A mixed methods evaluation of paediatric trainee preparedness to manage cardiopulmonary arrests
- 434 Downloads
Paediatric cardiopulmonary arrest (CPA) survival rates are strongly linked to the training of the doctors responding to the event. This study sought to characterise the level of experience in managing CPAs among paediatric trainees and to investigate the nontechnical (NTS) required to effectively lead a paediatric CPA team. A mixed-methods research design was used. For the quantitative phase, a questionnaire was developed to assess training, confidence, and experiences related to CPA management. During the qualitative phase, 17 paediatric trainees participated in a series of critical incident technique (CIT) interviews to explore the NTS used during the management of paediatric CPAs. A total of 56 of 131 (37.1% response rate) trainees responded to the preparedness questionnaire. A total of 48.2% of respondents expressed low confidence in their skill as a team leader during the management of a CPA. The CIT interviews highlighted deficiencies in specific NTS (identifying options, prioritising, and identifying and utilising resources).
What is Known
• Levels of preparedness to be a paediatric cardiopulmonary arrests team member/leader are generally lower than desirable.
• The importance of nontechnical skills to the effective performance of adult cardiopulmonary arrests teams has been identified.
What is New
• Levels of preparedness to be a cardiopulmonary arrests team member were higher than reported in US studies.
• There is a need for greater training in cardiopulmonary arrest management which includes a focus on key nontechnical skills to include identifying options, prioritising, identifying and utilising resources.
KeywordsResuscitation Paediatrics Nontechnical skills Preparedness
Anaesthetists Non-Technical Skills
critical incident technique
Crew Resource Management.
OW carried out the data collection, data analysis, wrote the draft of the manuscript and rewrote new drafts. POC contributed to the design of the project, data analysis, data interpretation, provided input into the content of the manuscript and contributed to the revisions of the manuscript. SL contributed to the data interpretation, provided input into the content of the manuscript and contributed to the revisions of the manuscript. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
Órla Walsh declares that she has no conflict of interest. Sinéad Lydon declares that she has no conflict of interest. Paul O’Connor declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 1.Knudson JD, Neish SR, Cabrera AG, Lowry AW, Shamzad P, Morales DL, Graves DE, Williams EA, Rossano JW (2012) Prevalence and outcomes of pediatric in-hospital cardiopulmonary resuscitation in the United States: an analysis of the kids’ inpatient database. Crit Care Med 40:2940–2944CrossRefPubMedGoogle Scholar
- 6.Luten R, Wears RL, Broselow J, Croskerry P, Joseph MM, Frush K (2002) Managing the unique size-related issues of pediatric resuscitation: reducing cognitive load with resuscitation aids. Acad. Emerg Med 9:840–847Google Scholar
- 11.Flin R, O’Connor P, Crichton M (2008) Safety at the sharp end: training non-technical skills. Ashgate Publishing Ltd, AldershotGoogle Scholar
- 22.University of Aberdeen (2015) Framework for observing and rating Anaesthetists’ Non-Technical Skills (ANTS) system handbook Available from: http://www.abdn.ac.uk/iprc/documents/ants/ants_handbook_v1.0_electronic_access_version.pdf (Accessed 2 December 2015)
- 23.Health Services Excutive (2016) Sixth annual assessment of NCHD posts 2015–2016. Author, DublinGoogle Scholar
- 27.Brilli RJ, Gibson R, Luria JW, Wheeler TA, Shaw J, Linam M, Kheir J, McLain P, Lingsch T, Hall Haering A, McBride M (2007) Implementation of a medical emergency team in a large pediatric teaching hospital prevents respiratory and cardiopulmonary arrests outside the intensive care unit. Ped Crit Care Med 8:236–246CrossRefGoogle Scholar