Abstract
OBJECTIVES: Pediatric out-of-hospital cardiac arrest (OHCA) is rare but critical, requiring rapid and effective cardiopulmonary resuscitation (CPR). Delivering high-performance CPR (HPCPR) in the prehospital setting is challenging, especially for EMS clinicians with limited pediatric exposure. This study aimed to assess EMS clinicians' pediatric CPR experience, confidence in HPCPR, and access to CPR feedback systems. A secondary objective was to evaluate perceptions of augmented reality (AR) feedback systems. METHODS: A cross-sectional survey was distributed electronically to EMS clinicians in 5 Maryland counties from January to May 2024. The survey included items on demographics, CPR experience, confidence in pediatric resuscitation, feedback device usage, and opinions on AR-based guidance. Descriptive and comparative analyses were conducted based on clinician type, experience, and administrative role. RESULTS: Fifty-eight EMS clinicians participated. While 78% had performed pediatric CPR, experience differed significantly by clinician type and years of service. Paramedics (87%) and clinicians with >6 years' experience (87%) had greater exposure than EMTs (46%) and less experienced clinicians (42%) ( P <0.05). Confidence in HPCPR was higher for adults (98%) than for infants (84%) and toddlers (83%). Only 52% had access to pediatric CPR feedback devices, although 97% of users reported improved CPR quality. Among those without access, 93% believed feedback would improve performance. Interest in AR feedback was moderate; barriers included cost, reliability, and training. CONCLUSIONS: EMS clinicians vary in pediatric CPR experience and access to performance tools. Expanded pediatric training and real-time feedback technologies may improve prehospital resuscitation outcomes.