Demographics, bystander CPR, and AED use in out-of-hospital pediatric arrests

M. Austin Johnson, Brian J.H. Grahan, Jason S. Haukoos, Bryan McNally, Robert Campbell, Comilla Sasson, David E. Slattery

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Background: In 2005 the American Heart Association released guidelines calling for routine use of automated external defibrillators during pediatric out-of-hospital arrest. The goal of this study was to determine if these guidelines are used during resuscitations. Methods: We conducted a secondary analysis of prospectively collected data from 29 U.S. cities that participate in the Cardiac Arrest Registry to Enhance Survival (CARES). Patients were included if they were older than 1 year of age and had a documented resuscitation attempt from October 1, 2005 through December 31, 2009 from an arrest presumed to be cardiac in nature. Hierarchical multivariable logistic regression analysis was used to estimate the associations between age, demographic factors, and AED use. Results: 129 patients were 1-8 years of age (younger children), 88 patients were 9-17 years of age (older children), and 19,338 patients were ≥18 years of age (adults). When compared to adults, younger children were less likely to be found in a shockable rhythm (young children 11.6%, adults 23.7%) and were less likely to have an AED used (young children 16.3%, adults 28.3%). Older children had a similar prevalence of shockable rhythms as adults (31.8%) and AED use (20.5%). A multivariable analysis demonstrated that, when compared to adults, younger children had decreased odds of having an AED used (OR 0.42, 95% CI 0.26-0.69), but there was no difference in AED use among older children and adults. Conclusions: Young children suffering from presumed out-of-hospital cardiac arrests are less likely to have a shockable rhythm when compared to adults, and are less likely to have an AED used during resuscitation.

Original languageEnglish (US)
Pages (from-to)920-926
Number of pages7
JournalResuscitation
Volume85
Issue number7
DOIs
StatePublished - Jul 2014

Bibliographical note

Funding Information:
This was a secondary analysis of CARES, which is funded by Medtronic, Zoll, American Heart Association, and the Red Cross, and is supported by the Centers for Disease Control and Prevention and Emory University. The CARES sample includes an overall catchment area of approximately 22 million people in 29 cities across the United States. CARES is an EMS-based registry for out-of-hospital cardiac arrest, composed of a limited standard set of data elements from three sources: 911 call centers, EMS providers, and receiving hospitals in accordance with the CARES user agreement. Data from submitted reports are linked and reviewed by an independent data analyst. Detailed information on the design and development of this registry as well as the data elements included in the registry is published elsewhere. 14

Funding Information:
Supported, in part, by K02HS017526 from the Agency for Healthcare Research and Quality (Haukoos) and American Heart Association , Emergency Medicine Foundation .

Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.

Keywords

  • AED
  • CPR
  • Cardiac arrest
  • Pediatrics

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