Abstract 273: A Comparison of Two Methods for Measuring Pediatric CPR Quality in a Pediatric Emergency Department
Background: Studies examining CPR using a sensor/accelerometer device (Q-CPR) have demonstrated that pediatric CPR is often performed suboptimally. The majority of children receiving CPR in the ED are ineligible for Q-CPR use. Recent data has shown that video recording of critical procedures in the pediatric ED is reliable for measuring outcomes.
Objective: To determine the correlation between video review and Q-CPR measurement in quantifying chest compression parameters in pediatric patients.
Methods: Children > 8 years who received CPR using the Q-CPR device and whose events were video recorded were eligible for inclusion. Videos were reviewed by study personnel; compressions were measured in 30-second epochs. Compression rate was counted directly; compression depth and chest wall release were scored dichotomously as ‘adequate’ or ‘inadequate’ based on a threshold of 80% of observed compressions meeting parameters. Q-CPR data was measured for compression rate, percent compressions with depth > 38 mm, and percent compressions with leaning force > 2.5 kg; epochs were designated as ‘adequate’ or ‘inadequate’ for depth and leaning with 80% as a threshold for parameters. Correlation between video and Q-CPR data was done by Spearman’s ρ (rate) and f coefficient (depth, release).
Results: Four patients were captured on video receiving CPR using the Q-CPR device; complete data was available for 79 30-second epochs of compressions. By Q-CPR measurement, median rate of compressions was 114 per minute (range 91 - 127). A median of 53% (range 0 - 100%) of compressions were > 38 mm per epoch. A median of 2% (range 0 - 100%) compressions had residual leaning force of > 2.5 kg. By video review, median rate was 108 compressions per minute (range 66 - 132); depth was scored as adequate in 72/79 (91%) of epochs; release was scored as adequate in 72/79 (91%) of epochs. Correlation was very good for rate (ρ = 0.73) and poor for release (f = 0.06) and depth (f = 0.02).
Conclusions: Video review of CPR in children measures compression rate reliably when compared with Q-CPR data. Video review does not accurately determine compression depth or chest wall release. Future studies should examine whether video recording can be optimized to allow reliable measurement of depth and leaning in children.
- © 2013 by American Heart Association, Inc.