PMID- 21969287
OWN - NLM
STAT- MEDLINE
DCOM- 20120124
LR  - 20220321
IS  - 1098-4275 (Electronic)
IS  - 0031-4005 (Linking)
VI  - 128
IP  - 5
DP  - 2011 Nov
TI  - Hyperventilation in pediatric resuscitation: performance in simulated pediatric 
      medical emergencies.
PG  - e1195-200
LID - 10.1542/peds.2010-3696 [doi]
AB  - OBJECTIVE: To examine the hypothesis that pediatric resuscitation providers 
      hyperventilate patients via bag-valve-mask (BVM) ventilation during performance 
      of cardiopulmonary resuscitation (CPR), quantify the degree of excessive 
      ventilation provided, and determine if this tendency varies according to provider 
      type. METHODS: A retrospective, observational study was conducted of 72 
      unannounced, monthly simulated pediatric medical emergencies ("mock codes") in a 
      tertiary care, academic pediatric hospital. Responders were code team members, 
      including pediatric residents and interns (MDs), respiratory therapists (RTs), 
      and nurses (RNs). All sessions were video-recorded and reviewed for the rate of 
      BVM ventilation, rate of chest compressions, and the team members performing 
      these tasks. The type of emergency, location of the code, and training level of 
      the team leader were also recorded. RESULTS: Hyperventilation was present in 
      every mock code reviewed. The mean rate of BVM ventilation for all providers in 
      all scenarios was 40.6 +/- 11.8 breaths per minute (BPM). The mean ventilation 
      rates for RNs, RTs, and MDs were 40.8 +/- 14.7, 39.9 +/- 11.7, and 40.5 +/- 10.3 BPM, 
      respectively, and did not differ among providers (P = .94). All rates were 
      significantly higher than the recommended rate of 8 to 20 BPM (per Pediatric 
      Advanced Life Support guidelines, varies with patient age) (P < .001). The mean 
      ventilation rate in cases of isolated respiratory arrest was 44.0 +/- 13.9 BPM and 
      was not different from the mean BVM ventilation rate in cases of cardiopulmonary 
      arrest (38.9 +/- 14.4 BPM; P = .689). CONCLUSIONS: Hyperventilation occurred in 
      simulated pediatric resuscitation and did not vary according to provider type. 
      Future educational interventions should focus on avoidance of excessive 
      ventilation.
FAU - Niebauer, Julia M
AU  - Niebauer JM
AD  - Division of Critical Care, Department of Pediatrics, University of Alabama at 
      Birmingham, Birmingham, AL 35233, USA. julianiebauer@yahoo.com
FAU - White, Marjorie Lee
AU  - White ML
FAU - Zinkan, J Lynn
AU  - Zinkan JL
FAU - Youngblood, Amber Q
AU  - Youngblood AQ
FAU - Tofil, Nancy M
AU  - Tofil NM
LA  - eng
PT  - Journal Article
DEP - 20111003
PL  - United States
TA  - Pediatrics
JT  - Pediatrics
JID - 0376422
SB  - IM
MH  - Academic Medical Centers
MH  - Cardiopulmonary Resuscitation/adverse effects/*methods
MH  - Child
MH  - Child, Preschool
MH  - Clinical Competence
MH  - Computer Simulation
MH  - *Emergencies
MH  - Female
MH  - Heart Arrest/diagnosis/*therapy
MH  - Hospital Rapid Response Team/*organization & administration
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Hyperventilation/*prevention & control
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Manikins
MH  - Needs Assessment
MH  - *Patient Simulation
MH  - Retrospective Studies
MH  - Time Factors
MH  - Total Quality Management
MH  - United States
EDAT- 2011/10/05 06:00
MHDA- 2012/01/25 06:00
CRDT- 2011/10/05 06:00
PHST- 2011/10/05 06:00 [entrez]
PHST- 2011/10/05 06:00 [pubmed]
PHST- 2012/01/25 06:00 [medline]
AID - peds.2010-3696 [pii]
AID - 10.1542/peds.2010-3696 [doi]
PST - ppublish
SO  - Pediatrics. 2011 Nov;128(5):e1195-200. doi: 10.1542/peds.2010-3696. Epub 2011 Oct 
      3.