{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:42:56Z","timestamp":1792392176791,"version":"4.4.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Aim:<\/jats:title>\n This study evaluated whether a human factors-driven, integrated, color-coded resuscitation system that combines equipment standardization and prefilled-medication cognitive aids improves workflow efficiency and accuracy compared with a conventional crash cart during simulated pediatric resuscitations.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A prospective, randomized, crossover simulation study was conducted with 28 health care professionals. Each team participated in 2 pediatric resuscitation scenarios using either the SCC or the CCCC in random order. All sessions were video-recorded to measure equipment retrieval and medication preparation times. Statistical comparisons were made using paired statistical tests appropriate for crossover designs, with significance set at\n P<\/jats:italic>\n <0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Use of the CCCC significantly reduced the time to locate airway devices (13.1\u00b16.9 vs. 41.7\u00b122\u00a0s,\n P<\/jats:italic>\n <0.001) and airway adjuncts (13.8\u00b111.9 vs. 30.8\u00b117.4\u00a0s,\n P<\/jats:italic>\n =0.03). Prefilled color-coded syringes significantly reduced medication preparation time (median: 16 vs. 19\u00a0s; absolute reduction 3\u00a0s,\n P<\/jats:italic>\n =0.04), with no dosing errors observed. Teams using the CCCC demonstrated more consistent workflow and fewer procedural delays.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In this randomized crossover simulation study, the integrated color-coded system reduced equipment retrieval and medication preparation times for selected pediatric resuscitation tasks. These findings are limited to the simulation setting and should be interpreted in light of the Broselow framework's use for both cart organization and assessment of correct equipment selection. Further research is needed to evaluate the feasibility of color-coded prefilled syringes and determine whether the observed workflow benefits translate to real-world pediatric patient care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/pec.0000000000003742","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:00:13Z","timestamp":1792389613000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Human Factors-Driven Optimization of Pediatric Resuscitation Workflow Using Integrated Color-Coded Systems"],"prefix":"10.1097","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8340-2819","authenticated-orcid":false,"given":"Manal A.","family":"Halwani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah A.","family":"Bakhsh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"R1-20261019","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1542\/peds.2008-0714","article-title":"New opportunity to improve pediatric emergency preparedness: pediatric emergency assessment, recognition, and stabilization course","volume":"123","author":"Ralston","year":"2009","journal-title":"Pediatrics"},{"key":"R2-20261019","doi-asserted-by":"crossref","first-page":"549710","DOI":"10.3389\/fped.2020.549710","article-title":"More than 500 kids could be saved each year! Ten consensus actions to improve the quality of pediatric resuscitation in DACH countries (Austria, Germany, and Switzerland)","volume":"8","author":"Jung","year":"2020","journal-title":"Front Pediatr"},{"key":"R3-20261019","doi-asserted-by":"crossref","first-page":"93","DOI":"10.5847\/wjem.j.1920-8642.2018.02.002","article-title":"The emergency department crash cart: a systematic review and suggested contents","volume":"9","author":"Jacquet","year":"2018","journal-title":"World J Emerg Med"},{"key":"R4-20261019","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1542\/hpeds.2015-0161","article-title":"Saving time under pressure: effectiveness of standardizing pediatric resuscitation carts","volume":"6","author":"Maul","year":"2016","journal-title":"Hosp Pediatr"},{"key":"R5-20261019","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1097\/PEC.0b013e318258ac2e","article-title":"Weighing the pediatric patient during trauma resuscitation and its concordance with estimated weight using Broselow Luten Emergency Tape","volume":"28","author":"Sinha","year":"2012","journal-title":"Pediatr Emerg Care"},{"key":"R6-20261019","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1093\/bja\/88.2.283","article-title":"How reliable is length-based determination of body weight and tracheal tube size in the pediatric age group? The Broselow tape reconsidered","volume":"88","author":"Hofer","year":"2002","journal-title":"Br J Anaesth"},{"key":"R7-20261019","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s12630-010-9274-8","article-title":"Standardising anaesthesia medication drawers using human factors and quality assurance methods","volume":"57","author":"Ruggles","year":"2010","journal-title":"Can J Anaesth"},{"key":"R8-20261019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12960-019-0441-x","article-title":"Do cognitive aids reduce error rates in resuscitation team performance? Trial of emergency medicine protocols in simulation training (TEMPIST) in Australia","volume":"18","author":"Hall","year":"2020","journal-title":"Hum Resour Health"},{"key":"R9-20261019","doi-asserted-by":"crossref","first-page":"e326","DOI":"10.1542\/peds.2005-0320","article-title":"Comparing the utility of a standard pediatric resuscitation cart with a Pediatric resuscitation cart based on the Broselow tape: a randomised, controlled, crossover trial involving simulated resuscitation scenarios","volume":"116","author":"Agarwal","year":"2005","journal-title":"Pediatrics"},{"key":"R10-20261019","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1111\/acem.13509","article-title":"Providers\u2019 perceptions of caring for pediatric patients in community hospital emergency departments: a mixed-methods analysis","volume":"25","author":"Goldman","year":"2018","journal-title":"Acad Emerg Med"},{"key":"R12-20261019","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1097\/00000446-200508000-00031","article-title":"Color coding to reduce errors: the Broselow-Luten system streamlines pediatric emergency treatment","volume":"105","author":"DeBoer","year":"2005","journal-title":"Am J Nurs"},{"key":"R15-20261019","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1001\/archinte.162.16.1897","article-title":"Medication errors were observed in 36 health care facilities","volume":"162","author":"Barker","year":"2002","journal-title":"Arch Intern Med"},{"key":"R16-20261019","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1136\/qhc.11.4.340","article-title":"Prescribing errors in hospital inpatients: their incidence and clinical significance","volume":"11","author":"Dean","year":"2002","journal-title":"Qual Saf Health Care"},{"key":"R17-20261019","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1016\/S0196-0644(05)82924-5","article-title":"Length-based endotracheal tube and emergency equipment in Pediatrics","volume":"21","author":"Luten","year":"1992","journal-title":"Ann Emerg Med"},{"key":"R18-20261019","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1542\/peds.2006-0854","article-title":"Changes to the emergency medical services system reduce pediatric epinephrine dosing errors in the prehospital setting","volume":"118","author":"Kaji","year":"2006","journal-title":"Pediatrics"},{"key":"R19-20261019","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S0736-4679(01)00354-7","article-title":"Estimation of pediatric patient weight by EMT-PS","volume":"21","author":"Vilke","year":"2001","journal-title":"J Emerg Med"},{"key":"R20-20261019","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/S0039-6109(02)00007-5","article-title":"Error and time delay in pediatric trauma resuscitation: addressing the problem with color-coded resuscitation aids","volume":"82","author":"Luten","year":"2002","journal-title":"Surg Clin North Am"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003742","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:00:16Z","timestamp":1792389616000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/PEC.0000000000003742"}},"subtitle":["A Randomized Crossover Study"],"short-title":[],"issued":{"date-parts":[[2026,10,19]]},"references-count":17,"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003742","relation":{},"ISSN":["0749-5161","1535-1815"],"issn-type":[{"value":"0749-5161","type":"print"},{"value":"1535-1815","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,19]]},"assertion":[{"value":"2026-03-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}