Quick Take: Improving your psychological response to pediatric resuscitation

Prepare ahead of time to eliminate 'slow' responses that require greater thought from your care of critically ill children


By Scott Kier, NREMT-P, B.S. EMSM

Dr. Peter Antevy gave a session on psychological wiring and pediatric resuscitation at EMS Today in Baltimore, Maryland:

Changing the mental approach

Dr. Peter Antevy.
Dr. Peter Antevy. (Image Tom Bouthillet)

While successful resuscitation rates for in-hospital pediatric cardiac arrests have increased three fold since 1980, they have remained under 10 percent for pediatric cardiac arrests that occur out-of-hospital. Antevy discussed the intricacies of the human mind while under significant stress from the viewpoint of psychologist Daniel Kahneman.

Kahneman’s studies break the brain’s response into two categories; “fast” automatic responses or “System 1” responses and “slow” responses that require greater thought or “System 2” responses. Antevy stresses that if a provider eliminates “System 2” responses from their approach to the care of critically ill children they will become more successful pediatric caregivers.

Memorable quotes on pediatric resuscitation

“Despite recent advances in adult cardiac arrest care, out-of-hospital pediatric resuscitation care has not budged over the past 30 years.”

“If you want to be successful in pediatric care you need two types of people on scene; one to engage the family and child and the other to do the critical thinking needed to prepare and deliver the correct medication doses.”

Key takeaways

  • Preparation: the key to successful care of a critically ill child starts with preparation. Know the equipment that will be needed, know the possible drug doses that might be needed, and decide who will fulfill which role before the ambulance arrives at the scene.
  • Mindful practice: With practice and training, actions that were previously handled by “System 2” responses can be adapted and handled by the “System 1” portion of the brain.
  • No math: Strive to do no math during a pediatric resuscitation. Know the drug dosages and equipment sizes that will be needed before care starts. This will reduce errors and make calls go more smoothly

Preparation for pediatric cardiac arrest is the top consideration

Regardless of what level of care you provide, having yourself as ready as possible before you walk into a pediatric resuscitation situation will significantly reduce the stress that you will experience.

To read more about Dr. Antevy visit PediatricEmergencyStandards.com 

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