Each day in the United States, approximately 41 children experience in-hospital cardiac arrest (IHCA) requiring cardiopulmonary resuscitation (CPR). A lack of situation awareness was cited as the most common contributing factor to serious safety events within children's hospitals. Situation awareness is the ability to monitor what is happening, integrate information to develop a comprehensive picture, and extrapolate forward to project the future. The primary objective of this study is to implement unit based interventions (SAMURAI PICU bundle) to reduce the incidence of IHCA in pediatric intensive care units using quality improvement methodology.

The primary purpose of this clinical investigation is to evaluate the SpO2
accuracy of neonatal, infant, and pediatric Philips SpO2 sensors with the Philips
FAST Pulse Oximetry System. Accuracy will be evaluated against the gold
standard, SaO2 obtained from arterial blood samples and assessed by COOximetry.

Additionally, this study will be used to determine if skin pigmentation impacts
SpO2 accuracy and to identify the occurrence of occult hypoxemia, defined as an
SaO2 <88% with an SpO2 ≥92%, with consideration to skin pigmentation.

This observational, multi-center cohort study of pediatric cardiac arrest management will contribute to a clinical CPR Learning Laboratory. The objectives of this study are to characterize the quality of CPR and post-cardiac arrest care delivered to children across a broad spectrum of hospitals, to determine the association between quantitative CPR quality measures (depth, rate, compression release, flow fraction) and survival to hospital discharge, and to determine the association of survival with site-specific post-cardiac arrest care (PCAC). The study will enroll pediatric cardiac arrests requiring chest compressions for ≥1 minute identified as part of standard clinical operations. The CPR quantitative measures, defibrillator data (when available), monitor data (when available), and post-arrest care will be de-identified and submitted to a central database.