A Prospective, Population-Based Study of the Epidemiology and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest

• DOI: 10.1542/peds.114.1.157
• Publication Date: 2004-08-14T00:53:04Z
• Authors: Kelly D. Young; Marianne Gausche-...; Christian D. McClung; Roger J. Lewis
• Keywords: Pulseless electrical activity; Asystole; Etiology

Background. This study reports the epidemiologic features, survival rates, and neurologic outcomes of largest population-based series pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data. Methods. Secondary analysis data from a prospective, interventional trial airway management conducted 1994 to 1997 (Gausche M, Lewis RJ, Stratton SJ, et al. JAMA. 2000;283:783-790). Consecutive 2 large urban counties in California <12 years old or 40 kg bodyweight who were determined by paramedics be pulseless apneic included. Main outcome measures included hospital discharge, patient demographics, etiology, rhythm, event intervals, outcomes. Results. In 599 patients, 601 events studied (54% <1 year old, 58% male). Return spontaneous circulation was achieved 29%; 25% admitted hospital, 8.6% (51) survived discharge. The most prevalent etiologies sudden infant death syndrome trauma; these resulted relatively higher mortality. Respiratory submersions followed; lower Twenty-six percent arrests witnessed citizens, an additional 8% rescue personnel. Witnessed had rate (16%). Thirty-one received bystander resuscitation, which not demonstrated result improved rates. Arrest rhythms asystole (67%), electrical activity (24%), ventricular fibrillation (9%); children latter better One third survivors (16 51) good outcome, none whom >3 doses epinephrine resuscitated for >31 minutes emergency department. Conclusions. after is poor. Administration prolonged resuscitation futile.