Epidemiology of paediatric out-of-hospital cardiac arrest presented to a local emergency department: A retrospective case series

Abstract

Objective: To outline the epidemiology of paediatric out-of-hospital cardiac arrest (OHCA) cases presented to a regional hospital. Design: Retrospective case series. Methods: Attendance records of critical cases aged from 0 to 17 years old from year 2001 to 2014 attending Emergency Department (ED) of Yan Chai Hospital were searched. Demographic data and predictive parameters were analysed for association with outcome. Results: There were 40 cases of paediatric OHCA throughout the study period. A total of 21 (52.5%) had witnessed arrest; 27 (67.5%) had cardiac arrest at home. Twenty-eight (70%) of the cardiac arrest were first noted by family members; 8 (20%) received bystander cardiopulmonary resuscitation (CPR). Only 13 (32.5%) cases had return of spontaneous circulation (ROSC) in the ED and were admitted. Seven patients (17.5%) survived to hospital discharge. Conclusion: Paediatric OHCA, although a rare occurrence, has a high mortality of 82.5% in our series. Majority of the cases occur at home, and are witnessed. Family members are often the first persons to detect the arrest. Yet the rate of providing bystander CPR is low in Hong Kong.