Pediatric prehospital evaluation of NYC cardiac arrest survival (PHENYCS)

George L. Foltin, Neal Richmond, Marsha Treiber, Andrew Skomorowsky, Sandro Galea, David Vlahov, Shannon Blaney, Monique Kusick, Robert Silverman, Michael G. Tunik

    Research output: Contribution to journalArticlepeer-review

    Abstract

    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 OOHCA 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.

    Original languageEnglish (US)
    Pages (from-to)864-868
    Number of pages5
    JournalPediatric emergency care
    Volume28
    Issue number9
    DOIs
    StatePublished - Sep 1 2012

    Keywords

    • EMS
    • cardiac arrest
    • observational cohort
    • prehospital

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Emergency Medicine

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