Cardiac Arrest Survival in Pediatric and General Emergency Departments

This study demonstrated variable adherence to pediatric cardiac arrest guidelines across a spectrum of EDs. Overall adherence was not associated with ED pediatric volume. Medium-high-volume EDs demonstrated the highest levels of adherence for BLS and PEA. Lower-volume EDs were noted to have lower adherence to BLS guidelines. Improved adherence was not directly associated with higher PRS score provider experience, simulation teamwork performance, or more providers with PALS training. This study demonstrates that current approaches optimizing the care of children in cardiac arrest in the ED (provider training, teamwork training, environmental preparation) are insufficient.

Section: Discussioncontrasting

confidence: 95%

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confidence: 99%

Adherence to Pediatric Cardiac Arrest Guidelines Across a Spectrum of Fifty Emergency Departments: A Prospective, In Situ, Simulation‐based Study

Auerbach

Brown

Whitfill

et al. 2018

“…Emergency department visits were classified as occurring at either a pediatric or general ED. A pediatric ED was defined as having more than 75% of its visits made by patients under 18 years of age …”

Section: Methodsmentioning

confidence: 99%

Use of a National Database to Assess Pediatric Emergency Care Across United States Emergency Departments

Michelson

Lyons

Hudgins

et al. 2018

Self Cite

“…In terms of patient outcomes, mortality is the ultimate outcome that differs by type of ED. Children with atraumatic out‐of‐hospital cardiac arrest have higher survival in pediatric EDs than general EDs (33.8% vs. 18.9%, p < 0.001) with an adjusted OR of survival in pediatric ED compared to general EDs of 2.2 (95% CI = 1.7–2.8) . Other studies have shown similar findings, with halved mortality rates in very high pediatric volume EDs (≥50,000 annual pediatric visits per year) compared with low‐pediatric‐volume EDs …”

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confidence: 63%

A Research Agenda to Advance Pediatric Emergency Care Through Enhanced Collaboration Across Emergency Departments

Barata

Auerbach

Badaki-Makun

et al. 2018

This subcommittee consisting of emergency medicine, pediatric emergency medicine, and quality improvement (QI) experts, as well as a patient advocate, identified main outcome gaps in the care of children in the emergency departments (EDs) in the following areas: variations in pediatric care and outcomes, pediatric readiness, and gaps in knowledge translation. The goal for this session was to create a research agenda that facilitates collaboration and partnering of diverse stakeholders to develop a system of care across all ED settings with the aim of improving quality and increasing safe medical care for children. The following recommended research strategies emerged: explore the use of technology as well as collaborative networks for education, research, and advocacy to develop and implement patient care guidelines, pediatric knowledge generation and dissemination, and pediatric QI and prepare all EDs to care for the acutely ill and injured pediatric patients. In conclusion, collaboration between general EDs and academic pediatric centers on research, dissemination, and implementation of evidence into clinical practice is a solution to improving the quality of pediatric care across the continuum.