Pediatric Resuscitation Quality Collaborative
CPR Coach
Effective chest compression depth, rate and minimal interruptions are essential to improve outcomes following IHCA. Devices placed on the chest that provide visual feedback during cardiopulmonary resuscitation (CPR) can improve chest compression quality, but there is substantial room for improvement. Strategies are needed to help teams translate visual CPR feedback into optimized CPR delivery.
Despite continued training, adherence to CPR guidelines is low. Many institutions have introduced CPR feedback defibrillators into their acute care environments. Optimal incorporation of CPR feedback technology requires CPR providers receive information from the device and adjust CPR performance accordingly. Additionally, it has been recognized that resuscitation leaders are challenged to simultaneously manage high quality basic life support (BLS), pediatric advanced life support (PALS), diagnose and treat reversible causes, and direct and manage a complex clinical team with high accuracy and efficiency during a resuscitation event.
The CPR Coach is a supplementary resuscitation provider that provides real- time feedback to chest compressors to optimize compliance with American Heart Association (AHA) CPR guidelines and to cognitively unload the Resuscitation Leader, enabling them to focus on the PALS algorithm and reversible causes.
The CPR coach has six main responsibilities:
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Coordinate early initiation of CPR and timely defibrillation;
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Work with the leader to define specific AHA chest compression performance goals given the patient’s age and other modifying factors (i.e. BT shunt, etc.);
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Provide real-time coaching to improve the quality of chest compressions (CC), incorporating data available at the bedside (e.g. arterial line, end tidal carbon dioxide (ETCO2), real time measurements of depth and rate, etc.);
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Ergonomically optimize the team’s interaction with their environment (i.e. patient, bed, step stool, ventilator, defibrillator, etc.) to optimize performance;
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Ensure all procedures are coordinated with a goal of minimizing pauses in CC (e.g. placing backboard, intubation, defibrillation, neck dissection during ECMO, etc.);
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Keep the Resuscitation Leader informed, (e.g. meeting the defined goals or not, etc).
Many sites within the pediRES-Q collaborative have elected to implement the standardized simulation-based “CPR Coach Roll-out” curriculum and QI program under the guidance and leadership of Betsy Hunt (Johns Hopkins). This standardized curriculum utilizes the combination of rapid cycle debriefing with on-line educational materials. These select sites will initiate the curriculum within the randomized stepped wedge design in order to track the training and implementation of the standardized CPR Coach program. To ensure that the CPR Coach implementation is meeting its objective, providers will complete an online NASA Task Load Index survey to assess the resuscitation leaders perceived workload in relation to managing the resuscitation.
Visit the CPR Coach Study website for more information.