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

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.


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

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