| Anesthesiology residents' performance of pediatric resuscitation during a simulated hyperkalemic cardiac arrest. | |
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MedLine Citation:
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PMID: 20234308 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Anesthesiologists are responsible for the management of perioperative cardiopulmonary arrest in children. This study used simulation to assess the pediatric resuscitation skills of experienced anesthesia residents. METHODS: Nineteen anesthesia residents were evaluated using a pediatric pulseless electrical activity scenario. The authors used a standardized checklist to evaluate the residents' diagnostic and therapeutic interventions. RESULTS: After the onset of pulseless electrical activity, 79% of residents initiated cardiopulmonary resuscitation within 1 min. Approximately one third (31%) performed chest compressions at the recommended rate. Epinephrine was administered by 95% of residents, but only one third used the correct pediatric dose. All residents administered fluid boluses, but only 16% administered the recommended volume. Only one fourth of the residents considered hyperkalemia as a cause of pulseless electrical activity. None of the residents asked for dosing aids. CONCLUSION: During this simulated pediatric emergency, anesthesia residents demonstrated an acceptable knowledge of general resuscitation maneuvers. However, a subset of resuscitation skills was incorrectly performed, mostly related to age or weight. Importantly, many residents did not consider the full differential diagnosis of pulseless electrical activity. Anesthesia residents may benefit from additional pediatric resuscitation training and practice using cognitive aids to access dosages and complicated diagnostic algorithms. |
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Authors:
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Kimberly J Howard-Quijano; Marjorie A Stiegler; Yue Ming Huang; Cecilia Canales; Randolph H Steadman |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Anesthesiology Volume: 112 ISSN: 1528-1175 ISO Abbreviation: Anesthesiology Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-14 Completed Date: 2010-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
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Languages: eng Pagination: 993-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California 90095-7403, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesiology
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education* Cardiopulmonary Resuscitation Checklist Child Clinical Competence Electroencephalography Epinephrine / administration & dosage, therapeutic use Heart Arrest / therapy* Humans Hyperkalemia / complications* Infant Internship and Residency Male Patient Simulation Resuscitation Vasoconstrictor Agents / administration & dosage, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Vasoconstrictor Agents; 51-43-4/Epinephrine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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