Automated external defibrillator application before EMS arrival in pediatric cardiac arrests

CARES Surveillance Group

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

BACKGROUND: 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. METHODS: 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). RESULTS: 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%. CONCLUSIONS: The overall pre-EMS AED application rate in pediatric patients remains low.

Original languageEnglish (US)
Article numbere20171903
JournalPediatrics
Volume142
Issue number4
DOIs
StatePublished - Oct 2018

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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