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Resuscitation. 2015 Aug;93:150-7. doi: 10.1016/j.resuscitation.2015.04.010. Epub 2015 Apr 25.

A quantitative analysis of out-of-hospital pediatric and adolescent resuscitation quality--A report from the ROC epistry-cardiac arrest.

Author information

1
The Children's Hospital of Philadelphia, 34th Street, Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: suttonr@chop.edu.
2
Resuscitations Outcome Consortium, 1107 NE 45th Street, Suite 505, Seattle, WA 98105-4680, United States. Electronic address: ecase@uw.edu.
3
Resuscitations Outcome Consortium, 1107 NE 45th Street, Suite 505, Seattle, WA 98105-4680, United States. Electronic address: spes@uw.edu.
4
University of Iowa Carver College of Medicine, Stead Family Department of Pediatrics, Iowa City, IA 52242, United States. Electronic address: dianne-atkins@uiowa.edu.
5
The Children's Hospital of Philadelphia, 34th Street, Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: nadkarni@chop.edu.
6
National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Bethesda, MD 20817, United States. Electronic address: kaltmanj@nhlbi.nih.gov.
7
University of Pittsburgh, 400A Iroquois, 3600 Forbes Avenue, Pittsburgh, PA 15260, United States. Electronic address: callawaycw@upmc.edu.
8
University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8579, United States. Electronic address: ahamed.idris@utsouthwestern.edu.
9
Resuscitation Outcome Consortium Clinical Trial Center, University of Washington, Seattle, WA 98104, United States. Electronic address: grahamnichol@icloud.com.
10
The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8. Electronic address: jamie.hutchison@sickkids.ca.
11
Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada M5B 1W8. Electronic address: DrennanI@smh.ca.
12
University of Ottawa, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON, Canada K1Y 4E9. Electronic address: tassiemlm@yahoo.com.au.
13
Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode CDW-EM, Portland, OR 97239-3098, United States. Electronic address: dayam@ohsu.edu.
14
Sunnybrook Center for Prehospital Medicine, 77 Browns Line, Toronto, ON, Canada M8W 3S2. Electronic address: Sheldon.Cheskes@sunnybrook.ca.
15
Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States. Electronic address: nuttallj@ohsu.edu.
16
Resuscitations Outcome Consortium, 1107 NE 45th Street, Suite 505, Seattle, WA 98105-4680, United States. Electronic address: hherren@uw.edu.
17
Department of Emergency Medicine, University of British Columbia Faculty of Medicine, Room 3300 3rd Floor, 910 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9. Electronic address: jim.christenson@ubc.ca.
18
School of Medical Sciences, Faculty of Health, Engineering and Science, Edith Cowan University, Building 19, Room 129d, 270 Joondalup Dr. Joondalup, Western Australia 6023, Australia. Electronic address: dug.andrusiek@alumni.ubc.ca.
19
University of Ottawa, The Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Room F649, 1053 Carling Avenue, Ottawa, ON, Canada K1Y 4E9. Electronic address: cvaillancourt@ohri.ca.
20
University of Pittsburgh, 3600 Forbes Avenue, Pittsburgh, PA 15261, United States. Electronic address: menegazzijj@upmc.edu.
21
University of Washington, 206 3rd Avenue South, Seattle, WA 98104, United States. Electronic address: rea123@u.washington.edu.
22
The Children's Hospital of Philadelphia, 34th Street, Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: bergra@chop.edu.

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 100-120 min(-1); depth ≥ 38 mm; 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

[Indexed for MEDLINE]
Free PMC Article

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