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 journalArticle

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 2012
Externally publishedYes

Fingerprint

Out-of-Hospital Cardiac Arrest
Heart Arrest
Pediatrics
Cardiopulmonary Resuscitation
Survival
Pediatric Hospitals
Emergency Medical Services
Ventricular Fibrillation
Allied Health Personnel
Resuscitation
Reaction Time
Survival Rate
Demography
Interviews

Keywords

  • cardiac arrest
  • EMS
  • observational cohort
  • prehospital

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

Foltin, G. L., Richmond, N., Treiber, M., Skomorowsky, A., Galea, S., Vlahov, D., ... Tunik, M. G. (2012). Pediatric prehospital evaluation of NYC cardiac arrest survival (PHENYCS). Pediatric Emergency Care, 28(9), 864-868. https://doi.org/10.1097/PEC.0b013e3182675e70

Pediatric prehospital evaluation of NYC cardiac arrest survival (PHENYCS). / Foltin, George L.; Richmond, Neal; Treiber, Marsha; Skomorowsky, Andrew; Galea, Sandro; Vlahov, David; Blaney, Shannon; Kusick, Monique; Silverman, Robert; Tunik, Michael G.

In: Pediatric Emergency Care, Vol. 28, No. 9, 09.2012, p. 864-868.

Research output: Contribution to journalArticle

Foltin, GL, Richmond, N, Treiber, M, Skomorowsky, A, Galea, S, Vlahov, D, Blaney, S, Kusick, M, Silverman, R & Tunik, MG 2012, 'Pediatric prehospital evaluation of NYC cardiac arrest survival (PHENYCS)', Pediatric Emergency Care, vol. 28, no. 9, pp. 864-868. https://doi.org/10.1097/PEC.0b013e3182675e70
Foltin GL, Richmond N, Treiber M, Skomorowsky A, Galea S, Vlahov D et al. Pediatric prehospital evaluation of NYC cardiac arrest survival (PHENYCS). Pediatric Emergency Care. 2012 Sep;28(9):864-868. https://doi.org/10.1097/PEC.0b013e3182675e70
Foltin, George L. ; Richmond, Neal ; Treiber, Marsha ; Skomorowsky, Andrew ; Galea, Sandro ; Vlahov, David ; Blaney, Shannon ; Kusick, Monique ; Silverman, Robert ; Tunik, Michael G. / Pediatric prehospital evaluation of NYC cardiac arrest survival (PHENYCS). In: Pediatric Emergency Care. 2012 ; Vol. 28, No. 9. pp. 864-868.
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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.",
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AU - Galea, Sandro

AU - Vlahov, David

AU - Blaney, Shannon

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N2 - 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.

AB - 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.

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