A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest

P. E. Sirbaugh, P. E. Pepe, J. E. Shook, K. T. Kimball, M. J. Goldman, M. A. Ward, D. M. Mann

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Abstract

Study objectives: To perform a population-based study addressing the demography, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest (PCPA). Methods: Prospective, population- based study of all children (17 years of age or younger) in a large urban municipality who were treated by EMS personnel for apneic, pulseless conditions. Data were collected prospectively for 3 1/2 years using a comprehensive data collection tool and on-line computerized database. Each child received standard pediatric advanced cardiac life support. Results: During the 3 1/2 -year period, 300 children presented with PCPA (annual incidence of 19.7/100,000 at risk). Of these, 60% (n=181) were male (P=.0003), and 54% (n=161) were patients 12 months of age or younger (152,500 at risk). Compared with the population at risk (32% black patients, 36% Hispanic patients, 26% white patients), a disproportionate number of arrests occurred in black children (51.6% versus 26.6% in Hispanics, and 17% in white children; P<.0001). Over 60% of all cases (n=181) occurred in the home with family members present, and yet those family members initiated basic CPR in only 31 (17%) of such cases. Only 33 (11%) of the total 300 PCPA cases had a return of spontaneous circulation, and 5 of the 6 discharged survivors had significant neurologic sequelae. Only 1 factor, endotracheal intubation, was correlated positively with return of spontaneous circulation (P=.032). Conclusion: This population-based study underscores the need to investigate new therapeutic interventions for PCPA, as well as innovative strategies for improving the frequency of basic CPR for children.

Original languageEnglish (US)
Pages (from-to)174-184
Number of pages11
JournalAnnals of Emergency Medicine
Volume33
Issue number2
DOIs
StatePublished - Jan 1 1999

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ASJC Scopus subject areas

  • Emergency Medicine

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