Chan Jesse L, Nallamothu Brahmajee K, Tang Yuanyuan, Roberts Joan S, Kennedy Mary, Trumpower Brad, Chan Paul S
Pembroke Hill High School, 5121 State Line Road, Kansas City, MO 64112, USA.
VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA.
Resusc Plus. 2022 Mar 17;9:100199. doi: 10.1016/j.resplu.2021.100199. eCollection 2022 Mar.
Resuscitation practices in pediatric hospitals have not been compared, and whether practices differ between freestanding pediatric only hospitals and combined hospitals (which care for adults and children) is unknown.
We surveyed hospitals that submit data on pediatric in-hospital cardiac arrest (IHCA) to Get-With-The Guidelines®-Resuscitation, to elicit information on resuscitation practices. Hospitals were categorized as pediatric only and combined hospitals, and rates of resuscitation practices were compared.
Thirty-three hospitals with ≥5 IHCA events between 2017-2019 completed the survey, of which 9 (27.3%) were pediatric only and 24 (72.7%) were combined hospitals. Overall, 18 (54.5%) hospitals used a device to measure chest compression quality, 16 (48.5%) had a staff member monitor chest compression quality, 10 (30.3%) used lanyards or hats to designate code leaders during a resuscitation, 16 (48.5%) routinely conducted code debriefings immediately after a resuscitation, and 7 (21.2%) conducted mock codes at least quarterly with 17 (51.5%) reporting no set schedule. Pediatric only hospitals were more likely to employ a device to measure chest compressions (88.9% vs. 41.7%; P = 0.02), conduct code debriefings always or frequently after resuscitations (77.8% vs. 37.5%, P = 0.04), use lanyards or a hat to designate the code team leader during resuscitations (66.7% vs. 16.7%, P = 0.006), and allow nurses to defibrillate using an AED (77.8% vs. 29.2%, P = 0.01). There were no differences in simulation frequency or other resuscitation practices between the two hospital groups.
Across hospitals caring for children, substantial variation exists in resuscitation practices, with notable differences between pediatric only and combined hospitals.
儿科医院的复苏实践尚未得到比较，独立的儿科专科医院与综合医院（同时收治成人和儿童）的实践是否存在差异尚不清楚。
我们对向“遵循指南®-复苏”提交儿科院内心脏骤停（IHCA）数据的医院进行了调查，以获取复苏实践的相关信息。医院被分为儿科专科医院和综合医院，并对复苏实践率进行了比较。
33家在2017 - 2019年间发生≥5次IHCA事件的医院完成了调查，其中9家（27.3%）为儿科专科医院，24家（72.7%）为综合医院。总体而言，18家（54.5%）医院使用设备测量胸外按压质量，16家（48.5%）有工作人员监测胸外按压质量，10家（30.3%）在复苏期间使用挂绳或帽子指定代码负责人，16家（48.5%）在复苏后立即常规进行代码汇报，7家（21.2%）至少每季度进行一次模拟代码演练，17家（51.5%）报告没有固定时间表。儿科专科医院更有可能使用设备测量胸外按压（88.9%对41.7%；P = 0.02），在复苏后总是或频繁进行代码汇报（77.8%对37.5%，P = 0.04），在复苏期间使用挂绳或帽子指定代码团队负责人（66.7%对16.7%，P = 0.006），并允许护士使用自动体外除颤器（AED）进行除颤（77.8%对29.2%，P = 0.01）。两组医院在模拟演练频率或其他复苏实践方面没有差异。
在照顾儿童的医院中，复苏实践存在很大差异，儿科专科医院和综合医院之间存在显著差异。
