Abstract 325: Resuscitation Practices in Pediatric Hospitals: Insights From Get with the Guidelines-Resuscitation

Abstract

Background: Resuscitation practices for adult in-hospital cardiac arrest (IHCA) vary widely, based on setting and size. Resuscitation practices in pediatric hospitals have not been examined in detail, and whether practices differ between free-standing pediatric hospitals and combined hospitals (which care for adults and children) is unknown. Methods: We conducted a survey of U.S. hospitals that submit data on pediatric IHCA to GWTG-Resuscitation, a large national registry of IHCA, to elicit detailed information on resuscitation practices. Hospitals were categorized as free-standing pediatric hospitals and combined hospitals, and rates of resuscitation practices were compared. Results: A total of 33 hospitals with at least 5 IHCA events between 2015-2019 completed the survey, of which 9 (27.3%) were freestanding pediatric hospitals and 24 (72.7%) were combined hospitals. Overall, 18 (54.5%) hospitals used a device to measure chest compression quality, 2 (6.1%) used a mechanical device to deliver chest compressions, 6 (18.2%) routinely monitored diastolic pressures during resuscitations, 16 (48.5%) had a staff member monitor chest compression quality, 10 (30.3%) used lanyards or hats to designate leaders during a resuscitation, 16 (48.5%) routinely conducted immediate code debriefings, and 7 (21.2%) conducted mock codes at least quarterly and 17 (51.5%) reported no set schedule. Freestanding pediatric hospitals were more likely to employ a device to measure chest compressions (88.9% vs. 41.7%; P=0.016), conduct code debriefing always or frequently after resuscitations (77.8% vs. 37.5%, P=0.044), use lanyards or a hat to designate the code team leader during resuscitations (66.7% vs. 16.7%, P=0.006), and allow nurses to defibrillate using an AED (77.8% vs. 29.2%, P=0.01). There were no differences in simulation frequency or other resuscitation practices between the 2 hospital groups. Conclusions: Across hospitals caring for pediatric patients, substantial variation exists in resuscitation practices. For some resuscitation practices, there were differences between freestanding pediatric hospitals and hospitals which care for both adults and children.