Abstract
Introduction
Bystander cardiopulmonary resuscitation (BCPR) is strongly advocated by resuscitation
councils for paediatric out-of-hospital cardiac arrests (OHCAs). However, there are
limited reports on rates of BCPR in children and its relationship with return of spontaneous
circulation (ROSC) or survival outcomes.
Objective
We describe the rate of BCPR and its association with any ROSC and survival- to- hospital-discharge.
Methods
We conducted retrospective analysis of prospectively collected paediatric (<18 years
of age) OHCA cases in England; we included specialist registry patients treated by
emergency medical services (EMS) with known BCPR status and outcome between January
2014 and November 2018. Data included patient demographics, aetiology, witness status,
initial rhythm, EMS, season, time of day and bystander status. Associations between
BCPR, and any ROSC and survival-to-hospital-discharge outcomes were explored using
multivariable logistic regression.
Results
There were 2363 paediatric OHCAs treated across 11 EMS regions. BCPR was performed
in 69.6% (1646/2363) of the cases overall (range 57.7% (206/367) to 83.7% (139/166)
across EMS regions). Only 34.9% (550/1572) of BCPR cases were witnessed. Overall,
any ROSC was achieved in 22.8% (523/2289) and survival to hospital discharge in 10.8%
(225/2066). Adjusted odds ratio (aOR) for any ROSC was significantly improved following
BCPR compared to no BCPR (aOR 1.37, 95% CI 1.03–1.81), but adjusted odds ratio for
survival-to-hospital-discharge were similar (aOR 1.01, 95% CI 0.66–1.55).
Conclusions
BCPR was associated with improved rates of any ROSC but not survival-to-hospital-discharge.
Variations in EMS BCPR rates may indicate opportunities for regional targeted increase
in public BCPR education.
Keywords
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Article info
Publication history
Published online: November 05, 2021
Accepted:
October 28,
2021
Received in revised form:
October 23,
2021
Received:
September 14,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
