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Abstract PD-004: IMPROVED QUALITY OF RESUSCITATION FOLLOWING SIMULATION TRAINING USING AN INNOVATIVE MANNEQUIN TO REPRODUCE POSTOPERATIVE TAMPONADE-ASSOCIATED ARREST

Bhalala, U.1; Thangavelu, M.1; Velazques, S.1; Patel, A.1; Weaver, K.1; Muller, N.1; McElroy, J.2; Nento, D.3; Mumtaz, M.A.3

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 29
doi: 10.1097/01.pcc.0000537406.77978.6b
Poster Discussion Abstracts
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1The Children’s Hospital of San Antonio- Baylor College of Medicine, Pediatrics, San Antonio, USA

2The Children’s Hospital of San Antonio- Baylor College of Medicine, Simulation, San Antonio, USA

3The Children’s Hospital of San Antonio- Baylor College of Medicine, Cardio-Thoracic Surgery, San Antonio, USA

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Aims & Objectives:

Tamponade-associated arrest requires timely sternotomy, and cardiopulmonary resuscitation (CPR). Additional task of sternotomy during CPR affects quality of CPR. We aimed to determine if simulation training of cardiac ICU (CICU) team using an innovative sternotomy mannequin improves quality of CPR.

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Methods

We conducted a prospective observational study using an innovative mannequin with a median sternotomy and the capability of reproducing cardiac tamponade. A structured video debriefing was conducted at the end of the scenario and CPR quality metrics were compared between the first session and 6-month follow-up session. The data was analyzed using student t-test and chi-square test (significant p≤0.05).

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Results

A total 54 CICU providers participated. At baseline, the median (IQR) times to recognize cardiac arrest, initiate CPR, place backboard and first dose of epinephrine were 9.5 (7–22), 15.5 (10–23.5), 16.5 (9.8–22.5) and 176 (107.5–186.8) seconds, respectively; number of chest compression (CC) interruptions was 22 (17.5–28) and subsequent epinephrine was administered every 3–5 min in 38% scenarios. At 6-month follow-up, the median (IQR) times to recognize cardiac arrest, initiate CPR, place backboard and first epinephrine were 8 (6–12), 12 (7–15.5), 16.5 (12.5–23.5) and 88 (62–98) seconds, respectively; number of CC interruptions was 10 (9–11) and subsequent epinephrine was administered every 3–5 min in all scenarios. After simulation training, there was a significant improvement in time to first dose (p=0.045) and subsequent doses of epinephrine (p=0.02) and number of CC interruptions (p=0.005).

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Conclusions

Simulation training of tamponade-associated arrest improved quality of CPR, especially epinephrine administration and number of CC interruptions.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies