Secondary prevention of sudden cardiac death: does it work in children?

Over half of young sudden cardiac arrest victims show no prior warning signs or symptoms and survival depends on secondary prevention, notably prompt initiation of cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED), for out-of-hospital arrests. There is increasing public interest in and uptake of public access defibrillation programs in communities and schools. Our purpose was to review recent data on sudden cardiac arrest in children and its outcome to identify ways to improve the current low survival rate of youth who experience sudden cardiac arrest.

Increases in bystander cardiopulmonary resuscitation in Norway to 73% have occurred alongside increasing survival from sudden cardiac arrest from shockable rhythms to 52%. Studies in Denmark and the US show that survival of 69-74% is possible when a shockable rhythm is present and an automated external defibrillator is immediately applied. Up to 70-80% of US schools have automated external defibrillators, but not all have effective emergency action plans to maximize the impact of the presence of the AED.

Studies suggest that education to increase bystander CPR and implementation of school AEDs and other public access defibrillation programs improve the survival of youth experiencing sudden cardiac arrest to 74% when optimal programs are in place. Methods to enhance such programs are presented. All involved with the health and education of youth are urged to implement best practices to protect youth and improve survival from sudden cardiac arrest.