Observational studyThe American journal of emergency medicine2021
Evaluating pediatric advanced life support in emergency medical services with a performance and safety scoring tool.
Observational study in The American journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Does heart rate variability predict and improve performance in pediatric CPR?-a simulation study.BMC emergency medicine · 2025Trial
- Impact of emergency medical services transport on non-traumatic out-of-hospital cardiac arrest in pediatric and young adult: 25-year single-center experience.Pediatric research · 2026Article
- RESCUER mobile app to support pediatric resuscitation: Study protocol for a randomized controlled trial.Contemporary clinical trials communications · 2025Article
- A survey of team culture and learning organization in the resuscitation of neonates with congenital anomalies: A single center experience.Resuscitation plus · 2025Article
- Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children.BMC emergency medicine · 2024Article
- Comparison of Resuscitation Quality in Simulated Pediatric and Adult Out-of-Hospital Cardiac Arrest.JAMA network open · 2023Article
- Evaluation of Local Pediatric Out-of-Hospital Cardiac Arrest and Emergency Services Response.Frontiers in pediatrics · 2022Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionPediatric out-of-hospital cardiac arrests (P-OHCA) are infrequent, have low survival rates, and often have poor neurologic outcomes. Recent evidence indicates that high-performance emergency medical service (EMS) care can improve outcomes.
objectivesTo evaluate Pediatric Advanced Life Support (PALS) guideline performance in the out of hospital setting and introduce an easy-to-use tool that scores guideline compliance and patient safety.
methodsWe observed EMS teams responding to standardized pediatric resuscitation simulations. Teams were dispatched to a mock assisted living home for a choking 6-year-old with a complex medical history. The child manikin was presented as unconscious and apneic, with bradycardic pulse. Teams were expected to monitor vitals; initiate airway management and cardiopulmonary resuscitation (CPR); and establish vascular access and administer epinephrine based on PALS guidelines. We developed a tool to score the quality of care for critical tasks and had a clinical expert evaluate technical performance using blinded video review.
resultsWe observed 34 EMS teams providing care in P-OHCA simulations. Teams were proficient at assessing vitals, using correct-sized equipment, intubation, and confirmation of tube placement. Teams were delayed in initiating positive pressure ventilation (PPV) and chest compressions. Many teams (53%) deviated from guidelines in chest compressions with 17 (50%) performing continuous compressions before establishing an advanced airway and one (3%) not performing compressions. Similarly, 20 (59%) teams deviated from medication guidelines with 12 (35%) failing to administer epinephrine, six (18%) underdosing, and two (6%) overdosing by more than 20%.
conclusionEMS teams were successful in selecting the appropriate equipment but delayed initiating ventilations in a child with severe bradycardia. We also noted frequent use of continuous chest CC rather than the AHA recommended 15:2 ratio. We developed a scoring tool with time-based criteria that can be used to assess guideline compliance, individual performance, and/or educational effectiveness.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.