Out‐of‐hospital arrests attending an Australian tertiary paediatric emergency department over 13 years: An observational study

Abstract

Children presenting to ED still receiving cardiac compressions following OHCA had a universally poor outcome, regardless of age and underlying cause. This implies resuscitative efforts could be discontinued earlier in this subgroup. A national, multicentre study is needed to determine if this finding is reproducible with a larger population.

Impact of loading and ambulance transport on cardiopulmonary resuscitation quality

“…1 The authors found that none of the 60 paediatric patients survived and reasoned that prolonged pre-hospital CPR and delayed transport may be an important factor in the dismal survival rate. 1 The authors found that none of the 60 paediatric patients survived and reasoned that prolonged pre-hospital CPR and delayed transport may be an important factor in the dismal survival rate.…”

“…1 Simply exhorting ambulance personnel 'to scoop up the child in arms, run to the ambulance, and drive as fast as possible to hospital' 2 may not lead to increased survival except in rare circumstances, such as hypothermia, drug overdose and in some cases of refractory ventricular fibrillation. 1 Simply exhorting ambulance personnel 'to scoop up the child in arms, run to the ambulance, and drive as fast as possible to hospital' 2 may not lead to increased survival except in rare circumstances, such as hypothermia, drug overdose and in some cases of refractory ventricular fibrillation.…”

“…Dear Editor, Day and Hort investigated the outcomes of paediatric patients arriving at the ED with ongoing cardiopulmonary resuscitation (CPR) following out-of-hospital cardiac arrest. 1 The authors found that none of the 60 paediatric patients survived and reasoned that prolonged pre-hospital CPR and delayed transport may be an important factor in the dismal survival rate. 1 There are intuitively good reasons to minimise scene time and transport to hospital where advanced interventions, not available to paramedics, can be performed.…”

“…1 The authors found that none of the 60 paediatric patients survived and reasoned that prolonged pre-hospital CPR and delayed transport may be an important factor in the dismal survival rate. 1 There are intuitively good reasons to minimise scene time and transport to hospital where advanced interventions, not available to paramedics, can be performed. However, Adams and Benger argue that extrication, loading and ambulance transfer are likely to compromise CPR quality to the extent that ambulance transport could decrease survival.…”

“…Day and Hort found that CPR continued for an average of 19 min in the ED following patient arrival at hospital. 1 It is not clear how many additional clinical interventions were performed by ED staff within that short time frame that could not have been performed by paramedics on scene.…”