Hazwani Tarek R, Alosaimi Arwa, Almutairi Manal, Shaheen Naila, Al Hassan Zahra, Antar Mohannad
Pediatric Intensive Care, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, SAU.
Pediatric Critical Care, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Cureus. 2020 Jul 15;12(7):e9197. doi: 10.7759/cureus.9197.
Background Cardiopulmonary arrest is an uncommon event in pediatric patients. Additionally, physicians-in-training see far fewer cardiopulmonary arrest events. Therefore, they have limited confidence in their resuscitation skills. Mock code training with active participation and debriefing may be an effective tool to fill this gap in experience. The aims of the study were to assess the impact of a mock code simulation program on patient outcome for children with cardiopulmonary arrest in a tertiary pediatric academic center and provide evidence that code simulations can improve the quality of cardiopulmonary resuscitation (CPR). Methods This was a retrospective cohort study conducted in a tertiary academic center. This study had two phases: Phase 1 before the mock code simulation program began (pre-intervention) and Phase 2 after the mock code program began (post-intervention). The data were collected from pediatric patients with cardiopulmonary arrest during the study period who met the inclusion criteria, and variables included the survival rate at hospital discharge, CPR initiation time, time to the first dose of epinephrine, and the adherence rate to American Heart Association (AHA) guidelines. Results A total of 13 patients in the pre-intervention period and 19 patients in the post-intervention period were included. The results showed a significant improvement in team performance represented by a decrease in CPR initiation time post-intervention and improvement in AHA adherence; however, the results did not show a significant difference in the survival rate or mortality within 28 days of the cardiopulmonary arrest event between the pre- and post-intervention groups. Conclusions Mock code simulation was a helpful tool to enhance team performance and improve the quality of cardiac resuscitation and cardiac arrest recognition, while its impact on the survival rate was not significant in our study.
心肺骤停在儿科患者中是一种不常见的事件。此外，正在接受培训的医生目睹的心肺骤停事件要少得多。因此，他们对自己的复苏技能信心有限。积极参与和进行总结汇报的模拟急救培训可能是填补这一经验空白的有效工具。本研究的目的是评估模拟急救模拟项目对三级儿科教学中心心肺骤停儿童患者结局的影响，并提供证据证明急救模拟可提高心肺复苏（CPR）质量。方法：这是一项在三级教学中心进行的回顾性队列研究。本研究分为两个阶段：第一阶段在模拟急救模拟项目开始前（干预前），第二阶段在模拟急救项目开始后（干预后）。收集研究期间符合纳入标准的心肺骤停儿科患者的数据，变量包括出院生存率、CPR开始时间、首次使用肾上腺素的时间以及对美国心脏协会（AHA）指南的依从率。结果：干预前期共纳入13例患者，干预后期共纳入19例患者。结果显示，以干预后CPR开始时间缩短和AHA依从性提高为代表的团队表现有显著改善；然而，干预前组和干预后组之间在心肺骤停事件后28天内的生存率或死亡率没有显著差异。结论：模拟急救模拟是提高团队表现、改善心脏复苏质量和心脏骤停识别能力的有用工具，而在我们的研究中，其对生存率的影响并不显著。
