Paediatric cardiac arrest: time to ‘stay and play’?

Outcome for paediatric out-of-hospital cardiac arrest (OHCA) is generally poor, with survival reported as less than 10%. Those who do survive are likely to have an unfavourable neurological outcome. This retrospective observational analysis study examined the relationship between on-scene time and improved survival. The study also examined which pre-hospital interventions may lead to improved survival. The researchers had a focus on the length of time on scene, level of care (basic/advanced) and administration of fluids/medication.

The study used data from the Resuscitation Outcomes Consortium (ROC) database. This included data from eight American and three Canadian regions, with a mix of urban, suburban and rural populations. Patients aged 3 days to 19 years suffering a medical OHCA between December 2005 to December 2012 were included for analysis.

In total, 3 115 patients were identified, and after exclusion criteria were applied, the final sample size was 2 244. On-scene times were grouped into three categories: <10 minutes (n=486), 10–35 minutes (n=1542) and >35 minutes (n=216). The majority of patients (68.7%) had an on-scene time of between 10 and 35 minutes. For the <10 minute group, return of spontaneous circulation (ROSC) was achieved for 21/486 (4.3%) patients. For 10–35 minutes, ROSC was achieved for 299/1542 (19.4%) of patients. Lastly, the >35 minutes group had a ROSC rate of 76/216 (35.2%).