The design of this protocol is a prospective observational study to objectively measure the
rate, depth and quality of chest compressions and ventilations delivered during cardiac
arrest in the Pediatric Intensive Care Unit (PICU) and Emergency Department (ED) settings
utilizing the MRx/Q-CPR. The data collected will be analyzed for several purposes - for
comparison with current American Heart Association (AHA) Cardiopulmonary Resuscitation (CPR)
guidelines and to determine chest wall stiffness for CPR modeling efforts and construction
of biofidelic manikins or test dummies for CPR and auto safety.
Context: Cardiopulmonary Resuscitation (CPR) guidelines recommend target values for selected
CPR parameters related to rate and depth of chest compressions and ventilations, and
avoidance of CPR-free intervals. Recent studies on adult patients however show that rescuers
often do not adhere to these guidelines. There is currently very little data on the quality
of CPR performed on pediatric patients, but given the close similarity in therapy it can be
expected that the adherence to Guidelines is suboptimal for this patient group as well.
Feedback on quality of chest compressions and ventilations delivered during CPR are most
frequently guided by a subjective "code leader", and not objective measurements.
Quantitative systems that provide CPR feedback have demonstrated improvement to adult
patient treatment. Based on these studies, these feedback systems (termed Quality of CPR or
Q-CPR systems) were further improved in a new device called Heartstart MRx with Q-CPR option
(MRx/Q-CPR). These devices have been approved by the FDA for use for patients >8 years. The
MRX/Q-CPR, attached by a cord to the defibrillator/monitor, detects, displays and records
the rate, force and the depth of compressions through an accelerometer and force transducer
inside the compression pad. These devices have currently been approved by the CHOP
Resuscitation Committee and Medical device committee for clinical implementation in the CHOP
Intensive Care units (ICU) and Emergency Department (ED).
Objectives: The goal of this study is to record and analyze the data from the MRx/Q-CPR
during in-hospital cardiac arrests of children > 8 years for two research objectives. The
primary research objective is to evaluate the rate, depth, and quality of chest compressions
and ventilations delivered to children during in-hospital CPR. A secondary research
objective is to determine the chest wall stiffness of children in order to improve
quantitative CPR modeling efforts and to facilitate the construction of more biofidelic
pediatric manikins for CPR simulation and test dummies for automotive safety
Cardiac Arrest Inclusion Criteria:
- Cardiac arrests occurring in the PICU or ED at The Children's Hospital of
Philadelphia equipped with the MRx/Q-CPR
- Patient experiencing the arrest must be greater than or equal to 8 years old and
receive chest compressions with the Q-CPR sensor employed
Clinical Staff Inclusion Criteria:
- All clinical staff who participate in resuscitation events in CHOP's ICU or ED
- Cardiac arrests for patients classified as "do not attempt resuscitation" (DNAR) 1.
CPR chest compressions without the Q-CPR device