Abstract 129: A Videographic Analysis of CPR in a Pediatric Emergency Department
Objective: to describe the adherence to guidelines for CPR performance in a tertiary pediatric emergency department (ED) where resuscitations are reviewed by video recording and assess the reliability of data collection from video.
Methods: Resuscitations in a tertiary pediatric ED are video recorded as part of a continuous quality improvement project. Pediatric patients receiving CPR under video recorded conditions were eligible for inclusion. Elements of video recorded CPR were quantified by study team members. Data was described by 30-second epoch (compression rate, ventilation rate, C:V ratio) and by overall event (pauses, no-flow fraction, duration of individual compressor).
Results: A convenience sample of nine patients who received CPR under video recorded conditions were analyzed. A total of 186 30-second epochs of chest compressions were reviewed; ventilations were measureable during 84 epochs. Chest compressions were performed at less than 100 per minute in 9/186 (5%) of epochs; 100-120 per minute in 53/186 (28%); greater than 120 per minute in 124/186 (67%); and greater than 150 per minute in 49/186 (26%). Ventilations were 6 to 10 breaths per minute in 6/84 (7%); between 10 and 30 per minute in 43/84 (51%); and greater than 30 per minute in 33/84 (39%). Correct coordination of compressions and ventilations (15:2) in non-intubated patients was done in 6/104 (6%) of observable epochs. 48 pauses in CPR were observed; < 5 seconds in 25/48 (52%), 6-10, and > 10 seconds in 6/48 (13%). A total of 74 CPR periods by individual compressors were recorded; 32/74 (43%) were less than 60 seconds, 25/74 (34%) were between 1 and 2 minutes, and 17/74 (23%) were greater than 2 minutes. Median no-flow fraction was 9% (range 0-12%).
Conclusions: CPR in a tertiary pediatric ED under video recorded conditions met recommended parameters for compression rate and no-flow fraction. Hyperventilation and failure of C:V coordination were virtually ubiquitous. Future studies should focus on the impact of CPR training methods on meeting CPR parameters as documented by video recording.
- © 2013 by American Heart Association, Inc.