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Beyond the Barriers: Project EQUIP E MS Qu ality I mprovement in P ediatrics

Beyond the Barriers: Project EQUIP E MS Qu ality I mprovement in P ediatrics. Dianne L. Atkins, MD University of Iowa Children’s Hospital of Iowa. Disclosures. Research grant/equipment support from Philips Medical Systems - Heartstream Zoll Medical Systems

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Beyond the Barriers: Project EQUIP E MS Qu ality I mprovement in P ediatrics

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  1. Beyond the Barriers: Project EQUIPEMS Quality Improvement in Pediatrics Dianne L. Atkins, MD University of Iowa Children’s Hospital of Iowa

  2. Disclosures Research grant/equipment support from Philips Medical Systems - Heartstream Zoll Medical Systems Consulting Fees /equipment Medtronic-Physio-Control, Inc Philips Medical Systems-Heartstream Research support from EMS-C to study cardiac arrest and AED use in children Resuscitation Outcomes Consortium

  3. Objectives • Develop a Quality Improvement Program for Pediatric cardiac arrest for pre-hospital providers • Develop reporting methods to disseminate information from the Quality Improvement program to the Iowa Bureau of EMS and EMS providers

  4. Objectives • Develop education methods to convey information from Objectives 1 and 2 to EMS providers • Analyze impact of data analysis and instructional programs on outcomes

  5. Objective 1 • Analyze current algorithms • Pediatric capable AEDs added to Iowa first responder and pediatric protocols July 2002. • Collect and analyze cardiac arrest data from the Iowa EMS Program Registry • First analysis: Jan-Jun 2002 • Second analysis Jan-Jun 2004

  6. Database Problems • Initial construction of database had significant shortcomings, not user friendly, poor data quality. • 10 % of entries have no DOB or age • 51 % rhythm not reported or missing • 78 % pulse not reported or missing • Inconsistencies in data dictionary • Recommended to Bureau to develop alternate methods to collect data

  7. Data Analysis 2002

  8. Percentage of Records with Reliable Data

  9. Age range 0-18 years 2004

  10. Percentage of Cardiac Rhythms

  11. Median Time Intervals in Minutes

  12. Objective 2 • Presentations to Iowa EMS Advisory Council • Letters to EMS Medical Directors • Announcements, data analysis with standard format • EMS Listserve

  13. Objective 3 • Production of video/CD demonstrating use of AED in children • Production of web site for education • Didactic articles • Annotated Bibliography • Video • Pre and Post test with free CME • Database for reporting cardiac arrests

  14. Website • http://www.kidsdefib.org/

  15. Objective 4 Awareness of Iowa State Protocol about AED use in Children

  16. Awareness of AHA Guidelines

  17. Does this Make a Difference? • Philips post-market surveillance of use • Voluntary submission of data • 26 uses: • 8 episodes of VF 5 months – 10 years • 63% survival to hospital discharge • All other rhythms appropriately identified as non-shockable

  18. Project EQUIP

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