1. A Bundled Intervention to Improve
Outcomes from Pediatric Cardiac Arrest
Adam Cheng (University of Calgary), Vinay Nadkarni (CHOP)
INSPIRE @ IMSH 2014: San Francisco, California,USA
International Network for Simulation-based Pediatric Innovation, Research and Education

2. Background
• Outcomes from cardiac arrest are poor
• Several interventions (used in isolation) have been
shown to improve performance of CPR
– Use of real-time CPR feedback devices
– Post-arrest debriefing with quantitative CPR data
– Distributed CPR training (rolling refreshers)
• No studies combining these interventions and
evaluating impact on real patient outcomes
International Network for Simulation-based Pediatric Innovation, Research and Education

3. PICO Question
• P: For pediatric intensive care unit healthcare providers
• I: Does the implementation of a bundled intervention including:
(a) AHA RQI program; (b) simulation cardiac arrest program with
post-event CPR debriefing; and (c) use of real-time CPR
feedback during real events
• C: Current practice
• O: Improve quality of CPR during practice, simulated events,
real events, and ROSC in real patients?
International Network for Simulation-based Pediatric Innovation, Research and Education

4. Approach / Design
• Single group pre/post study
• Subjects: pediatric ICU providers (individuals and
teams)
– Attendings, fellows, residents, nurses, RT’s
• Phase 1: Baseline data capture
• Phase 2: Intervention phase
• Phase 3: Assessment phase
International Network for Simulation-based Pediatric Innovation, Research and Education

5. Design: Outcomes
• Performance of CPR during practice
• Performance of CPR during simulated events
• Performance of CPR during real events
• Outcomes from cardiac arrest: ROSC
International Network for Simulation-based Pediatric Innovation, Research and Education

6. Questions
• How long should each phase be?
• Should debriefing occur for simulated events and real
events?
• How many simulated events should be done per month?
• Multi-center?
International Network for Simulation-based Pediatric Innovation, Research and Education

7. Contact Information
Name:
Adam Cheng
Institution:
Alberta Children’s Hospital (KidSIM)
E-mail:
chenger@me.com
Phone:
+1-403-955-2633
International Network for Simulation-based Pediatric Innovation, Research and Education