Download CICU Survey 1. How would you categorize the primary hospital you

CICU Survey
1. How would you categorize the primary hospital you work at?
University Academic Hospital
Children's Hospital
Community Hospital
Private Hospital
2. What is the total number of beds in your CICU?
3. What other Pediatric based ICUs are present in your hospital?
Neonatal ICU
Pediatric ICU
Surgical ICU
Other (please specify)
4. Do you admit infants (age less 1 year) in your CICU?
Yes
No
5. Do you have a lower age limit for patients cared for in your CICU (e.g. 28 days of life,
44 weeks postmenstrual age, etc)?
Yes
No
If yes, what is the lower limit
6. Which of the following providers would be most likely to LEAD a cardiopulmonary
resuscitation of neonates in your CICU?
Pediatric Resident
CICU Fellow
CICU Attending
Pediatric Nurse Practitioners or Physician Assistants
7. Which practitioners working in your CICU are currently REQUIRED to
maintain PALS provider status?
(check as many as apply)
Nurses (LPN, RN)
Pediatric Nurse Practitioners or Physician Assistants
Pediatric Residents
CICU Fellows
CICU Attendings
Respiratory Therapists
Pharmacists
None of the above
I don't know
Please explain if not all your providers are required to
maintain PALS
8. Which practitioners working in your CICU are currently REQUIRED to
maintain NRP provider status?
(check as many as apply)
Nurses (LPN, RN)
Pediatric Nurse Practitioners or Physician Assistants
Pediatric Residents
CICU Fellows
CICU Attendings
Respiratory Therapists
Pharmacists
None of the above
I don't know
Please explain if not all your providers are required to maintain
NRP
9. Does your CICU have a policy concerning which national resuscitation program
guidelines NRP, PALS should be used during cardiopulmonary resuscitation of patients
in your CICU?
Yes*
No
If yes please enter your contact information and email a copy of the guidelines to
[email protected]. Any information you submit will remain
deidentified
10. At what age after birth do YOU THINK PALS guidelines should be used, rather than
NRP guidelines, for resuscitation of patients in the CICU? (PLEASE SELECT ONLY
ONE ANSWER FOR EACH AGE)
Preterm infants (born or admitted at 22 wks gestation to 37 wks gestation)
Immediately after leaving the delivery room (e.g. all resuscitations outside the DR
should follow PALS)
≥ 24hrs of life
≥ One (1) week of life
≥ 28 days of life
≥ Three (3) months of age
≥ Six (6) months of age
≥ One (1) year of age
Other:
Other (please explain)
11. At what age after birth do YOU THINK PALS guidelines should be used, rather than
NRP guidelines, for resuscitation of patients in the CICU? (PLEASE SELECT ONLY
ONE ANSWER FOR EACH AGE)
Term infants (born or admitted at 38 wks gestation to 42 wks + gestation)
Immediately after leaving the delivery room (e.g. all resuscitations outside the DR
should follow PALS)
≥ 24hrs of life
≥ One (1) week of life
≥ 28 days of life
≥ Three (3) months of age
≥ Six (6) months of age
≥ One (1) year of age
Other
Other (please explain)
12. Independent of age, for what specific scenarios do you think PALS* guidelines
should be used, rather than NRP* guidelines, for patients in the CICU?
*PALS defined as compression to ventilation ratio of 15:2 if no advanced airway is in
place and asynchronous compressions (100bpm) with ventilations (8-10 breaths/min) if
an advanced airway is in place. NRP defined as compression to ventilation ratio of 3:1
(CHECK AS MANY AS APPLY)
Any resuscitation outside of the delivery room
Ventricular fibrillation or pulseless V-tach
Asystole or pulseless electrical activity (PEA)
Symptomatic bradycardia
Arrest due to upper airway obstruction
Arrest due to lower airway obstruction
Arrest due to lung tissue (parenchymal) disease
Arrest due to disordered control of breathing
Arrest due to hypovolemic shock
Arrest due to obstructive shock (tension pneumothorax, cardiac tamponade)
Arrest due to distributive (septic) shock
Arrest due to cardiogenic shock
Arrest in a baby with structural congenital heart disease
Arrest in a baby with bronchopulmonary dysplasia
Arrest in a baby with pulmonary hypertension
Arrest in a baby with hypoxemic respiratory failure
Arrest in a baby with hypercarbic respiratory failure
Arrest in a neonate receiving mechanical ventilation
Arrest in a neonate with multi-organ system failure
Prolonged resuscitation (>2 minutes of CPR)
Prolonged resuscitation (>5 minutes of CPR)
Prolonged resuscitation (>10 minutes of CPR)
Prolonged resuscitation (>15 minutes of CPR)
Continued resuscitation (i.e. persistent bradycardia/asystole/PEA) once confirmation
of adequate ventilation established
Arrest on ECMO
Other
Other (please specify)
13. During cardiopulmonary arrest in your CICU, which of the following best describes
the most common approach to starting CPR?
one rescuer starts CPR with chest compressions, while a second rescuer prepares to
provide ventilations (chest compressions before ventilations)
one rescuer starts CPR with ventilations, while a second rescuer prepares to provide
compressions (ventilations before chest compressions)
one rescuer provides CPR with chest compressions at the same time a second rescuer
provides ventilations (simulataneous chest compressions and ventilations)
14. Current International Liaison Committee on Resuscitation (ILCOR) guidelines
recommend that newborns (intubated or not) who require Cardiopulmonary Resuscitation
(CPR) in the newborn nursery or NICU receive CPR using the same technique as for the
newly born in the delivery room (ie, 3:1 compression-to-ventilation ratio with a pause for
ventilation). Circulation. 2010 Oct 19;122(16 Suppl 2):S516-38
Do you agree with this statement?
Yes
No
15. Current NRP guidelines state that NRP should “apply primarily to newly born
infants… but the recommendations are also applicable to neonates who have completed
perinatal transition and require resuscitation during the first few weeks to months
following birth.” Textbook of Neonatal Resuscitation, 6th Edition. 2011. Pages 255-261
Do you agree with this statement?
Yes
No
16. Current PALS guidelines state that in delivery room, newborn nursery or NICU that
NRP should be used. In other settings, for newborns who require CPR, the infant PALS
guidelines should be used for ease of training. Circulation. 2010;122:S876-S908
Do you agree with this statement?
Yes
No
17. Do you believe there should be specific guidelines on when to use PALS or NRP for
resuscitation of patients in the CICU based on the age (Chronologic or Postmenstrual) of
the patient?
Yes
No
If yes why?
18. Do you believe there should be specific guidelines on when to use PALS vs. NRP for
resuscitation of patients in the CICU based on the etiology of the arrest (i.e cardiac,
respiratory, shock)?
Yes
No
If yes why?
19. In regards to cardiopulmonary arrest of patients in the CICU, which do YOU consider
most important in the decision on when to change from NRP to PALS guidelines?
Chronologic age after birth (e.g. days or weeks of life)
Postmenstrual age (e.g. weeks gestation + days or weeks of life)
Underlying etiology of arrest (i.e cardiac, respiratory, shock)