Abstract 302: Pediatric CPR Performance During One Year of RQI in a Pediatric Emergency Department

The Resuscitation Quality Improvement Program is a low-dose high-frequency training method for CPR skills. Evidence linking high-frequency training to improved performance during actual CPR is lacking. We have previously reported on the simultaneous use of video review and chest compression (CC) monitoring devices to describe CC quality at the level of individual providers. We sought to evaluate CC quality in pediatric CPR over a one year period following RQI implementation. Methods: Observational study in a pediatric ED where codes are videorecorded and where all providers were enrolled in RQI in October 2017. Video review is used to identify CPR providers and measure the duration of CC segments they perform. A monitor device is used to record CC depth and rate, allowing summarization of CC parameters for those individual time segments (i.e. CC performance by individual providers). CCs were analyzed by ‘compressor segment’, defined as the period of time where a single provider performed chest compressions until replaced by another. Data was summarized by quarter; change over time was analyzed by mixed effect logistic regression modeling adjusting for quarter and segment duration as fixed effects. Results: 159 providers enrolled in RQI. Data for 18 events totaling 206 CC segments were analyzed. 52 providers performed CC at some point during the study period. CC segments are graphed per quarter in Figure 1. There were no significant differences in proportion of CC segments meeting guidelines during the study period. Conclusions: CPR events in our ED are infrequent and a minority of providers perform CPR in routine clinical practice. Over a 15 month period following the implementation of RQI in a pediatric ED, CC quality during CPR events in children did not improve with time, although our analysis was limited by sample size constraints. Future research should expand this method to examine the impact of varied retraining intervals and varied participant groups on CC quality.