Analysis of Out-of-hospital Cardiac Arrest in A Pediatric Emergency Department: Report from A Regional Teaching Hospital

Abstract

Background and purpose: Cases of out-of-hospital cardiac arrest (OHCA) are uncommon in pediatric emergency departments. This study aimed to analyze the survival rate, etiology, and epidemiology of OHCA in a pediatric emergency department.Methods: Children (＜18 years) who presented with OHCA at the pediatric emergency department of Jen-Ai Hospital over a 7-year period were enrolled in this study. Patient information was collected from medical charts at the emergency department (ED) and after admission to the ward.Results: A total of 30 patients (average age, 5 years; range, 15 days-17 years; 15 boys, 15 girls) were enrolled. Causes of OHCA were nontraumatic, traumatic, and drowning in 22, 4, and 4 cases, respectively. Ten patients with nontraumatic OHCA were aged 1-12 months, nine of whom had sudden infant death syndrome (SIDS). Successful initial cardiopulmonary resuscitation (CPR) and return of spontaneous circulation (ROSC) was achieved in seven patients (23%), who were subsequently admitted to the intensive care unit (ICU). However, only three survived to hospital discharge, all with neurological defects.Conclusions: The overall survival rate of children with OHCA in our study was 10%. Children with nontraumatic OHCA had a higher survival rate than those with traumatic OHCA. In 30% patients, OHCA was caused by SIDS. The incidence of OHCA was higher between January and March.