This study aims to develop a consensus framework that guides the process of reviewing and classifying pediatric in-hospital cardiac arrest in the PICU. The modified electronic Delphi contained a list of survey questions that were sent to the expert panel with the goals of attaining consensus on the definitions of unavoidable, avoidable, and potentially avoidable PICU in-hospital cardiac arrest. Electronic surveys of resuscitation experts, including pediatric critical care, emergency medicine, nurses, advanced practice nurses, cardiac critical care, hospital medicine physicians, and resuscitation researchers were involved.

About twenty-four pediatric resuscitation experts participated over the three rounds of an electronic Delphi. A consensus was achieved in round one for the definitions of potentially avoidable and unavoidable cardiac arrest. The consensus was not reached for avoidable cardiac arrest. In round two, the panel agreed with seven factors from the achieved consensus and literature on an additional seven factors. The consensus was achieved on the modified definition of avoidable cardiac arrest. In round three, the participants were asked to rank the contributing factors in the order of their importance.

In conclusion, a multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to Review and classify pediatric in-hospital cardiac arrest in the PICU. All the work in the future will focus on the further validation of these definitions, and contributing factors as well as the application of this framework for the in-hospital cardiac arrest in the PICU.