Use of cognitive aids in paediatric out-of-hospital cardiac arrest

Abstract

Background: Paediatric cardiac arrest resuscitation is a high-stakes, rare event that can cause high stress levels in emergency medical services (EMS) practitioners. The demands of this work could raise cognitive load on practitioners, which may contribute to adverse safety events. Methods: An EMS agency survey was developed as part of a larger study into organisation-level factors that affect paediatric out-of-hospital cardiac arrest care. Questions focused on the types and numbers of cognitive aids, and whether a paediatric emergency care coordinator (PECC) was present. The number and frequency of these aids were analysed, and statistical significance assessed. The number and type of aids were stratified according to the presence of a PECC and paediatric call volumes. Results: The number of available resources ranged from 0 to 4, with a mean of 2.6 and a median of 3; the average number used was 2.0. These figures are higher than for adults. The most commonly available resources were local protocols, followed by local medication/equipment guides and Broselow tape. The least commonly available were paediatric advanced life support cards. No significant differences were found between the number of resources and the presence of a PECC or call volume. Conclusion: There is wide variability of resources to support EMS providers in the resuscitation of infants and children in out-of-hospital cardiac arrest.