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Outcomes After Pediatric Out-of-Hospital Cardiopulmonary Interventions

Jennifer Y Lo, Lloyd Y Tani, Miles Christensen

    Pediatric Emergency Care
    |June 3, 2016
    PubMed

    Insights

    Pediatric cardiopulmonary interventions by emergency medical services (EMS) show that infants under 1 year face higher death risks. EMS transport and dispatch times significantly impact survival and neurologic outcomes in children receiving CPI.

    Area of Science:

    • Pediatric Emergency Medicine
    • Cardiopulmonary Resuscitation
    • Out-of-Hospital Care

    Background:

    • Pediatric out-of-hospital cardiopulmonary interventions (CPI) are critical for young patients.
    • Evaluating the effectiveness of Emergency Medical Services (EMS) in pediatric CPI is essential for improving outcomes.

    Purpose of the Study:

    • To assess the outcomes of pediatric patients who received out-of-hospital cardiopulmonary interventions (CPI) administered by emergency medical services (EMS).

    Main Methods:

    • Retrospective analysis of pediatric patients (≤18 years) receiving CPI by EMS from 2001-2008 in Utah.
    • CPI defined as oxygenation, ventilation, or CPR with EMS transport.
    • Regression analyses identified predictors of death and new neurologic dysfunction.

    Main Results:

    • Of 464 patients, 327 were alive on EMS arrival; 205 received CPI without CPR.
    • 6% of these patients died in-hospital, and 6% were diagnosed with new neurologic dysfunction.
    • Increased risk of death associated with age <1 year, shorter transport time, and longer dispatch time. Increased risk of neurologic dysfunction linked to pulselessness and CPR duration.

    Conclusions:

    • Infants under 1 year, shorter EMS transport, and longer dispatch times increase mortality risk in pediatric CPI.
    • Pulselessness and need for CPR correlate with new neurologic dysfunction.
    • Optimizing EMS interventions for infants <1 year undergoing CPI may enhance patient outcomes.
    Abstract

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