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Epidemiology of cardiac arrest and resuscitation in children
Insights
Pediatric out-of-hospital cardiac arrest is rare but has a poor survival rate. Sudden infant death and drowning are leading causes, with asystole being the most common rhythm. Survival rates are low for children experiencing cardiac arrest.
Area of Science:
- Pediatric Emergency Medicine
- Cardiology
- Public Health Surveillance
Background:
- Out-of-hospital cardiac arrest (OHCA) in children is a critical medical emergency.
- Understanding the epidemiology of pediatric OHCA is essential for improving outcomes.
Purpose of the Study:
- To characterize the etiology, cardiac rhythm, and outcomes of pediatric out-of-hospital cardiac arrest.
- To determine the incidence and survival rates of cardiac arrest in individuals under 18.
Main Methods:
- A surveillance system was utilized to identify all pediatric patients (<18 years) experiencing out-of-hospital cardiac arrest in suburban King County, Washington.
- Data collected included etiology, cardiac rhythm, emergency medical services (EMS) care received, and patient outcomes.
- The study period spanned 6.5 years, capturing 119 cases of pediatric cardiac arrest.
Main Results:
- The annual incidence of pediatric OHCA was 12.7 per 100,000 individuals under 18.
- Sudden infant death (32%) and drowning (22%) were the most frequent etiologies.
- Asystole was the predominant cardiac rhythm, occurring in 66% of cases.
- Survival discharge rates were low, with 6% for basic EMT care and 7% for EMT-paramedic care.
Conclusions:
- Pediatric out-of-hospital cardiac arrest has a poor prognosis compared to adults.
- Etiologies such as sudden infant death and drowning, along with a high prevalence of asystole, contribute to low resuscitation success rates.
- Improved strategies are needed to address the unique challenges of pediatric cardiac arrest resuscitation.
Abstract:
A surveillance system identified all out-of-hospital cardiac patients under the age of 18 who received emergency care in suburban King County, Washington. The etiology, cardiac rhythm, and outcome were identified for each case. During a 6 1/2-year period, 119 cardiac arrests occurred (annual incidence, 12.7/100,000 among individuals less than 18). Sudden infant death was the most common etiology (32%), and drowning was the second most common (22%). The most common rhythm was asystole, accounting for 66% of all rhythms. Six percent of patients treated with basic EMT care were discharged, compared with 7% of patients treated with EMT and paramedic care. In contrast to resuscitation from cardiac arrest in adults, the likelihood of successful resuscitation in children is very poor. This is due to different etiologies and the higher proportion of asystole seen in pediatric cardiac arrest as compared with adults.