(1382) Variability Among Medical Professionals in the PICU and Pediatric ED for Post-Arrest Care Practices

Introduction: Return of spontaneous circulation (ROSC) in pediatric populations will occur in up to 89% of in-hospital cardiac arrests and 36% of out-of-hospital cardiac arrests. Pediatric advanced life support (PALS) courses provide AHA published post arrest guidelines. Management of children after cardiac arrest remains widely variable.

Methods: We used a 14-question electronic survey to assess baseline knowledge of AHA guidelines, management goals, and self-reported confidence of post arrest care at our academic Level-I pediatric trauma facility from Nov to Dec 2022. Distribution lists included RN, RT, and MDs in the pediatric emergency department (PED) and pediatric intensive care unit (PICU). Reminder emails were sent, and the survey was closed after a 4-week period.

Results: 58 survey responses were completed from 19 RNs (32.8%), 21 residents (36.2%), 11 RTs (19%), and 7 attendings (12.1%). Work location was identified as 33.4% PICU only, 29.8% ED only, and 36.8% both. Clinical experience < 2years 19%, 2-5 years 31%, >5 years 50%. PALS certified staff accounted for 94.8%. Respondents (35, 60.3%) self-identified as AHA instructors for the following course BLS 52.9%, PALS 64.7%, ACLS 58.8%, and other emergency courses 29.4%. Self-reported confidence in knowledge of post arrest care per AHA PALS guidelines 10-point Likert scale rating of 1 to 4 as low confidence (25.8%), moderate 5 to 7 (46.6%), and high confidence as 8 to 10 (27.6%). Respondents reported variable goals for when to wean oxygen and glucose, temperature, PaCO2.

Conclusions: Our survey demonstrated variability in clinical experience, AHA certification and confidence in pediatric post-arrest goals among medical professionals in PICU and PED. This identified an opportunity to introduce education to increase knowledge and a post arrest care goals bundle. This may improve confidence, reduce variability, and align with AHA post arrest care.