Background: The American Heart Association has identified cardiac arrest as a leading cause of death and committed to focus on doubling survival rates from cardiac arrest by 2020. Despite this important commitment, little is known about pediatric cardiac arrest (pCA) survival.
Hypothesis: Participation in a cardiac arrest registry will provide data that will better characterize the demographics and epidemiology of cardiac arrest in children in the state of Maryland.
• Maryland participation in the Cardiac Arrest Registry to Enhance Survival (CARES) began in 2016 over 6 phases
• Participation included all EMS agencies and all acute care hospitals
• First full-year reporting period from January 1, 2017 to December 31, 2017 for 12 months of available statewide data, including patient
• Pediatric patients in cardiac arrest who received prehospital care by EMS providers were included
• Patient data was recorded into the electronic patient care report (eMEDS) and then electronically reported to the CARES registry following
• The CARES registry was then queried for non-traumatic cardiac arrest from birth to 18 years of age
• There were 6,888 non-traumatic cardiac arrests in Maryland in 2017
• 154 (2.2%) of cardiac arrests occurred in pediatric patients
• Bystander CPR
o Delivered in 54 patients
o No Bystander CPR in 92
• AED Use
o Shock delivered by bystanders in 3 patients
o AED use by public safety responders documented in 26 patients
Survival to hospital discharge was reported by age; categorized by infants (0 to 1 year), children (>1 to 12) and teenagers (>12-18). Of the 154 pediatric cardiac arrests, the majority of arrests, 90 (58.4%) were in infants, with 36 (23.4%) in children and 28 (18.2%) in teenagers. Regarding initial rhythm shockable, in the age range 0-1 year, there were zero shockable cases (0/90). For >1-12, there were three shockable cases out of 36 total, 8.3%. In >12-18, six shockable cases occurred out of 28 (21.4%). Utstein survival (Witnessed arrest, shockable initial rhythm) was 0% for < 1 year old, 8.3% >1-12 and >12-18 had 21.4% survival.
Conclusions: Participation in CARES, delivers accurate data which helps to characterize pediatric cardiac arrest in Maryland and provided opportunities to measure and improve. Rates of survival for pediatric cardiac arrest increase in each age range, mirroring the frequency of witnessed arrest with in initial shockable rhythm. CARES provides opportunities to pilot educational and implementation programs and measure subsequent impact on survival from pediatric cardiac arrest statewide.