Pediatric Resuscitation Mock Code Practice Impacts Selected Skills

Objectives:  Determine the utility of a computer-controlled mannequin in training and assessment of resident pediatric resuscitation skills. Determine if mock code practice is beneficial in maintaining mastery of critical pediatric resuscitation skills. Methods:  A prospective randomized study of 22 interns (12 pediatric, 10 emergency medicine) randomized to: Group 1 (cases who participated in 3 mock codes over a 6 month period) and Group 2 (controls who did not receive mock code practice). Each intern was randomly paired in teams of two who participated at baseline in two code scenarios using the Laerdal Simbaby. The interns alternated airway and circulatory management responsibility. At 6 months all interns returned to the simulator in pairs to participate in another two pediatric code scenarios. All sessions were videotaped and time of computer initiation of scenario events recorded. Videos were examined by a pediatric emergency physician (blinded to Group participation) using a structured recording form. A general linear model was used to assess differences in response times and Fisher's exact tests for categorical data. Results:  Whether in charge of airway or circulatory management, at post test interns who had completed mock codes required less time to: recognize the need for bag mask ventilation (Diff 5.6 seconds, p < 0.005), initiate BVM (Diff 2.7 seconds, p < 0.006), intubate (Diff 22 seconds, p < 0.03), and recognizing the need for chest compressions (Diff 24 seconds, p < 0.03). There were no differences in times for recognizing the need for fluid resuscitation or for factors such as appropriate mask size, rate of ventilation, intubation success (including number of attempts), compression techniques, or IO placement. Conclusions:  Computer controlled mannequins provide reproducible measurable experiences. This study demonstrates that mock code practice may impact some, but not all, aspects of pediatric resuscitation skill retention.