedback.
A defibrillator with CPR monitoring was used to record CPR data and to provide automated feedback when applicable per study design.
Results: Sixty-nine in-hospital pediatric care providers were randomized. Demographics between groups were not different. Prior to instruction, 57% of participants performed compressions within guideline rate recommendations (rate ≥90 min–1 and ≤120 min–1); 71% within depth targets (depth ≥38mm), and 36% with overall CPR compliance (both rate and depth within targets). After instruction, guideline compliance was more common: Instructor Only Debriefing: rate 52% to 87% (p=0.01), depth 74% to 87% (p=0.26), and overall CPR compliance 43% to 78% (p<0.02); Automated Feedback Only: rate 70% to 96% (p=0.02), depth 61% to 100% (p<0.001), and overall CPR compliance 35% to 96% (p<0.001); and Instructor Debriefing Assisted by Automated Feedback: rate 48% to 100% (p<0.001), depth 78% to 100% (p<0.02), and overall CPR compliance 30% to 100% (p<0.001).
Conclusions: Prior to instruction, most pediatric BLS providers did not perform guideline compliant CPR. After a brief bedside skill review program with CPR skill debriefing and automated corrective feedback, 100% of participants performed high quality CPR. Future studies should investigate the effect of focused bedside debriefing on CPR quality performed during actual pediatric resuscitations.