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Mock CPR 'codes' expose weaknesses in hospital emergency response for children
Date:2/8/2008

Staging mock cardiac and respiratory arrests - code situations in hospital parlance - easily expose common failures in rapid response with CPR and other life-saving care for children and also set up powerful incentives to sharpen emergency skills and move fast to use them, suggests a study from the Johns Hopkins Childrens Center.

Results of the study, conducted in part at Hopkins Childrens, and published in the January issue of Pediatrics, found sometimes alarming delays and lapses in emergency care among first-responders during the critical five minutes after a childs heart or breathing stops.

Although cardiopulmonary arrest deaths or permanent brain damage are relatively rare among hospitalized children, the mock drills, the researchers say, could help hospitals nationwide improve such dismal outcomes by focusing attention on fast action and the highly detectable events that lead up to such failures before they occur in real patients.

Past research estimates that only 14 percent to 36 percent of children who suffer an arrest in the hospital survive, although the absolute number of deaths is quite small.

An honest look at what goes wrong is uncomfortable but worth it if it means preventing harm to patients, says lead investigator Elizabeth Hunt, M.D., M.P.H., a critical-care specialist at Hopkins Childrens. Our hope is that other hospitals will use our model to test their own performance.

Using a child-size dummy, researchers staged a series of pretend codes between 2000 and 2003 at Hopkins Childrens and another local hospital, simulating cardiac or pulmonary distress. In 75 percent of the 34 mock codes, nurses and residents failed to immediately check the ABCs (airway, breathing, circulation) and perform basic cardiopulmonary resuscitation (CPR) maneuvers such as opening the airway, checking the pulse and starting chest compressions. Virtually all mock codes revealed at least one resuscitation error, and
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Contact: Katerina Pesheva
epeshev1@jhmi.edu
410-516-4996
Johns Hopkins Medical Institutions
Source:Eurekalert

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