The Egyptian Pediatic Advanced Life Support: - Monitoring and evaluating the impact of the guideline | EHC | Egyptian Health Council

البحث الشامل غير مفعل

"last update: 8 September 2026" Download Guideline

- Monitoring and evaluating the impact of the guideline

A. Facility based indicators:

Pediatric Resuscitation Audit Checklist

Hospital		Department
Date		Auditor
Case/Code Number
Comments

1. Recognition of Clinical Deterioration

Audit Item	Yes	No	N/A
1-Rapid response team	☐	☐	☐
2-Vital signs documented regularly (age-appropriate)	☐	☐	☐
3-Structured deterioration recognition system if available (PEWS) or equivalent(Abnormal vital signs identified and documented)	☐	☐	☐
4-Escalation pathway activated according to hospital policy (Senior clinician notified) (ASA)	☐	☐	☐
5-Time from deterioration recognition to escalation recorded	☐	☐	☐
6-Reassessment documented after intervention	☐	☐	☐

2. Initial Response

Audit Item	Yes	No	N/A
7-Airway assessed promptly	☐	☐	☐
8-Oxygen administered when indicated	☐	☐	☐
9-Monitoring attached (ECG, SpO₂, BP)	☐	☐	☐
10-IV access obtained promptly or IO( if available and when IV access difficult)	☐	☐	☐
11-VBG &Blood glucose measured	☐	☐	☐

3.Cardiac Arrest Management

Audit Item	Yes	No	N/A
12-Code blue team	☐	☐	☐
13-Cardiac arrest recognized promptly	☐	☐	☐
14-CPR started immediately of arrest recognition	☐	☐	☐
15-Correct compression rate to ventilation (15:2)	☐	☐	☐
16-Rhythm and pulse checks limited to ≤10 seconds	☐	☐	☐
17-Defibrillator attached rapidly when indicated	☐	☐	☐
18-Shock joules delivered according to guidelines	☐	☐	☐
19-CPR resumed immediately after shock delivery for 2 min.	☐	☐	☐
20-Adrenaline administered according to guidelines	☐	☐	☐
21-Reversible causes (4Hs & 4Ts) considered	☐	☐	☐
22-Time elapsed from starting chest compression until rhythm check 2min	☐	☐	☐

4.Post-ROSC Care

Audit Item	Yes	No	N/A
23-Return of spontaneous circulation (ROSC) documented	☐	☐	☐
24-Airway: Oxygenation optimized; target SpO2 94-98%	☐	☐	☐
25-Breathing: Ventilation optimized;co2 35-45mmHg	☐	☐	☐
26-Circulation: Blood pressure monitored aim MAP>10th percentile	☐	☐	☐
27-Blood glucose monitored (normoglycemic)	☐	☐	☐
28-Temperature monitored(36-37.5)	☐	☐	☐
29-Neurological status assessed and documented GCS	☐	☐	☐
30-Family informed appropriately	☐	☐	☐

5. Equipment and Medication Readiness

Audit Item	Yes	No	N/A
31-Pediatric resuscitation trolley available	☐	☐	☐
32-Daily equipment check documented	☐	☐	☐
33-Defibrillator functional checked daily	☐	☐	☐
34-Oxygen source available and functional	☐	☐	☐
35-Bag-mask devices available in pediatric size	☐	☐	☐
36-Airway equipment available in appropriate pediatric sizes	☐	☐	☐
37-Emergency drugs available and not expired	☐	☐	☐

Documentation and Debriefing

Audit Item	Yes	No	N/A
38-Arrest record completed	☐	☐	☐
39-Critical interventions timed and documented	☐	☐	☐
40-Drugs documented accurately	☐	☐	☐

Compliance Summary

Total Applicable Items: __________

Total Yes Responses: __________

Compliance Score (%) = (Yes ÷ Applicable Items) × 100

Overall Rating: __________________

B. High authority based indicators
1. System Performance Indicators (RRS/RRT)

Indicator	Definition	Target
RRT activation rate	Number of RRT calls per 1000 admissions	Institution-specific benchmark
Time from trigger to RRT arrival	Minutes from call to bedside response	≤ 5–10 min
Appropriate activation rate	% of RRT calls meeting PEWS/criteria	>80%
Missed deterioration cases	Patients who arrested without prior RRT activation	Should decrease over time
Repeat RRT calls within 24h	Recurrent instability after first RRT	Monitor trend ↓

2. Early Recognition of Deterioration

Indicator	Definition	Target
PEWS compliance rate	% of patients with documented PEWS	>90%
Escalation compliance	% of abnormal PEWS with documented escalation	>85–90%
Time from abnormal vitals to action	Delay in response to deterioration	<30–60 min
Unplanned ICU transfer	Transfer from ward without prior ICU planning	Decrease over time

3. Cardiac Arrest Quality Indicators

Indicator	Definition	Target
Time to CPR initiation	Collapse → first chest compression	<1 minute
Time to first defibrillation (VF/pVT)	Collapse → shock delivery	<3–5 minutes in monitored patients
CPR quality compliance	Adequate rate, depth, recoil	>80–90% adherence
Chest compression fraction	% time compressions delivered	>80%
EtCO₂ during CPR (if available)	Marker of CPR quality	Documented in ≥80% of arrests
ROSC rate	Return of spontaneous circulation	Institution benchmark

4. Medication & Advanced Intervention Indicators

Indicator	Definition	Target
Epinephrine timing compliance	Given within recommended interval	>80% compliance
Correct dosing accuracy	Weight-based drug accuracy	>90%
Airway success rate	Successful advanced airway placement	Documented + first-pass success tracked
Interruption time during advanced airway insertion (ETT, LMA)	CPR pause during intubation	<10 seconds

5. Post–Cardiac Arrest Care Indicators

Indicator	Definition	Target
Oxygen titration compliance	Avoidance of hyperoxia/hypoxia	>85%
Hemodynamic stability achieved	SBP appropriate for age after ROSC	Increasing trend
Time to vasoactive support	ROSC → vasopressor start in shock	<15–30 min
Fever prevention compliance	Temperature maintained <38°C	>90%
Neurological monitoring use	EEG / neuro assessment documented	Increasing utilization
Seizure detection and treatment	Documented seizure management after ROSC	>90% treated promptly

6. Outcome Measures (Clinical Impact)

Outcome	Definition	Target
Survival to ROSC	Any sustained ROSC after arrest	Improve over baseline
Survival to ICU discharge	Survival after arrest admission	Increase trend
Survival to hospital discharge	Final survival outcome	Increase trend
Neurologically favorable survival	CPC 1–2 or age-appropriate function	Key quality endpoint
Pediatric in-hospital cardiac arrest rate	Arrests per 1000 admissions	Decrease over time

جميع الحقوق محفوظة المجلس الصحى المصري

المجلس

تواصل معنا

Find us on