Are Pediatrics Being Left Out of the Equation for Simulated Resuscitation Training?

Did you know that over 7,000 children experience an out-of-hospital cardiac arrest (OHCA) in the United States each year? Sadly, only 9% of children survive, and many have poor neurological outcomes. When bystanders and practitioners act with the same confidence and skill set with which they would treat an adult, a child’s chances of survival improve. Unfortunately, hands-on cardiopulmonary resuscitation (CPR) practice for pediatric patients can be overlooked, mainly because people don’t want to imagine doing CPR on anyone – especially on a child. This is why incorporating a pediatric manikin into your existing training curriculum should be a key consideration, so that many more bystanders and healthcare professionals alike can improve their pediatric resuscitation skills to improve these unfortunate statistics.

Some roadblocks to life-saving pediatric resuscitation:

  • Misperceptions of a SCA victim can hinder proper care. Stereotypes of an older, ill SCA victim do not reflect reality. SCA can affect people of all ages, regardless of their gender and regardless if they have an existing heart condition.
  • Training for adult patients doesn’t prepare you for a pediatric patient. Pediatric arrest is generally caused by two conditions: progressive tissue hypoxia as the result of respiratory failure and/or shock, or a congenital heart condition that did not present symptoms until the event. This is in contrast with coronary artery disease, which is the cause of many adult SCA.
  • Witnesses may be paralyzed by surprise and panic, limiting their ability to provide quality CPR. In many cases of pediatric SCA, providers are often ill prepared to act.

Of the witnessed pediatric arrests, bystander CPR is only performed 35% of the time. Experts suggest that one way to improve pediatric survival rates is to build bystander confidence. And, practice has been proven to increase confidence and self-efficacy. Quality CPR training can help to reduce the fear factor, increasing survival and making a huge difference within a community.

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One way to make training stick is to keep learners engaged using interactive activities. Incorporating measurement, assessment, and feedback into pediatric CPR training can help to teach a class of future lifesavers.

Another way to improve SCA survival rates for children is to gear the training specifically to the people who are most likely to witness the arrest. This might be parents, teachers, coaches, and even other children as young as 9 years old. Creating a network of willing and confident bystanders makes all the difference.

As for emergency medical services (EMS) and healthcare providers, who are more accustomed to treating adult patients, training for the unexpected can offer a huge benefit. One study found that more than half of EMS providers see only one sick child in a month. This just shows that real-life pediatric practice is lacking.

In addition, many EMTs and paramedics have a tendency to automatically transport pediatric patients, whereas they would remain on site to treat adult patients. These first few minutes are critical to the patient’s chance of survival, and these chances decrease with the decision to transport. Training specifically for pediatric victims can help to develop the skills to stay put.

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For both laypeople and professionals, pediatric cardiac arrest is unsettling and challenging to treat. Children are less likely than adults to experience cardiac arrest, but that shouldn’t create a void for pediatrics in CPR training. Instead, training for these low-frequency, high-acuity events should be made equally as important — which is why we at believe every simulation program should consider investing in at least one high-fidelity pediatric manikin.

Read more on this concerning issue on Laerdal’s Article
“Are Pediatrics Being Left Out of the Equation?”

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