Concurrent Block #4

911, EMS, Fire & Law Enforcement

Best Practices for Caring for Rare but High-Risk Patients in Sudden Cardiac Arrest

Pediatric High Performance CPR: From protocol to training to practice with the introduction of a novel method to improve prehospital pediatric CPR quality

Thursday, November 30, 2023

4:30 PM – 4:45 PM PST

Location: Town and Country Ballroom B

Primary Presenter(s)

Karen O'Connell, MD, MEd

Professor of Pediatrics and Emergency Medicine; Director of Patient Safety and Resuscitation
Children's National Hospital, Emergency Medicine and Trauma Center; The George Washington University School of Medicine and Health Sciences
Upper Marlboro, Maryland, United States

Disclosure information not submitted.

Moderator(s)

Loralee Olejnik, MA, EMT-B

Public Health Educator
Not representing current agency
San Diego, California, United States

Disclosure information not submitted.

Summary: Pediatric cardiac arrest continues to have poor survival outcomes. A novel chest compression: ventilation delivery method has potential to offer near continuous chest compressions, similar to hands-only CPR, with increased likelihood of survival.

Synopsis: Pediatric Out-of-Hospital Cardiac Arrests (POHCA) occur daily across the United States and the survival rate remains low. Survival is directly impacted by the response of everyone in the Chain of Survival. First with caregivers (family, friends, childcare) performing bystander CPR and activating 911. Then, the focus is on High Performance CPR for infants, children, and adolescents. Outcomes after cardiac arrest are dependent upon early, high-quality CPR (adequate rate, depth, recoil), rapid defibrillation when indicated, and early epinephrine administration.

In 2008, the AHA released new recommendations for bystander Hands-only CPR (CPR without rescue breaths). It is simple, easy to learn, especially outside the medical setting, and associated with increases in the likelihood of survival after adult cardiac arrest. Similar recommendations for the pediatric population have not yet been proposed or endorsed.

In 2018, Maryland EMS rolled out a pediatric high performance CPR protocol that incorporated a novel ventilation delivery method that resulted in nearly continuous chest compressions. The “Maryland Hiccup” method of HPCPR delivers one ventilation on each upstroke after compressions 14 and 15. Pediatric recommendations by the American Heart Association (AHA), however, still emphasize the 15:2 compression: ventilation ratio for CPR without an advanced airway in place. This new approach has the potential to simulate Hands-only CPR with minimal interruptions in children suffering from cardiac arrest.

Learning Objectives:

Become familiar with the challenges in delivering pediatric cardiac arrest care.
Learn a novel approach to delivering chest compressions and ventilations that has the potential to increase bystander initiation of CPR and improve survival outcomes.
This presentation will include ways to educate citizens that can lead to a comprehensive change to a culture of excellence and improved CPR training in the community, schools and workplace.