Participatory Design and Simulation for Designing and Validating a Decision Pathway and Checklist for a Pediatric Emergency Department’s Resuscitation Room

Abstract

The Emergency Department (ED) Resuscitation room is a cognitively demanding and fast-paced environment where clinicians must respond rapidly, and often with incomplete information, to make life-saving medical decisions (Madani et al., 2018). This complex decision-making requires collaboration with multiple care teams, including teams from other units in the hospital. Rapid decisions become critical when a patient is in cardiac arrest with ongoing Cardiopulmonary Resuscitation (CPR), as guidelines for the initiation of Extracorporeal Membrane Oxygenation (ECMO) require cannulation within <60 minutes from arrest. The speed and quality of the team’s response impact the chances of survival, so the ED team must promptly assess ECMO candidacy and activate the appropriate response. An ECMO activation for a patient receiving ongoing CPR is referred to as Extracorporeal Cardiopulmonary Resuscitation (ECPR). Our ED’s current ECPR process prompts the Intensive Care Unit (ICU) team to present to the ED resuscitation room to evaluate the patient, and, if ECMO is indicated, move the patient to the ICU or operating room (OR) in collaboration with the ED team.