ABSTRACT
AIM OF STUDY: The aim of this study was to evaluate the quality of cardiopulmonary resuscitation (CPR) as it relates to American Heart Association (AHA) guidelines during cardiac arrests in a pediatric emergency department at a quaternary children's hospital. BACKGROUND AND OBJECTIVES: High-quality CPR increases the likelihood of survival from pediatric out-of-hospital cardiac arrest. However, optimal performance of high-quality CPR during transition of care between prehospital and pediatric emergency department providers is challenging, and survival without comorbidities remains extremely low for out-of-hospital cardiac arrest. METHODS: This was a retrospective study of data collected from a free-standing children's hospital emergency department and level 1 trauma center. RESULTS: There were 23 pediatric CPR events for subjects younger than 18 years in the emergency department during the time of the study. Median chest compression (CC) fraction was 85% overall with the AHA goal of 80%. Compliance with this recommendation was achieved in all age groups. The CC rate averaged 112 for the entire sample. Median depth was 2.06 cm in subjects younger than 1 year, 3.95 cm in subjects 1 year old to younger than 8 years, and 5.33 cm in subjects 8 years old to younger than 18 years. These compression depth rates fell below the AHA recommendations, with the exception of those 8 years and older. CONCLUSIONS: In our study, CC fraction and CC rate were found to meet AHA targets for all age groups, whereas CC depth only met AHA targets for the 8- to 18-year-old group. The most difficult parameter was CC depth for the group of subjects younger than 1 year.
