Format

Send to

Choose Destination
Pediatrics. 2018 Oct;142(4). pii: e20171903. doi: 10.1542/peds.2017-1903.

Automated External Defibrillator Application Before EMS Arrival in Pediatric Cardiac Arrests.

Author information

1
Department of Pediatrics, Cleveland Clinic Children's, Cleveland, Ohio.
2
University Hospitals Harrington Heart and Vascular Institute, University Hospitals and Case Western Reserve University, Cleveland, Ohio.
3
Division of Emergency Medicine, School of Medicine and Rollins School of Public Health, Emory University, Atlanta, Georgia; and.
4
Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland, Ohio.
5
Division of Pediatric Cardiology, azizp@ccf.org.

Abstract

BACKGROUND:

Little is known about the predictors of pre-emergency medical service (EMS) automated external defibrillator (AED) application in pediatric out-of-hospital cardiac arrests. We sought to determine patient- and neighborhood-level characteristics associated with pre-EMS AED application in the pediatric population.

METHODS:

We reviewed prospectively collected data from the Cardiac Arrest Registry to Enhance Survival on pediatric patients (age >1 to ≤18 years old) who had out-of-hospital nontraumatic arrest (2013-2015).

RESULTS:

A total of 1398 patients were included in this analysis (64% boys, 45% white, and median age of 11 years old). An AED was applied in 28% of the cases. Factors associated with pre-EMS AED application in univariable analyses were older age (odds ratio [OR]: 1.9; 12-18 years old vs 2-11 years old; P < .001), white versus African American race (OR: 1.4; P = .04), public location (OR: 1.9; P < .001), witnessed status (OR: 1.6; P < .001), arrests presumed to be cardiac versus respiratory etiology (OR: 1.5; P = .02) or drowning etiology (OR: 2.0; P < .001), white-populated neighborhoods (OR: 1.2 per 20% increase in white race; P = .01), neighborhood median household income (OR: 1.1 per $20 000 increase; P = .02), and neighborhood level of education (OR: 1.3 per 20% increase in high school graduates; P = .006). However, only age, witnessed status, arrest location, and arrests of presumed cardiac etiology versus drowning remained significant in the multivariable model. The overall cohort survival to hospital discharge was 19%.

CONCLUSIONS:

The overall pre-EMS AED application rate in pediatric patients remains low.

PMID:
30262669
DOI:
10.1542/peds.2017-1903
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center