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

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



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.


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).


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%.


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

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center