Improper defibrillator pad usage by emergency medical care providers for children: an opportunity for reeducation

Abstract Purpose Approximately 14 000 pediatric out-of-hospital arrests occur annually. With this significant number and the diversity in the training backgrounds of medical providers, correct choice and placement of defibrillator pads are imperative to ensure maximum efficacy. Methods One hundred f...

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Bibliographic Details
Published in:The American journal of emergency medicine 2014-09, Vol.32 (9), p.953-957
Main Authors: Fraser, Kiesha N., MD, Kou, Maybelle M., MD, Howell, John M., MD, Fullerton, Kaidi T., MD, Sturek, Charles, MS
Format: Article
Language:English
Subjects:
Cardiac arrhythmia
Cardiopulmonary resuscitation
Child
CPR
Defibrillators
Emergency
Emergency medical care
Emergency Medical Services - methods
Emergency Medical Services - standards
Health Personnel - education
Heart attacks
Hospitals
Humans
Manikins
Out-of-Hospital Cardiac Arrest - therapy
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Summary:Abstract Purpose Approximately 14 000 pediatric out-of-hospital arrests occur annually. With this significant number and the diversity in the training backgrounds of medical providers, correct choice and placement of defibrillator pads are imperative to ensure maximum efficacy. Methods One hundred fifty-two emergency medical care providers from 6 medical fields were recruited for the study. Each participant answered a series of questions to ascertain baseline knowledge of correct defibrillator pad choice and placement in 2 scenarios with mannequins weighted less than 15 kg and more than 15 kg. After the testing, each participant received an educational intervention. Six months after the first phase, participants received a questionnaire to ascertain knowledge retention. Results In the primary study phase, for correct pad choice for mannequins weighing less than 15 kg and more than 15 kg, overall results were 98% (95% confidence interval [CI], 94.1%-100%) and 38.8% (95% CI, 31.4%-46.8%), respectively. In the second phase, pad choices for mannequins weighing less than 15 kg and more than 15 kg were 77.3% (95% CI, 68.6%-84.2%) and 60% (95% CI, 47.7%-71.1%). The rates of correct pad placement during the initial phase for mannequins weighing less than 15 kg and more than 15 kg were 5.8% (95% CI, 2.8%-11.2%) and 25.7%, respectively (95% CI, 19.4%-35.7%). Rates for correct pad placement (< 15-kg and > 15-kg mannequins) improved in the second phase to 68.2% (95% CI, 56%–78.4%) and 71.2% (95% CI, 62.8%-81.5%). Conclusion Pediatric emergency providers have poor understanding of pad choice and placement. Emergency medical care providers for children who are educated about the correct defibrillator pad choices and placement have improved knowledge and can retain that knowledge for at least 6 months.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2013.11.016