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Study Objectives: Severe events of respiratory distress can be life threatening. Although rare in some outpatient settings, effective recognition and management are essential to improving outcomes. The value of high-fidelity simulation has not been assessed for sleep technologists (STs). We hypothesized that knowledge of and comfort level in managing emergent pediatric respiratory events would improve with this innovative method., Methods: We designed a course that utilized high-fidelity human patient simulators (HPS) and that focused on rapid pediatric assessment of young children in the first 5 minutes of an emergency. We assessed knowledge of and comfort with critical emergencies that STs may encounter in a pediatric sleep center utilizing a pre/post-test study design., Results: Ten STs enrolled in the study, and scores from the pre- and posttest were compared utilizing a paired samples t-test. Mean participant age was 42 ± 11 years, with average of 9.3 ± 3.3 years of ST experience but minimal experience in managing an actual emergency. Average pretest score was 54% ± 17% correct and improved to 69% ± 16% after the educational intervention (p < 0.05). Participant ratings indicated the course was a well-received, innovative educational methodology., Conclusions: A simulation course focusing on respiratory emergencies requiring basic life support skills during the first 5 min of distress can significantly improve the knowledge of STs. Simulation may provide a highly useful methodology for training STs in the management of rare life-threatening events.

Objective: To examine the hypothesis that pediatric resuscitation providers hyperventilate patients via bag-valve-mask (BVM) ventilation during performance of cardiopulmonary resuscitation (CPR), quantify the degree of excessive ventilation provided, and determine if this tendency varies according to provider type., Methods: A retrospective, observational study was conducted of 72 unannounced, monthly simulated pediatric medical emergencies ("mock codes") in a tertiary care, academic pediatric hospital. Responders were code team members, including pediatric residents and interns (MDs), respiratory therapists (RTs), and nurses (RNs). All sessions were video-recorded and reviewed for the rate of BVM ventilation, rate of chest compressions, and the team members performing these tasks. The type of emergency, location of the code, and training level of the team leader were also recorded., Results: Hyperventilation was present in every mock code reviewed. The mean rate of BVM ventilation for all providers in all scenarios was 40.6 ± 11.8 breaths per minute (BPM). The mean ventilation rates for RNs, RTs, and MDs were 40.8 ± 14.7, 39.9 ± 11.7, and 40.5 ± 10.3 BPM, respectively, and did not differ among providers (P = .94). All rates were significantly higher than the recommended rate of 8 to 20 BPM (per Pediatric Advanced Life Support guidelines, varies with patient age) (P < .001). The mean ventilation rate in cases of isolated respiratory arrest was 44.0 ± 13.9 BPM and was not different from the mean BVM ventilation rate in cases of cardiopulmonary arrest (38.9 ± 14.4 BPM; P = .689)., Conclusions: Hyperventilation occurred in simulated pediatric resuscitation and did not vary according to provider type. Future educational interventions should focus on avoidance of excessive ventilation.