Pediatric Prehospital Evaluation of NYC Cardiac Arrest Survival (PHENYCS)

被引:22
作者
Foltin, George L. [1 ]
Richmond, Neal [2 ]
Treiber, Marsha [3 ]
Skomorowsky, Andrew
Galea, Sandro [4 ]
Vlahov, David [5 ]
Blaney, Shannon [6 ]
Kusick, Monique [6 ]
Silverman, Robert [7 ]
Tunik, Michael G. [3 ]
机构
[1] Maimonides Infant & Childrens Hosp Brooklyn, Dept Pediat, Brooklyn, NY 11219 USA
[2] Louisville Metro Emergency Med Serv, Louisville, KY USA
[3] NYU, Sch Med, Dept Emergency Med & Pediat, New York, NY 10003 USA
[4] Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA
[5] Univ Calif San Francisco, Sch Nursing, San Francisco, CA 94143 USA
[6] New York Acad Med, Ctr Urban Epidemiol Studies, New York, NY USA
[7] Albert Einstein Coll Med, Bronx, NY 10467 USA
关键词
prehospital; cardiac arrest; EMS; observational cohort; EUROPEAN-RESUSCITATION-COUNCIL; AMERICAN-HEART-ASSOCIATION; HEALTH-CARE PROFESSIONALS; CARDIOPULMONARY ARREST; TASK-FORCE; EPIDEMIOLOGY; STATEMENT; CHILDREN; CANADA;
D O I
10.1097/PEC.0b013e3182675e70
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives: The objective of this study was to describe the demographics of out-of-hospital cardiac arrests (OOHCAs) in children younger than 18 years and characteristics associated with survival among these children in New York City (NYC). Methods: A prospective observational cohort of all children younger than 18 years with OOHCA in NYC between April 1, 2002, and March 31, 2003. Data were collected from prehospital providers by trained paramedics utilizing a previously validated telephone interview process. Data included Pediatric Utstein core measures and critical prehospital time intervals. Analyses utilized descriptive statistics and bivariate association with survival. Results: Resuscitation was attempted on 147 pediatric OOHC A patients in NYC during the study period; outcome data were collected on these patients. The median age was 2 years; most (58%) were male. The majority of arrests occurred at home (69%). Lay bystanders witnessed 33% of all OOHCA; 68% of witnesses were family members. Bystander cardiopulmonary resuscitation (CPR) was performed on 30% of children. Median emergency medical services response time was 3.6 minutes (range, 0.4-14.4 minutes). Initial rhythm was as follows: ventricular fibrillation, 2%; asystole, 50%; pulseless electrical activity, 9.5%; other rhythms, 11.6%; no rhythm recorded, 26%. Survival was 4% to hospital discharge and was present only among witnessed arrests (6/58 witnessed vs 0/70 unwitnessed, P < 0.05). Conclusions: Pediatric OOHCA survival rate is low. Witnessed arrest was the most important determinant of survival. Ventricular fibrillation was an uncommon rhythm measured by emergency medical services. The majority of arrests occurred at home. The rate of bystander CPR was low. Strategies to increase the rate of bystander CPR for children, especially by family members, are needed.
引用
收藏
页码:864 / 868
页数:5
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