Workbench

P-ICECAP

Workbench

Welcome to the P-ICECAP Workbench! The workbench (formerly toolbox) provides key resources for study coordination, including ancillary study policies, consent practice tools, essential forms and logs, IDE and IRB approvals, and publication guidelines. It offers readiness checklists, pediatric quality of life assessments in English and Spanish, and practical resources such as calculators, workflows, and clinical pathways. Click on the categories below to explore the available resources.

Would you like a resource on this page that isn’t here? Please use the “submit a workbench request” button!

Submit a Workbench request

P-ICECAP Ancillary Study Policy

SIREN Ancillary/Substudy Approval process

Ancillary Study Application Schematic

P-ICECAP E-consent Practice Enviornment

P-ICECAP E-consent Practice Enviornment with Bill of Rights and HIPAA sections

Contact Tracking Log

Family and Household Information Form

Manuscript analysis request form (MARF)

MARF (Manuscript Analysis Request Form)

Participant Contact Information Form

P-ICECAP Main manuscript MARF

P-ICECAP Main manuscript MAP

PRCA Neurological Outcome 2 days to less than 3 years old

PRCA Neurological Outcome 3 years and older

Temperature Recording Aid

FDA IDE Approval G210126/S004 & G210126/S004/A001 – April 26, 2023

FDA IDE Approval G210126-S004 – April 21, 2023

FDA IDE Approval with Contingencies – December 2022

FDA IDE Approval with Contingencies – October 2022

FDA IDE Approval with Contingencies – July 2022

FDA IDE Approval with Contingencies – June 2022

FDA IDE Approval with Contingencies – March 2022

FDA IDE Approval with Contingencies – August 2021

FDA IDE Approval with Contingencies – May 2021

PICECAP Protocol Approval – Version 4

English

2 days – <13 months

13 months – <2 years

2 – <5 years (updated 1/15/25)

5 – <8 years

8 – <13 years

13 – 18 years

Spanish

2 days – <13 months SPANISH

13 months – <2 years SPANISH

2 – <5 years SPANISH

5 – <8 years SPANISH

8 – <13 years SPANISH

13 – 18 years SPANISH

P-ICECAP Publication Policy

Sample – Note this is a sample document, the CCC will send your site an editable version

The following resources have been provided for your use. Please note that these are not official P-ICECAP documents. Most have been shared by sites to save you time.

Always refer to the Protocol, MOP, CRF Completion Guidelines and the Clinical Standardization Guidelines for approved, study-related information.

3 and 12 month Post CA Window Calculator

Age Calculator

C.S. Mott P-ICECAP Ordersets -PDFs

Checklist with Critical Times

CHOP Pediatric Cardiac Arrest Clinical Pathway

CHOP PICECAP Orderset

Educational Information Sheet

Esophageal Probe Placement Slides

Follow-up Family Reminder Card

Kennedy Krieger Institute Phone Numbers

P-ICECAP Unit Flyer