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Implementation of an Extracorporeal Cardiopulmonary Resuscitation Simulation Program Reduces Extracorporeal Cardiopulmonary Resuscitation Times in Real Patients*
- Source :
- Pediatric Critical Care Medicine. 15:856-860
- Publication Year :
- 2014
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2014.
-
Abstract
- To determine if development of an extracorporeal cardiopulmonary resuscitation simulation program reduced extracorporeal cardiopulmonary resuscitation times in real patients: Before-after study.Twenty-six bed pediatric cardiac ICU in a tertiary urban hospital.Forty-three cardiac patients (aged 1 d to 16 yr) who received extracorporeal cardiopulmonary resuscitation.An interdisciplinary team collaborated to define the roles and clarify responsibilities of each individual involved in extracorporeal cardiopulmonary resuscitation. An "ideal rapid deployment" was defined and tested using simulation sessions. This included a task analysis, role creation, and multidisciplinary simulations, including structured debriefings and video review and the creation of a master checklist.There were a total of 43 episodes of extracorporeal cardiopulmonary resuscitation during the study period, 16 (37%) of which occurred during the preintervention time period (from February 2009 to March 2010) and 27 (63%) during the postintervention time period (April 2010 to March 2013). The median deployment time in the preintervention time period was 51 minutes (interquartile range, 43-62 min), whereas the median deployment time in the postintervention time period was 40 minutes (interquartile range, 23-52 min) (p = 0.018).There are no standard guidelines of how a team should coordinate the efforts of nursing, physicians, extracorporeal membrane oxygenation specialists, surgeons, respiratory therapists, patient care technicians, and unit clerks to emergently execute this complex procedure. Because time is of the essence, it is essential to develop a highly functioning and well-coordinated team with a standardized method of the procedure, its documentation, and communication. Simulation accomplished this for our program. Following these simulation exercises, not only was there a subjectively observed improved coordination and smoother deployment of extracorporeal membrane oxygenation in real-life extracorporeal cardiopulmonary resuscitation, but we have also demonstrated a significantly faster deployment of extracorporeal membrane oxygenation as compared with the presimulation era.
- Subjects :
- Male
medicine.medical_specialty
Inservice Training
Time Factors
Adolescent
Treatment outcome
Intensive Care Units, Pediatric
Critical Care and Intensive Care Medicine
Tertiary Care Centers
Extracorporeal Membrane Oxygenation
medicine
Humans
Extracorporeal cardiopulmonary resuscitation
Child
Patient simulation
Extramural
business.industry
Infant, Newborn
Infant
Cardiopulmonary Resuscitation
Heart Arrest
Patient Simulation
Treatment Outcome
Child, Preschool
Pediatrics, Perinatology and Child Health
Emergency medicine
Female
business
Hospital Rapid Response Team
Urban hospital
Subjects
Details
- ISSN :
- 15297535
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- Pediatric Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....3a2b7f8ec946136526ef6544b9ed768e