Monday, June 13, 2016

Code Team Training: Demonstrating Adherence to American Heart Association Resuscitation Guidelines

Claire Stewart
Cincinnati Children's Hospital Medical Center
Background: Pediatric code blue activations outside of the intensive care unit are rare, yet often fatal eventsinfrequent events with a high mortality rate.  Code teams respond to these activations and can be made up of a variety of disciplines from a variety of departments.  The best method for training these code teams is still being sought, however, it is clear that training is needed to assure adherence to American Heart Association Resuscitation Guidelines and to prevent the decay that invariably occurs after Pediatric Advanced Life Support training.  We sought to train a multi-disciplinary, multi-departmental code team and assess our adherence to AHA guidelines during pediatric code blue simulation.

Methods: Code team training sessions were held using high-fidelity, in-situ simulation.  Each session was filmed.  Each session was then reviewed for adherence to five AHA guidelines: compression rate 100-120 compressions per minute, respiratory rate of less than 12 respirations per minute, chest compression fraction of greater than 80%, use of a backboard and presence of a team leader.

Results: Twelve sessions were held during the initial analysis and nineteen sessions were held during the secondary analysis.  Of the first twelve, only one session adhered to all AHA guidelines.  Of the second nineteen, after alteration of the code team and implementation of just-in-time training, no sessions adhered to all AHA guidelines.

Conclusion: We present a method for training a large code team drawn from multiple hospital departments.  Despite subjective improvement in code team positioning, communication, and role completion, we failed to show improvement in adherence to AHA guidelines.