The etiology of cardiac arrest in children and young adults: Special considerations for ED management

Children and young adults rarely present to the emergency department (ED) i n cardiac arrest. This review examines published series on nontraumatic, ca rdiac arrest for patients aged 1 to 45 years and discusses the differential diagnosis for cardiovascular collapse. Among the most common entities enco untered are cardiac diseases (hypertrophic cardiomyopathy, myocarditis), ai rway diseases (pneumonia, epiglottitis, and asthma), epilepsy, hemorrhage ( gastrointestinal bleeding, ectopic pregnancy), and drug toxicity (tricyclic antidepressants, cocaine). ED manage ment of children and young adults in cardiac arrest requires an understanding of the heterogeneous pathophysiolo gic mechanisms and etiologies leading to cardiopulmonary dysfunction in the se patients. The emergency physician should give particular focus to airway management for toddlers and preadolescents, because respiratory diseases p redominate. When treating an adolescent or young adult, the resuscitation t eam should also consider toxic causes as well as occult hemorrhage, Managem ent considerations unique to this patient population are discussed. Copyrig ht (C) 1999 by W.B. Saunders Company.