Quality of cardio-pulmonary resuscitation (CPR) during paediatric resuscitation training: time to stop the blind leading the blind.

Authors:	Muhammad Arshid, Tsz-Yan Milly Lo, Fiona Reynolds
Language:	Eng.
Date:	2009-05-04
Journal:	Resuscitation (0300-9572)
Release:	Resuscitation. 2009 May;80(5):558-60
Abstract:	AIMS: Recent evidence suggested that the quality of cardio-pulmonary resuscitation (CPR) during adult advanced life support training was suboptimal. This study aimed to assess the CPR quality of a paediatric resuscitation training programme, and to determine whether it was sufficiently addressed by the trainee team leaders during training. METHODS: CPR quality of 20 consecutive resuscitation scenario training sessions was audited prospectively using a pre-designed proforma. A consultant intensivist and a senior nurse who were also Advanced Paediatric Life Support (APLS) instructors assessed the CPR quality which included ventilation frequency, chest compression rate and depth, and any unnecessary interruption in chest compressions. Team leaders' response to CPR quality and elective change of compression rescuer during training were also recorded. RESULTS: Airway patency was not assessed in 13 sessions while ventilation rate was too fast in 18 sessions. Target compression rate was not achieved in only 1 session. The median chest compression rate was 115 beats/min. Chest compressions were too shallow in 10 sessions and were interrupted unnecessarily in 13 sessions. More than 50% of training sessions did not have elective change of the compression rescuer. 19 team leaders failed to address CPR quality during training despite all team leaders being certified APLS providers. CONCLUSIONS: The quality of CPR performance was suboptimal during paediatric resuscitation training and team leaders-in-training had little awareness of this inadequacy. Detailed CPR quality assessment and feedback should be integrated into paediatric resuscitation training to ensure optimal performance in real life resuscitations.
Copyright:	Resuscitation Department of Paediatric Intensive Care Medicine, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.
Full text:	DOI - Resuscitation (DOI) EBSCO - HTML (needs subscription) Elsevier Science - HTML (needs subscription) OhioLINK Electronic Journal Center - HTML (needs subscription) Swets Information Services - HTML (needs subscription)
Terms:	Cardiopulmonary Resuscitation, Clinical Competence, Guideline Adherence, Heart Massage, Humans, Infant, Inservice Training, Manikins, Models, Educational, Pediatrics, Practice Guidelines as Topic, Program Evaluation, Teaching