In this issue, we collaborated with the INSPIRE (International Network for Simulation-based Pediatric Innovation, Research, & Education) team to create an infographic on the article “Adherence to Pediatric Cardiac Arrest Guidelines Across a Spectrum of Fifty Emergency Departments: A Prospective, In Situ, Simulation-Based Study” published by Auerbach et al.1
Previous research has demonstrated an increase in the adherence of American Heart Association (AHA) guidelines lead to better survival rates, and emergency departments (ED) with higher patient volume had decreased mortality in adults.2,3 As there was a gap in the research regarding the association of pediatric ED volume with adherence to AHA guidelines, Dr. Auerbach and his team proceeded with investigations in this area using in situ simulation of pediatric cardiac arrest.
The methods and results are summarized above. In addition, path analysis was also performed. In layman terms, a path analysis is a type of multiple regression used to determine the influence of multiple independent variables on one another. Significant path coefficients included:
- Direct path between median pediatric volume and the basic life support (BLS) and pulseless electrical activity (PEA) cardiac arrest domain scores
- Direct path between pediatric volume and simulation team assessment tool (STAT) and pediatric readiness score (PRS) scores
- The effects of PRS scores on cardiac arrest domains was only evident for ventricular fibrillation (VF)
These findings mean that teams whose pediatric volume was higher than the median had better BLS and PEA cardiac arrest domain scores, and better STAT and PRS scores. See below for a visual representation.
In summary, this study demonstrated variable adherence to pediatric guidelines across a spectrum of EDs. Currently, approaches to optimizing pediatric arrest care are insignificant and consideration of improving approaches should be taken.