A prospective, population-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest

Study objectives: To perform a population-based study addressing the demogr aphy, epidemiology, management, and outcome of out-of-hospital pediatric ca rdiopulmonary arrest (PCPA). Methods: Prospective, population-based study of all children (17 years of a ge or younger) in a large urban municipality who were treated by EMS person nel for apneic, pulseless conditions. Data were collected prospectively for 3 1/2 years using a comprehensive data collection tool and on-line compute rized database. Each child received standard pediatric advanced cardiac lif e support. Results: During the 3 1/2-year period, 300 children presented with PCPA (an nual incidence of 19.7/100,000 at risk). Of these, 60% (n=181) were male (P =.0003), and 54% (n=161) were patients 12 months of age or younger(152,500 at risk). Compared with the population at risk (32% black patients, 36% His panic patients, 26% white patients), a disproportionate number of arrests o ccurred in black children (51.6% versus 26.6% in Hispanics, and 17% in whit e children; P<.0001). Over 60% of all cases (n=181) occurred in the home wi th family members present, and yet those family members initiated basic CPR in only 31 (17%) of such cases. Only 33 (11%) of the total 300 PCPA cases had a return of spontaneous circulation, and 5 of the 6 discharged survivor s had significant neurologic sequelae. Only 1 factor, endotracheal intubati on, was correlated positively with return of spontaneous circulation (P=.03 2). Conclusion: This population-based study underscores the need to investigate new therapeutic interventions for PCPA, as well as innovative strategies f or improving the frequency of basic CPR for children. [Sirbaugh PE, Pepe PE , Shook JE, Kimball KT Goldman MJ, Ward MA, Mann DM: A prospective, populat ion-based study of the demographics, epidemiology, management, and outcome of out-of-hospital pediatric cardiopulmonary arrest.