Overview

Purpose

The goal of the Pediatric Perioperative Cardiac Arrest (POCA) Registry is to collect a large set of cases of cardiac arrests and deaths of pediatric patients during the administration of or recovery from anesthesia in order to investigate the possible relationship of anesthesia to these incidents.

Background

The POCA Registry was created after the analysis of closed malpractice claims data from the American Society of Anesthesiologists Closed Claims Project suggested that mechanisms of anesthetic injury of pediatric patients were not adequately understood (click here for journal article reference). Data collected specifically to address problems in pediatric anesthesia were needed. The POCA Registry was formed to provide detailed data collection focussed on perioperative cardiac arrest and death among pediatric patients. Data collection is focussed on the immediate perioperative period in order to concentrate on incidents in which anesthesia may have been an important factor. All cases are submitted anonymously.

The first institutions were enrolled in the POCA Registry in April 1994.

Sponsorship

The POCA Registry is sponsored by the American Academy of Pediatrics Section on Anesthesiology and the Committee on Professional Liability of the American Society of Anesthesiologists. Funding is provided by the American Society of Anesthesiologists. Facilities are provided by the Department of Anesthesiology at the University of Washington.

Case eligibility criteria

All pediatric cardiac arrests and deaths occurring during induction or administration of anesthesia or in the post anesthesia care unit are eligible for inclusion in the POCA Registry. Cardiac arrest is broadly defined as the need for cardiopulmonary resuscitation (CPR), including closed chest massage. Pediatric patients are defined as being 18 years or less.

Enrollment Temporarily Halted

The POCA Steering Committee has decided to temporarily halt collections from participating institutions. This temporary hiatus in data collection will help us to analyze our existing data and focus our future efforts on a case control study to better assess risk factors for perioperative cardiac arrest in pediatric patients.

Institutional eligibility

Any healthcare organization providing anesthesia services to pediatric patients (18 years or less) in the U.S. or Canada.

Participation

Participating institutions agree to submit a data form describing each eligible case as soon as possible after the case occurs. A single institutional representative is identified at each participating institution. This institutional representative is responsible for data collection and case submission. Many institutions incorporate data collection into their normal quality assurance or quality improvement activities. All data forms are submitted anonymously, without any institutional, patient or provider identifiers. Completed data forms are submitted by mail.

At enrollment, each participating institution is asked to complete a brief demographic questionnaire describing their organization including the number of patients served, the types or anesthesia services provided and the types of anesthesia providers.