CPR Quality Assessment

The purpose of this study is to find out if a Doppler ultrasound patch placed on the neck can accurately and quickly detect when a cardiac arrest patient's heart starts beating again (return of spontaneous circulation, or ROSC) during resuscitation in the emergency department. The study compares the ultrasound readings to data from an arterial line, which is considered the most reliable way to check for a pulse. The main question the study is trying to answer is whether using Doppler ultrasound is better than the traditional method of feeling for a pulse, which can be unreliable, especially in stressful situations. Secondarily, this study aims to assess blood flow through the carotid artery from chest compressions during resuscitative events to determine overall effectiveness. This research hopes to show that Doppler ultrasound can help medical teams recognize when a patient's heart has restarted more accurately and quickly, leading to better care during cardiac arrest.

High-quality chest compressions are critical for outcomes after pediatric cardiac arrest, yet rescuer ergonomics and bed height may adversely affect compression quality and fatigue. This randomized crossover simulation study will evaluate how four different bed-height settings influence pediatric CPR quality and rescuer biomechanics. Pediatric emergency medicine residents will perform 2-minute chest-compression-only CPR on a pediatric manikin placed on a hospital bed under four bed-height conditions in randomized order across separate sessions. CPR quality metrics from the manikin's feedback system, rescuer fatigue, physiologic responses, and arm angle over time will be compared to identify an ergonomically optimal bed-height approach.