@article{4bbeaec04023449a90ae6cd4bc99abb2,
title = "A quantitative analysis of out-of-hospital pediatric and adolescent resuscitation quality - A report from the ROC epistry-cardiac arrest",
abstract = "Aim: High-quality cardiopulmonary resuscitation (CPR) may improve survival. The quality of CPR performed during pediatric out-of-hospital cardiac arrest (p-OHCA) is largely unknown. The main objective of this study was to describe the quality of CPR performed during p-OHCA resuscitation attempts. Methods: Prospective observational multi-center cohort study of p-OHCA patients ≥1 and <19 years of age registered in the Resuscitation Outcomes Consortium (ROC) Epistry database. The primary outcome was an a priori composite variable of compliance with American Heart Association (AHA) guidelines for both chest compression (CC) rate and CC fraction (CCF). Event compliance was defined as a case with 60% or more of its minute epochs compliant with AHA targets (rate 100-120min-1; depth ≥38mm; and CCF ≥0.80). In a secondary analysis, multivariable logistic regression was used to evaluate the association between guideline compliance and return of spontaneous circulation (ROSC). Results: Between December 2005 and December 2012, 2564 pediatric events were treated by EMS providers, 390 of which were included in the final cohort. Of these events, 22% achieved AHA compliance for both rate and CCF, 36% for rate alone, 53% for CCF alone, and 58% for depth alone. Over time, there was a significant increase in CCF (p<. 0.001) and depth (p= 0.03). After controlling for potential confounders, there was no significant association between AHA guideline compliance and ROSC. Conclusions: In this multi-center study, we have established that there are opportunities for professional rescuers to improve prehospital CPR quality. Encouragingly, CCF and depth both increased significantly over time.",
keywords = "Cardiopulmonary resuscitation, Emergency medical services, Pediatric",
author = "{on behalf of the ROC Investigators} and Sutton, {Robert M.} and Erin Case and Brown, {Siobhan P.} and Atkins, {Dianne L.} and Nadkarni, {Vinay M.} and Jonathan Kaltman and Clifton Callaway and Ahamed Idris and Graham Nichol and Jamie Hutchison and Drennan, {Ian R.} and Michael Austin and Mohamud Daya and Sheldon Cheskes and Jack Nuttall and Heather Herren and James Christenson and Dug Andrusiek and Christian Vaillancourt and Menegazzi, {James J.} and Rea, {Thomas D.} and Berg, {Robert A.}",
note = "Funding Information: Financial disclosure: The ROC is supported by a series of cooperative agreements to 10 regional clinical centers and one Data Coordinating Center (5U01 HL077863 – University of Washington Data Coordinating Center, HL077865 – University of Iowa, HL077866 – Medical College of Wisconsin, HL077867 – University of Washington, HL077871 – University of Pittsburgh, HL077872 – St. Michael's Hospital, HL077873 – Oregon Health and Science University, HL077881 – University of Alabama at Birmingham, HL077885 – Ottawa Hospital Research Institute, HL077887 – University of Texas SW Medical Ctr/Dallas, HL077908 – University of California, San Diego) from the NHLBI in partnership with the National Institute of Neurological Disorders and Stroke (NINDS), U.S. Army Medical Research & Material Command, The Canadian Institutes of Health Research (CIHR) – Institute of Circulatory and Respiratory Health, Defense Research and Development Canada, the Heart, Stroke Foundation of Canada and the AHA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHLBI or the NIH. Funding Information: Dr. Robert M. Sutton receives funding from the National Institute of Child Health and Human Development (NICHD; K23HD062629 ) and has received a speaker honoraria from Zoll Medical. Dr. Christian Vaillancourt is supported by a University of Ottawa Research Chair. He has received funding from the Canadian Institutes of Health Research , the Heart and Stroke Foundation of Canada , and the National Institutes of Health (NIH) for work related to cardiac arrest and prehospital care. Dr. Mohamud Daya receives funding from the NIH and is an unpaid consultant for Philips HealthCare. Dr. Sheldon Cheskes receives grant funding from the NIH as co-primary investigator (PI) of the ROC Toronto site. He has received speaker honoraria and funding from Zoll Medical. Dr. Ahamed H. Idris receives research funding from the National Heart, Lung, and Blood Institute (NHLBI), the US Army , and the AHA . Dr. James J. Menegazzi receives funding from the NHLBI ( R01HL117979 ). Dr. Graham Nichol receives salary support from the University of Washington via the Leonard A Cobb Medic One Foundation Endowed Chair in Prehospital Emergency Care. He holds Research Grants from the following: (1) Resuscitation Outcomes Consortium (NIH U01 HL077863-05) 2004–2015; Co-PI; (2) Food and Drug Administration, Silver Spring, MD; Cardiac Science Corp, Waukesha, WI; Heartsine Technologies Inc., Newtown, PA; Philips Healthcare Inc., Bothell, WA; Physio-Control Inc., Redmond, WA; ZOLL Inc., Chelmsford, MA. University of Washington Dynamic AED Registry, PI. 2013–2015 (4) Velomedix Inc., Menlo Park, CA. Velocity Pilot Study of Ultrafast Hypothermia in Patients with ST-Elevation Myocardial Infarction, National Co-PI. 2014–2015 (waived personal compensation). Erin Case, Jack Nuttall, Heather Herren, and Drs. Ian R. Drennan, Michael A. Austin, Siobhan P. Brown, Clifton W. Callaway, Douglas L. Andrusiek, Jim Christenson, Diane L. Atkins, Vinay M. Nadkarni, Jonathan Kaltman, Jamie Hutchison, Thomas D. Rea, and Robert A. Berg have nothing to disclose. Publisher Copyright: {\textcopyright} 2015 Elsevier Ireland Ltd.",
year = "2015",
month = aug,
day = "1",
doi = "10.1016/j.resuscitation.2015.04.010",
language = "English (US)",
volume = "93",
pages = "150--157",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
}