Are Pediatrics Being Left Out of the Equation?

奥利维亚·奎格利（Olivia Quigley）遭受突然心脏骤停（SCA）时年仅六岁。当她突然倒塌时，她当时在一年级，在体育课上进行热身。

她很幸运的是，她的学校排练了立即的医疗应急响应计划。在两名教师进行了六分钟的心肺复苏（CPR）之后，紧急医疗技术人员（EMT）带着恢复奥利维亚的除颤器来到了。她幸存下来。她的父亲说：“心脏骤停并不罕见 - 生存是罕见的。”¹

每年在美国，超过7,000名儿童都会出现院外心脏骤停（OHCA）。²Their chances of survival are largely dependent on whether bystanders and practitioners act with the same confidence and skill set with which they would treat an adult.³

Only 9% of children survive, and many have poor neurological outcomes.⁴

Olivia’s story shows the best possible outcome for a pediatric victim of SCA. Witnesses saw her collapse, teachers began bystander CPR right away, and EMS arrived within minutes to take over. Her survival is a testament to howpreparation can make the difference between life and death。但是，可悲的是，儿科患者的动手实践可能会被忽略。人们不喜欢想象对孩子做CPR。

在本文中,我们概述chall分享enges presented in a pediatric SCA and discuss how increasing the frequency and quality of hands-on practice for pediatric resuscitation can help.

Training for the unexpected is one of the many benefits offered through simulation. This can be particularly true for healthcare professionals who are more likely to treat adult patients and are now faced with a pediatric patient in SCA. Treating pediatric patients can often provoke a sense of anxiety and discomfort among EMS personnel.¹⁴The EMS for Children Survey (April 2020) found that 43.6% of EMS agencies see, on average, fewer than one pediatric patient per month.¹⁵This indicates that there is certainly a lack of real-life pediatric practice.

EMS professionals training for pediatric QCPR.

在过去的30年中，院前存活率保持不变。¹⁵与医院内的比率相比，这是不断增加的。¹⁶

Why is this?根据彼得·安特维（Peter Antevy）博士的说法，许多EMT和护理人员都有自动运输小儿患者的趋势，而不是像成年患者那样在现场治疗他们。¹⁷When these first, critical minutes are used to transport patients, the chances of survival decrease.¹⁸This is precisely why training for pediatric victims is so important –developing the confidence and skills to stay put makes all the difference.

重要的是要注意，即使小儿院内存活率正在提高，生存仍然是该规则的例外。根据美国心脏协会（AHA）的数据，小儿院内心脏骤停（IHCA）的生存率只有36％。¹⁹The majority of children do not recover, even with immediate attention from healthcare professionals.

Research shows that only 10% of professionals achieve the necessary chest compression fraction, chest compression depth, and chest compression rate in a pediatric resuscitation.²⁰What all of this points to is the need for additional training – more specifically, training with a focus on high-quality CPR.

儿科的质量CPR不再是猜测游戏。借助提供即时反馈和纠正指导的培训Manikins，专业人士可以充满信心，他们正在采用挽救生命的技术。

在见证的逮捕中bystander CPR is only performed 35% of the time。¹⁰Experts suggest that one way to improve pediatric survival rates is to build bystander confidence to take action.

One study found that a one-hour crisis resource management training improved the trainees’ response time in the initial steps in a pediatric resuscitation.¹¹And, another study found that self-efficacy increased and anticipated anxiety about CPR decreased one month after parents received CPR training.¹²This research highlights the impact that quality CPR training can make within a community.Reducing the fear factor means increasing survival.

In order to effectively train community members in CPR and ensure that they will leave the classroom confident in their ability save a life, it helps to use more engaging learning methods. It’s been shown that learners achieve the greatest competency through interactive activities. Incorporating measurement, assessment, and feedback into pediatric CPR training can better prepare them for optimal performance, and can help you rest assured that您刚刚教过一类未来的救生员。

为了提高儿童的SCA生存率，需要对最有可能与他们在一起的人进行培训 - 父母，老师，教练甚至9岁以上的孩子。¹³提供这些学习者需要的儿科实践的参与课程是制作训练棒的一种方法。

Pediatric cardiac arrest is unsettling and challenging to treat.Children are less likely than adults to experience cardiac arrest, but that shouldn’t create a void for pediatrics in CPR training.取而代之的是，应对这些低频，高吸引事件的培训同样重要。

By incorporating a pediatric manikin into your existing training curriculum, bystanders and healthcare professionals alike can improve their pediatric resuscitation skills. Laerdal Medical offers a range of pediatric CPR skills manikins that incorporate Quality CPR feedback and which will allow your learners to train to the highest CPR standards possible.