ESPNIC Resuscitation Survey Question Title * 1. What is your occupation? (PICU doctor, AICU doctor who looks after children, Emergency physician, paediatrician, neonatologist who also looks after children and infants, other - please specify) Question Title * 2. What hospital and in which country do you practice? Question Title * 3. Is your hospital a regional hospital or university affiliated centre? Question Title * 4. Does your country have a National Resuscitation Council? yes no don't know Question Title * 5. Is your resuscitation council affiliated to ERC? yes no don't know Question Title * 6. Do you have a national paediatric cardiac arrest register (database)? yes no don't know Question Title * 7. Does your hospital collect information on paediatric cardiac arrest either for the whole hospital or in the PICU? Hospital PICU Both none Question Title * 8. If you collect data on cardiac arrest how manya) In hospital paediatric cardiac arrestsb) Out of hospital paediatric cardiac arrests does your hospital admit/see each year? Question Title * 9. If you are collecting in hospital cardiac arrest data what are you collecting (select all that apply) Demographics (age, weight, ethnicity, diagnosis, co-morbidities) Site arrest (ward, ICU, Theatres, CT, MRI) Time and day of arrest Presenting rhythm - shockable/ non-shockable Time to first shock Time to first adrenaline Quality CPR measures - ETCO2, DBP, depth, rate, ventilation rate Use backboard other drugs and indications length arrest Number shocks Number adrenaline doses ROSC rate Other (please specify)any additional information? Question Title * 10. Do you collect post resuscitation care data on the following fields? (select all that apply) GCS after ROSC targeted temperature management Targeted CO2 and O2 EEG MRI SSEP Survival to PICU discharge for your unit Survival to hospital discharge for your unit Follow up for discharged survivors of paediatric cardiac arrest Any other information Question Title * 11. Which resuscitation algorithms do you use? ERC RC-UK AHA Other Other (please specify) Question Title * 12. Describe the resuscitation training requirements for your area of practice? (national requirement, hospital requirement, self directed learning - give frequency of training requirement if any) Question Title * 13. Which courses do you hold current instructor or provider status for? (tick all that apply) EPALS APLS PBLS EPILS ALS NLS BLS ILS GIC Question Title * 14. How often do you have resuscitation training? more than once per year once a year 4 yearly EPALS, APLS, PILS, NLS courses > 4 yearly Question Title * 15. How often do the following staff in your institution have resuscitation training? PICU doctors PICU nurses NICU doctors NICU nurses Emergency staff Paediatricians Paediatric ward nursing staff N/A more than once a year more than once a year PICU doctors more than once a year PICU nurses more than once a year NICU doctors more than once a year NICU nurses more than once a year Emergency staff more than once a year Paediatricians more than once a year Paediatric ward nursing staff more than once a year N/A once a year once a year PICU doctors once a year PICU nurses once a year NICU doctors once a year NICU nurses once a year Emergency staff once a year Paediatricians once a year Paediatric ward nursing staff once a year N/A between 1 and 4 yearly between 1 and 4 yearly PICU doctors between 1 and 4 yearly PICU nurses between 1 and 4 yearly NICU doctors between 1 and 4 yearly NICU nurses between 1 and 4 yearly Emergency staff between 1 and 4 yearly Paediatricians between 1 and 4 yearly Paediatric ward nursing staff between 1 and 4 yearly N/A > 4 yearly > 4 yearly PICU doctors > 4 yearly PICU nurses > 4 yearly NICU doctors > 4 yearly NICU nurses > 4 yearly Emergency staff > 4 yearly Paediatricians > 4 yearly Paediatric ward nursing staff > 4 yearly N/A Other (please specify) Question Title * 16. For those who are instructors - how many courses do you teach on per year? 0 1 2 3 > 3 PBLS No Yes PBLS 0 menu Yes No PBLS 1 menu Yes No PBLS 2 menu Yes No PBLS 3 menu Yes No PBLS > 3 menu EPILS No Yes EPILS 0 menu Yes No EPILS 1 menu Yes No EPILS 2 menu Yes No EPILS 3 menu Yes No EPILS > 3 menu EPALS No Yes EPALS 0 menu Yes No EPALS 1 menu Yes No EPALS 2 menu Yes No EPALS 3 menu Yes No EPALS > 3 menu APLS No Yes APLS 0 menu Yes No APLS 1 menu Yes No APLS 2 menu Yes No APLS 3 menu Yes No APLS > 3 menu ALS No Yes ALS 0 menu Yes No ALS 1 menu Yes No ALS 2 menu Yes No ALS 3 menu Yes No ALS > 3 menu NLS No Yes NLS 0 menu Yes No NLS 1 menu Yes No NLS 2 menu Yes No NLS 3 menu Yes No NLS > 3 menu BLS No Yes BLS 0 menu Yes No BLS 1 menu Yes No BLS 2 menu Yes No BLS 3 menu Yes No BLS > 3 menu ILS No Yes ILS 0 menu Yes No ILS 1 menu Yes No ILS 2 menu Yes No ILS 3 menu Yes No ILS > 3 menu GIC No Yes GIC 0 menu Yes No GIC 1 menu Yes No GIC 2 menu Yes No GIC 3 menu Yes No GIC > 3 menu Question Title * 17. Does your department conduct any research into paediatric resuscitation? Yes No Don't know Question Title * 18. If so which of the following best describes your area of study? Clinical investigation Animal lab investigation Simulation Question Title * 19. Would you be willing to participate in a European Registry on paediatric cardiac arrest organised through ESPNIC? Yes No Unsure Any comments Question Title * 20. What type of authorisation/ ethical permissions do you need in your country to enable data submission to a database Ethical permission Informed consent Anonymisation data Informed consent waiver Other (please specify) Question Title * 21. Thank you for your answers and for anyone willing to help in contributing to a potential registry of paediatric cardiac arrest patients please leave your name, job title and email address Next