Advertisement

Characteristics of paediatric out-of-hospital cardiac arrest in the United States

      Abstract

      Background

      The absence of nationwide surveillance data on out-of-hospital cardiac arrest (OHCA) in the United States (US) limits understanding of the epidemiology of paediatric OHCA. We investigated the national characteristics of paediatric OHCA using the National Emergency Medical Services Information System (NEMSIS).

      Methods

      We conducted a cross-sectional study using the 2016 NEMSIS dataset, a national registry of emergency medical services (EMS) activations at 46 states in the US. We included paediatric patients (age <18 years) with “9-1-1” EMS responses to OHCA. We defined OHCA as (a) presence of cardiac arrest; (b) EMS reported initiation of cardiac arrest resuscitation; (c) performance of chest compressions; or (d) performance of defibrillation. We reported the incidence and characteristics of paediatric OHCA, stratified by age group: <1 year: infants, 1–5 years: young children, 6–12 years: older children, and 13–17 years: adolescents.

      Results

      Among 1,531,469 paediatric EMS responses, we identified a total of 23,514 EMS responses to paediatric OHCA (95% confidence interval [CI], 23,217–23,814), incidence of 15.4 per 1000 paediatric EMS responses (95% CI, 15.2–15.5), and estimated national incidence of 37.9 per 100,000 child-years (95% CI, 37.4–38.4). Among 23,514 EMS responses to paediatric OHCA, we observed 4515 (19.2%) of EMS responses in infants, 5588 (23.8%) in young children, 4976 (21.2%) in older children, and 8435 (35.9%) in adolescents.

      Conclusion

      Using data from the NEMSIS, we estimate that there are over 23,000 annual paediatric OHCA in the US. These data provide key insights of paediatric OHCA in the US.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Resuscitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Benjamin E.J.
        • Muntner P.
        • Alonso A.
        • et al.
        American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2019 update: a report from the American Heart Association.
        Circulation. 2019; 139: e56-e528
        • Institute of Medicine of the National Academies
        Strategies to improve cardiac arrest survival: a time to act.
        National Academies Press, Washington, DC2015
        • Fink E.L.
        • Prince D.K.
        • Kaltman J.R.
        • et al.
        Unchanged pediatric out-of-hospital cardiac arrest incidence and survival rates with regional variation in North America.
        Resuscitation. 2016; 107: 121-128
        • Mann N.C.
        • Kane L.
        • Dai M.
        • et al.
        Description of the 2012 NEMSIS public-release research dataset.
        Prehosp Emerg Care. 2015; 19: 232-240
      1. National EMS Information System (NEMSIS). NEMSIS. (accessed 28 June 2019 at https://nemsis.org/).

        • Hsia R.Y.
        • Huang D.
        • Mann N.C.
        • et al.
        A US national study of the association between income and ambulance response time in cardiac arrest.
        JAMA Netw Open. 2018; 1: e185202
      2. United States Census Bureau. (Accessed 18 July 2019 at https://www.census.gov/en.html).

        • Bardai A.
        • Berdowski J.
        • Van Der Werf C.
        • et al.
        Incidence, causes, and outcomes of out-of-hospital cardiac arrest in children. A comprehensive, prospective, population-based study in the Netherlands.
        J Am Coll Cardiol. 2011; 57: 1822-1828
        • Okubo M.
        • Kiyohara K.
        • Iwami T.
        • et al.
        Nationwide and regional trends in survival from out-of-hospital cardiac arrest in Japan: a 10-year cohort study from 2005 to 2014.
        Resuscitation. 2017; 115: 120-128
        • Morrison L.J.
        • Nichol G.
        • Rea T.D.
        • et al.
        Rationale, development and implementation of the Resuscitation Outcomes Consortium Epistry–cardiac arrest.
        Resuscitation. 2008; 78: 161-169
        • Jayaram N.
        • McNally B.
        • Tang F.
        • et al.
        Survival after out-of-hospital cardiac arrest in children.
        J Am Heart Assoc. 2015; 4: e002122
        • Becker L.B.
        • Aufderheide T.P.
        • Graham R.
        Strategies to improve survival from cardiac arrest: a report from the Institute of Medicine.
        JAMA. 2015; 314: 223-224
        • Cummins R.O.
        • Chamberlain D.A.
        • Abramson N.S.
        • et al.
        Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style: a statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council.
        Circulation. 1991; 84: 960-975
        • Cummins R.O.
        • Chamberlain D.A.
        The Utstein Abbey and survival from cardiac arrest: what is the connection?.
        Ann Emerg Med. 1991; 20: 918-919
        • Perkins G.D.
        • Jacobs I.G.
        • Nadkarni V.M.
        • et al.
        Cardiac arrest and cardiopulmonary resuscitation outcome reports; update of the Utstein resuscitation registry templates for out-of-hospital cardiac arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care Perioperative and Resuscitation.
        Circulation. 2015; 132: 1286-1300