Inappropriate Shock Delivery Is Common During Pediatric In-Hospital Cardiac Arrest

James M. Gray; Tia T. Raymond; Dianne L. Atkins; Ken Tegtmeyer; Dana Niles; Vinay Nadkarni; Sandeep V. Pandit; Maya Dewan

doi:10.1097/pcc.0000000000003241

April 28, 2023Pediatric Critical Care MedicineOpen Access

Inappropriate Shock Delivery Is Common During Pediatric In-Hospital Cardiac Arrest

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Key Points

To characterize the frequency, circumstances, and electrocardiographic rhythms associated with inappropriate shock delivery during pediatric in-hospital cardiac arrest.
Retrospective cohort study analyzing pediatric in-hospital cardiac arrest events from 2015 to 2020 within the international pediRES-Q collaborative across 28 sites.
Evaluated 381 decipherable shocks delivered during 158 cardiac arrest events, classifying the pre-shock rhythm as appropriate, indeterminate, or inappropriate based on rhythm and rate.
Appropriate shocks occurred in 57% of deliveries for ventricular fibrillation or wide-complex tachycardia ≥ 150 beats/min, while 13% were classified as indeterminate.
Inappropriate shocks were delivered in 30% of cases, including instances of asystole (6.8%), sinus rhythm (3.1%), narrow-complex rhythms < 150 beats/min (11%), and wide-complex rhythms < 100 beats/min (8.9%).
Eighty-eight percent of all shocks occurred in intensive care units or emergency departments, where an identical 30% rate of inappropriate shock delivery was observed.

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Implication

Retrospective cohort study reveals frequent inappropriate defibrillation in pediatric in-hospital cardiac arrest, highlighting the need for improved rhythm identification training.

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Cite This Study

Gray et al. (2023) studied this question.

synapsesocial.com/papers/6a95dbeb0becc3d96d376efb https://doi.org/10.1097/pcc.0000000000003241

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Inappropriate Shock Delivery Is Common During Pediatric In-Hospital Cardiac Arrest

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Inappropriate Shock Delivery Is Common During Pediatric In-Hospital Cardiac Arrest

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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