7-Component CPR model improves in-hospital resuscitation of children

HealthLeaders reports that a new approach to cardiopulmonary resuscitation is helping to save children's lives at Johns Hopkins Children's Center in Baltimore. Pediatric CPR is a challenge in the hospital setting. Every year, more than 6,000 children have in-hospital cardiac arrest and most do not survive to discharge. In 2013, Johns Hopkins Children's Center started developing a new approach to CPR—Coaching, Objective‐Data Evaluation, Action‐linked phrases, Choreography, Ergonomics, Structured debriefing, and Simulation (CODE ACES2). The children's hospital published research on the approach this month. Johns Hopkins Children's Center staff can reliably start chest compressions within 10 seconds, the lead author of the research, Elizabeth Hunt, MD, MPH, PhD, told HealthLeaders recently.

"The idea is to teach in medicine similar to how world class chess players, athletes and musicians train—to practice the right way over and over again while getting feedback from an expert mentor. This also helps our resuscitation team to decrease variability," said Hunt, who is director of the Johns Hopkins Medicine Simulation Center and an associate professor at Johns Hopkins University School of Medicine. Under the CODE ACES2 approach, a debriefing is held after every cardiac arrest to review challenges that the resuscitation team encountered and identify any deviations from best practices. From 2013 to 2016, more than 300 cardiac arrests were debriefed. During this period, the probability of attaining excellent CPR based on American Heart Association (AHA) compliance for rate, depth, and chest compression fraction rose from 19.9% to 44.3%.

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