Pediatric patients requiring CPR in the prehospital setting

To determine the outcome of pediatric patients with prehospital cardiopulmonary arrest. Chart review of all patients with prehospital cardiopulmonary arrest who were subsequently admitted to a pediatric emergency department from January 1988 to January 1993. Cardiopulmonary arrest was considered to...

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Bibliographic Details
Published in:Annals of emergency medicine 1995-04, Vol.25 (4), p.495-501
Main Authors: HICKEY, R. W, COHEN, D. M, STRAUSBAUGH, S, DIETRICH, A. M
Format: Article
Language:English
Subjects:
Age Factors
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiopulmonary Resuscitation - methods
Cardiopulmonary Resuscitation - statistics & numerical data
Child, Preschool
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Emergency Medical Services
Female
Heart Arrest - etiology
Heart Arrest - therapy
Humans
Infant
Intensive care medicine
Male
Medical Audit
Medical sciences
Ohio
Survival Analysis
Treatment Outcome
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Summary:To determine the outcome of pediatric patients with prehospital cardiopulmonary arrest. Chart review of all patients with prehospital cardiopulmonary arrest who were subsequently admitted to a pediatric emergency department from January 1988 to January 1993. Cardiopulmonary arrest was considered to have been present if assisted ventilation and chest compressions were performed on an apneic, pulseless patient. Pediatric ED. Pediatric patients in prehospital cardiac arrest. In all, 95 patients were identified. Fifty-six had initial hospital care at the pediatric ED (primary patients). The remaining 39 were transported to the pediatric ED after initial care of another institution (secondary patients). Forty-one percent of patients were younger than 1 year. Most arrests were respiratory in origin; asystole was the most common dysrhythmia. Fifteen patients (27%) survived to discharge. Fourteen of the survivors had return of spontaneous circulation before ED arrival. Thirty-three patients were in arrest on ED arrival; in 16 (48%) of these, return of spontaneous circulation subsequently developed in the ED, and 1 survived to discharge. Two survivors, including the survivor with return of spontaneous circulation in the ED, had severe neurologic sequelae. Ten (26%) of the secondary patients survived. All survivors had return of spontaneous circulation before arrival in the ED. Two survivors had severe neurologic sequelae. Most successfully resuscitated pediatric arrest victims are resuscitated in the prehospital setting and do not suffer severe neurologic injury. Most patients who present to the ED in continued arrest and survive to discharge have severe neurologic injury.
ISSN:0196-0644
1097-6760
DOI:10.1016/S0196-0644(95)70265-2