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Pediatric Out-of-Hospital Cardiac Arrests: An Epidemiological Study

Rachel Irvine1, Tan Doan2, Emma Bosley2

  • 1Department of Paramedicine, Monash University, Clayton, Victoria, Australia.

Prehospital Emergency Care
|June 30, 2022
PubMed

Insights

Approximately a quarter of pediatric out-of-hospital cardiac arrests (OHCA) in Queensland achieved return of spontaneous circulation (ROSC). Outcomes varied significantly by arrest cause, patient age, and geographic location.

Area of Science:

  • Emergency Medicine
  • Pediatric Cardiology
  • Public Health

Background:

  • Pediatric out-of-hospital cardiac arrest (OHCA) is a critical medical emergency with significant mortality.
  • Understanding the epidemiological patterns and prehospital outcomes of pediatric OHCA is crucial for improving survival rates.

Purpose of the Study:

  • To determine the epidemiological characteristics of pediatric OHCA in Queensland, Australia.
  • To investigate factors associated with prehospital outcomes, specifically return of spontaneous circulation (ROSC), in pediatric OHCA patients.

Main Methods:

  • A retrospective analysis of pediatric OHCA cases attended by paramedics in Queensland from January 2009 to December 2019.
  • Descriptive statistics were used to characterize patient and arrest variables.
  • Multivariable analysis was performed to identify factors associated with ROSC on hospital arrival.

Main Results:

  • Over 1,600 pediatric patients were included; 1,001 received resuscitation attempts.
  • The overall rate of ROSC on hospital arrival was 26.8%.
  • Medical causes were most frequent (49.7%), while trauma had the lowest ROSC (9.6%) and drug overdose the highest (40%). Rural patients had lower ROSC rates (20.7%) than metropolitan (32.5%). Older children and adolescents had better ROSC rates than infants.

Conclusions:

  • About a quarter of pediatric OHCA patients achieved ROSC in the prehospital setting.
  • Prehospital outcomes are influenced by etiology, patient demographics, bystander presence, initial rhythm, and geographic location.
Abstract

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