Navigation Links
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 there was miscommunication among caregivers in all drills.

While the codes were staged in general pediatric wards rather than the intensive care unit or the emergency room, where children are most likely to arrest and receive aggressive treatment from special code teams, arrests also happen on general wards, and delays in stabilizing children can have disastrous consequences.

Nurses, who are typically the first-responders on general wards, seemed to focus first on preparing the room for the arrival of the critical-care team rather than responding directly with ABCs and CPR, investigators observed.

We see a lot of people whove lost their first-responder instincts because were asking them to do too much, says Hunt. The drills have a way of getting them back to the basics-open the airway, assess breathing and restore circulation. Its really as simple as that.

Since 2003, when the study ended, Hopkins Childrens now:

  • Clearly states in nurse job descriptions that they are required to act as first responders

  • Stages monthly mock codes for pediatric residents at all locations within Hopkins Childrens

  • Holds monthly classes on pediatric resuscitation and advanced life support

Hopkins Childrens also uses special rapid-response teams that can be called to a general ward anytime a nurse or a resident notices subtle changes in a childs status that might signal an impending crisis, such as heavy breathing, fast heart rate and irritability, an often-ignored red flag that might mean the brain isnt getting enough oxygen. Our mantra to the nurses has been call early even if it means a false alarm, Hunt says.


'/>"/>

Contact: Katerina Pesheva
epeshev1@jhmi.edu
410-516-4996
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. ZIP codes and property values predict obesity rates
2. Many Babies Exposed to Chemicals
3. Research finds allergic children exposed to peanuts at younger ages despite recommendations to avoid
4. UGA study: Youth exposed to smokeless tobacco ads despite settlement
5. With the Largest-Ever Buyout of a National Nursing Home Chain Pending ... New York Times Exposes Harm to Seniors After Private Equity Buyouts of Nursing Homes
6. New York Times Exposes Harm to Seniors After Private Equity Buyouts of Nursing Homes
7. Studies Probe Weaknesses in Donated Blood
8. Seattle Cancer Care Alliance and Northwest Hospital Sign Letter of Intent to Develop Proton Therapy Center for Cancer Treatment
9. Popular Florida Restaurant Leads Hospitality Industry by Converting to Pasteurized Shell Eggs Usage
10. NIH, Gates Foundation to support Riley Hospital and MoiU Program For Woman and Infant Health Researc
11. Elephant Ensemble Theater Brings New Production to Bronx Hospitals
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... ... health professionals, announced today its affiliation with Tennessee Counseling Association. This ... the network of the Tennessee Counseling Association, adding exclusive benefits and promotional offers. ...
(Date:6/27/2016)... ... June 27, 2016 , ... TopConsumerReviews.com recently awarded their highest five-star rating to ... of individuals in the United States and Canada wear eyeglasses. Once considered to be ... vision and make a fashion statement. Even celebrities use glasses as a way of ...
(Date:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... Pixel Film ... Pro X. , "Film editors can give their videos a whole new perspective by ... Austin - CEO of Pixel Film Studios. , ProSlice Levels contains over 30 ...
(Date:6/26/2016)... ... June 26, 2016 , ... ... have been diagnosed with endometriosis. These women need a treatment plan to not ... comprehensive approach that can help for preservation of fertility and ultimately achieving a ...
(Date:6/25/2016)... ... , ... The temporary closing of Bruton Memorial Library on June 21 due to a possible ... often overlooked aspect of head lice: the parasite’s ability to live away from a human ... but a necessary one in the event that lice have simply gotten out of control. ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... , June 24, 2016 According ... by Type (Standard Pen Needles, Safety Pen Needles), Needle ... GLP-1, Growth Hormone), Mode of Purchase (Retail, Non-Retail) - ... This report studies the market for the forecast period ... reach USD 2.81 Billion by 2021 from USD 1.65 ...
(Date:6/24/2016)... Belgium , June 24, 2016 ... the appointment of Dr. Edward Futcher ... Non-Executive Director, effective June 23, 2016.Dr. Futcher was ... Nominations and Governance Committees.  As a non-executive member ... independent expertise and strategic counsel to VolitionRx in ...
(Date:6/23/2016)... 2016  MedSource announced today that it has ... solution of choice.  This latest decision demonstrates MedSource,s ... their clients by offering a state-of-the-art electronic data ... nowEDC as the EDC platform of choice in ... "nowEDC has long been a preferred EDC platform ...
Breaking Medicine Technology: