Implementation of Paediatric Life Support Recommendations: A Survey in the D-A-CH Region

Background: Implementing recommendations to improve in-hospital resuscitation is a complex process. The extent to which an advisory statement formulating ten theses to improve resuscitation quality in paediatrics is applied in clinical practice across Germany, Austria, and Switzerland (D-A-CH-region) remains unclear. Methods: A web-based cross-sectional survey was conducted among paediatric physicians in the D-A-CH region between November 2022 and May 2023, comprising 50 questions focusing on experience and safety in paediatric emergency management and on the structural conditions at hospitals required to implement the ten theses. Ethics approval was obtained from the Ethics Committee Leipzig, Germany (218/19-ek). Results: Structural recommendations were implemented to varying and often limited degrees: An emergency telephone chain was available in 91% of workplaces, 19% had a Paediatric Early Warning System, and 38% had a designated resuscitation supervisor. Although in-house training was available to 89% of respondents, 31% had not participated in in-house training in the preceding 12 months, and 37% had not attended a certified resuscitation course in the last five years. A total of 48% of respondents reported that structured debriefings following emergency events were rarely or never conducted. Internal guidelines for post-resuscitation care were available in 26% of institutions. Only seven respondents (less than 1%) worked in a setting where all the recommendations surveyed were in place. No significant differences were observed according to hospital size or type. Conclusions: Structural implementation of paediatric resuscitation recommendations remains markedly inadequate across the D-A-CH region, with likely multifactorial causes that are not yet fully understood.