Prehospital care and outcome of pediatric out-of-hospital cardiac arrest |
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| Institution: | 1. School of economics and finance, Massey University, Auckland;2. Al-Farabi Kazakh National University, Almaty, Kazakhstan;1. Institute of Physics, Bhubaneswar 751 005, India;2. School of Biotechnology, KIIT University, Bhubaneswar 751 024, India;3. Division of Pediatric Hematology and Oncology, University Medical Center, University of Freiburg, 79106, Germany;4. Magnetic Materials Laboratory, Department of Physics, National Institute of Technology, Tiruchirappalli 620 015, India;5. Memorial University of Newfoundland, Department of Physics and Physical Oceanography, St. John''s, Newfoundland and Labrador NL A1C 5S7, Canada;6. Advanced Materials Laboratory, Department of Mechanical Engineering, University of Chile, Beauchef 851, Santiago, Chile;7. Materials Science Division, Bhabha Atomic Research Center, Mumbai 400 085, India;8. Homi Bhabha National Institute, Anushaktinagar, Mumbai 400 094, India;9. Centre for Nanoscience and Technology, Mepco Schlenk Engineering College, Sivakasi 626005, Tamilnadu, India |
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| Abstract: | Cardiac arrest in children outside the hospital is associated with high mortality rates. Recent investigations have suggested that the use of advanced life support (ALS) measures by emergency medical services (EMS) personnel may decrease survival. These studies have used the pediatric Utstein style of defining ALS and basic life support (BLS) measures. The pediatric Utstein style defines BLS as “an attempt to restore effective ventilation and circulation” using noninvasive means to open the airway but specifically excludes the use of bag-valve-mask devices. Advanced life support is defined as the “addition of invasive maneuvers to restore effective ventilation and circulation.” The authors of the study described below believe that using this definition would categorize some patients into an ALS group who would otherwise be categorized as having received BLS (i.E., “bag-valve-mask only”). Objective: To compare survival rates among children receiving BLS or ALS following out-of-hospital cardiac arrest using amended definitions of prehospital life support measures. Specifically, the definition of BLS was expanded to include the use of bag-valve-mask devices only. Methods: This was a retrospective chart review in an urban, pediatric emergency department. Patients included all children presenting to the emergency department between January 1, 1986, and December 31, 1999, following out-of-hospital cardiac arrest. The main outcome measure was survival to hospital discharge. Results: Two hundred ten children were identified. Twenty-one patients were excluded from further analysis because of absent or incomplete medical records. One hundred eighty-nine patients were studied. Five children (2.6%) survived to discharge from the hospital. Of 189 children, 39 (20.6%) were provided BLS measures by prehospital personnel; 150 (79.4%) received ALS. There was no significant difference between groups in survival to hospital discharge. Patients who survived to hospital discharge were more likely to be in sinus rhythm upon arrival in the emergency department (p < 0.001) and to have received fewer doses of standard-dose epinephrine in the emergency department (p < 0.001). Conclusion: The use of ALS by prehospital personnel for children with out-of-hospital cardiac arrest did not improve survival to discharge from the hospital when compared with the use of BLS. PREHOSPITAL EMERGENCY CARE 2002;6:283-290 |
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