184 QUANTITATIVE AND QUALITATIVE COMPARISON OF A NOVEL SIMULATION-BASED PEDIATRIC RESUSCITATION TRAINING PROGRAM WITH A STANDARD PEDIATRIC ADVANCED LIFE SUPPORT COURSE.

Respiratory failure is the most common cause of cardiopulmonary arrest in children. Early recognition of the critically ill child and aggressive management of respiratory failure and shock are crucial to preventing cardiopulmonary arrest. Although caring for a sick child can be highly stressful for emergency physicians, pediatric resuscitation largely mirrors that of adults, with special consideration of a few key anatomic and physiologic differences. It is important to have a systematic approach to patient assessment, medication dosing, and equipment sizing in order to cognitively offload the emergency provider. The following will help maximize performance in these high-stakes situations: the Pediatric Assessment Triangle combined with the familiar airway, breathing, circulation, disability, exposure approach; an age-, weight-, or length-based medication/equipment system; and routine application of Pediatric Advanced Life Support algorithms.

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Peer-led pediatric resuscitation training: effects on self-efficacy and skill performance

BMC Medical Education ◽

10.1186/s12909-020-02359-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

M. Binkhorst ◽

J M Th Draaisma ◽

Y. Benthem ◽

E. M. R. van de Pol ◽

M. Hogeveen ◽

...

Keyword(s):

Medical Students ◽

Self Efficacy ◽

Basic Life Support ◽

Life Support ◽

Controlled Trial ◽

Training Session ◽

Real Life ◽

Pediatric Resuscitation ◽

Resuscitation Training ◽

Skill Performance

Abstract Background Peer-led basic life support training in medical school may be an effective and valued way of teaching medical students, yet no research has been conducted to evaluate the effect on the self-efficacy of medical students. High self-efficacy stimulates healthcare professionals to initiate and continue basic life support despite challenges. Methods A randomized controlled trial, in which medical students received pediatric basic life support (PBLS) training, provided by either near-peer instructors or expert instructors. The students were randomly assigned to the near-peer instructor group (n = 105) or expert instructor group (n = 108). All students received two hours of PBLS training in groups of approximately 15 students. Directly after this training, self-efficacy was assessed with a newly developed questionnaire, based on a validated scoring tool. A week after each training session, students performed a practical PBLS exam and completed another questionnaire to evaluate skill performance and self-efficacy, respectively. Results Students trained by near-peers scored significantly higher on self-efficacy regarding all aspects of PBLS. Theoretical education and instructor feedback were equally valued in both groups. The scores for the practical PBLS exam and the percentage of students passing the exam were similar in both groups. Conclusions Our findings point towards the fact that near-peer-trained medical students can develop a higher level of PBLS-related self-efficacy than expert-trained students, with comparable PBLS skills in both training groups. The exact relationship between peer teaching and self-efficacy and between self-efficacy and the quality of real-life pediatric resuscitation should be further explored. Trial registration ISRCTN, ISRCTN69038759. Registered December 12th, 2019 – Retrospectively registered.

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The Potential Impact of Cardiopulmonary Cerebral Resuscitation (CPCR) Education

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00043855 ◽

1985 ◽

Vol 1 (S1) ◽

pp. 70-74

Author(s):

Peter Safar

Keyword(s):

Life Support ◽

Advanced Life Support ◽

Heart Association ◽

Pilot Project ◽

World Federation ◽

Ambulance Personnel ◽

Knowledge And Skills ◽

Training Systems ◽

Resuscitation Training ◽

Potential Impact

This is an introduction for a one-day CPCR course for intended instructors-coordinators. The course is a pilot project using a new manual. Its goal is to explore the feasibility of instructors using semi-self-training modes to acquire the necessary knowledge and skills for the organization of basic and advanced life support courses in CPR for all types of personnel, ranging from the lay public via ambulance personnel and nurses to physician generalists and physician specialists. The American Heart Association (AHA) CPR courses for instructors-to-be were originated in Pittsburgh in the early 1960s; this present course, sponsored by the World Federation of Societies of Anesthesiologists (WFSA) CPR Committee was given in 1981. The traditional 2 to 3 days CPR instructors' courses for physicians have spread knowledge and skills slowly. We believe that the dissemination and uniformity of resuscitation training could be enhanced by wider use of self-training systems, not only for doers but also instructors-to-be.

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Implementing Cardiac Surgical Unit—Advanced Life Support Through Simulation-Based Learning

Dimensions of Critical Care Nursing ◽

10.1097/dcc.0000000000000425 ◽

2020 ◽

Vol 39 (4) ◽

pp. 180-193

Author(s):

Gregory S. Marler ◽

Margory A. Molloy ◽

Jill R. Engel ◽

Gloria Walters ◽

Melanie B. Smitherman ◽

...

Keyword(s):

Life Support ◽

Advanced Life Support ◽

Simulation Based ◽

Surgical Unit

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LO38: Does spaced instructional design result in improved retention of pediatric resuscitation skills? A randomized education study

CJEM ◽

10.1017/cem.2018.100 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S20-S20

Author(s):

C. Patocka ◽

A. Cheng ◽

M. Sibbald ◽

J. Duff ◽

A. Lai ◽

...

Keyword(s):

Rating Scales ◽

Life Support ◽

Spacing Effect ◽

Advanced Life Support ◽

Course Completion ◽

Skill Learning ◽

Global Rating ◽

Procedural Skills ◽

Pediatric Resuscitation ◽

Significant Difference

Introduction: Survival from cardiac arrest has been linked to the quality of resuscitation care. Unfortunately, healthcare providers frequently underperform in these critical scenarios, with a well-documented deterioration in skills weeks to months following advanced life support courses. Improving initial training and preventing decay in knowledge and skills are a priority in resuscitation education. The spacing effect has repeatedly been shown to have an impact on learning and retention. Despite its potential advantages, the spacing effect has seldom been applied to organized education training or complex motor skill learning where it has the potential to make a significant impact. The purpose of this study was to determine if a resuscitation course taught in a spaced format compared to the usual massed instruction results in improved retention of procedural skills. Methods: EMS providers (Paramedics and Emergency Medical Technicians (EMT)) were block randomized to receive a Pediatric Advanced Life Support (PALS) course in either a spaced format (four 210-minute weekly sessions) or a massed format (two sequential 7-hour days). Blinded observers used expert-developed 4-point global rating scales to assess video recordings of each learner performing various resuscitation skills before, after and 3-months following course completion. Primary outcomes were performance on infant bag-valve-mask ventilation (BVMV), intraosseous (IO) insertion, infant intubation, infant and adult chest compressions. Results: Forty-eight of 50 participants completed the study protocol (26 spaced and 22 massed). There was no significant difference between the two groups on testing before and immediately after the course. 3-months following course completion participants in the spaced cohort scored higher overall for BVMV (2.2 ± 0.13 versus 1.8 ± 0.14, p=0.012) without statistically significant difference in scores for IO insertion (3.0 ± 0.13 versus 2.7± 0.13, p= 0.052), intubation (2.7± 0.13 versus 2.5 ± 0.14, p=0.249), infant compressions (2.5± 0.28 versus 2.5± 0.31, p=0.831) and adult compressions (2.3± 0.24 versus 2.2± 0.26, p=0.728) Conclusion: Procedural skills taught in a spaced format result in at least as good learning as the traditional massed format; more complex skills taught in a spaced format may result in better long term retention when compared to traditional massed training as there was a clear difference in BVMV and trend toward a difference in IO insertion.

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Pediatric Advanced Life Support (PALS): The Pharmacist's Role

Journal of Pharmacy Practice ◽

10.1177/089719009600900105 ◽

1996 ◽

Vol 9 (1) ◽

pp. 42-56

Author(s):

Paul C. Blahunka

Keyword(s):

Pharmaceutical Care ◽

Life Support ◽

Advanced Life Support ◽

Heart Association ◽

Role Playing ◽

Medication Administration ◽

Patient Specific ◽

Needle Stick Injury ◽

Pediatric Resuscitation ◽

Syncytial Virus

The provision of pharmaceutical care to the patient undergoing cardiopulmonary resuscitation (CPR) is an important evolving concept. Pediatric resuscitation and advanced cardiac life support (ACLS) presents a particularly challenging situation for the practicing pharmacist. Etiologies of pediatric arrests include pulmonary conditions such as bronchopulmonary dysplasia, respiratory distress syndrome, respiratory syncytial virus (RSV) infection, and a myriad of accidental factors. Important initial determinations on arriving at a pediatric arrest are described, such as determining the correct weight of the patient, assessing the need for vascular access and/or intubation, and establishing the "code" leader. Recent American Heart Association guidelines for the pharmacotherapy of pediatric ACLS are discussed in detail. Included are recommendations on oxygen delivery, routes of fluid and medication administration, recent changes in epinephrine dosing, and guidelines for the proper use of adjunct medications. A detailed description of a method of using adult emergency drug syringes in the pediatric arrest is provided. Proper use of this method can expedite drug dispensing in an arrest, minimize the potential for needle-stick injury, and optimize the delivery of a patient-specific dose of medication. A "mock code" program is described that includes involvement with pharmacists, nurses, medical residents, and respiratory therapists. This program provides a hands-on role-playing model of a simulated pediatric arrest and serves as a valuable teaching tool for those charged with the responsibility of patient care during an actual arrest. While the ultimate role of the pharmacist in the pediatric arrest continues to be defined, developing the competency to provide pharmaceutical care in this clinical setting can be extremely rewarding. Copyright © 1996 by W.B. Saunders Company

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