Cardiopulmonary arrest in children was an uncommon emergency with a high death rate. Its management was difficult, and following the rules incorrectly might have an impact on clinical results. For a study, researchers sought to assess the compliance with guidelines while teams of pediatric residents are managing a case of pediatric cardiac arrest. Additionally, the relationship between the teams’ adherence to global standards and the usage of the Pediatric Advanced Life Support-2015 (PALS-2015) pocket card was investigated.

PALS-2015 certified pediatric residents in their 3rd through 5th year of residency were included in a multicenter observational simulation-based research conducted in 2018 at three Italian university hospitals, separated into three teams. Each team carried out a typical non-shockable juvenile cardiac arrest scenario and independently chose whether to utilize the PALS-2015 pocket card.

The main result measured by the unique c-DEV15plus score was the total number and frequency of individual departures from the PALS-2015 criteria (range 0–15). In addition, the teams that used and didn’t use the PALS-2015 pocket card were contrasted in terms of how well they performed on the validated Clinical Performance Tool for asystole scenarios, the time it took to complete resuscitation tasks, and the quality metrics for cardiopulmonary resuscitation (CPR). There were 27 teams totaling 81 residents. In all, there were 7 out of 15 deviations per scenario [interquartile range (IQR), 6–8]. The most frequent errors were inaccurate or delayed administration of adrenaline (88.9%), asking for help (88.9%), and delays in situating a CPR board (92.6%). The clinical performance tool’s average score was 9 out of 13 (IQR, 7–10). Teams who utilized the PALS-2015 pocket card (n=13) performed considerably better on the Clinical Performance Tool than teams that did not (n=14) [9 (IQR 9-10) vs. 7 (IQR 6-8); P=0.002].

Pediatric residents frequently deviated from the rules when handling a scenario involving a pediatric cardiac arrest, even though this was evaluated using a nonvalidated technique. Better Clinical Performance Tool scores were linked to the usage of the PALS-2015 pocket card, however, none of these factors were linked to fewer deviations or quicker turnaround times for resuscitation activities.