OPENPediatrics

Reducing Cardiac Arrests in the PICU with ABC-PRO by L. Schlapbach, J. Kelly-Geyer | OPENPediatrics

Mar 24, 2026
Luregn Schlapbach, Professor and PICU/Neonatology lead focused on ICU quality and outcomes. Janet Kelly-Geyer, senior PICU consultant skilled in team-based safety improvements. They describe the ABC-PRO handover tool and its Plan, Risk, Options add-on. Conversation covers implementation, training, documentation, study design, and reported reductions in PICU cardiac arrests and mortality.
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INSIGHT

Handover Should Forecast Next 12 Hours

  • ICU handovers must shift from historical reporting to proactive forecasting of the next 12 hours.
  • Dr Luregn Schlapbach observed sentinel events where risks discussed earlier were lost, prompting a focus on anticipating patient trajectories.
ADVICE

Use ABC PRO To Empower Team Speaking Up

  • Encourage multidisciplinary participation and flatten hierarchy during handover so nurses and juniors can speak up.
  • At Zurich the resident formulates ABC-PRO and all present can challenge risk or plan, fostering shared mental model.
ADVICE

Add PRO To ABC For Actionable Handover

  • Use a structured add-on to ABC that specifies Plan, Risk (color coded), and Options at bedside each handover.
  • The resident, nurses, and consultant jointly state the 12-hour plan, list specific risks, and predefine management options.
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