Background: Out-of-hospital cardiac arrest (OHCA) is a major public health problem in the United States (US). Pediatric OHCA is particularly important, but only limited data describe pediatric OHCA in the US. We sought to determine the national characteristics of pediatric OHCA reported in the National Emergency Medical Services Information System (NEMSIS).
Methods: We analyzed NEMSIS data in 2016, including all emergency medical services (EMS) response data from 46 US states and territories. We included pediatric patients (age <18 years). We defined OHCA as any cases with a) presence of cardiac arrest, b) EMS attempted resuscitation of cardiac arrest, d) performance of cardiopulmonary resuscitation, or e) performance of defibrillation. We reported descriptive statistics of patient demographics, response characteristics, and clinical interventions. We stratified the prevalence by age category: <1 year, 1-5 years, 6-12 years, and 13-17 years.
Results: Among 1,531,469 reported pediatric EMS responses, there were 22,490 pediatric OHCA (14.7 per 1,000 pediatric EMS responses). Age-stratified OHCA prevalence were: <1 year, n=4,427 (19.7 %); 1-5 years, n=5,438 (24.2 %), 6-12 years, n=4,680 (20.8 %); 13-17 years, n=7,945 (35.3 %). Most pediatric OHCA occurred in females (n=13,747 [61.1 %]), at home (n=12,029 [53.5%]), and urban areas (n=17,411 [77.4 %]). EMS treatment time were: response mean 8.0 minutes (SD: 0.1), scene mean 18.3 minutes (SD: 0.2), transport mean 16.6 minutes (SD: 0.2). The most common advanced interventions were: defibrillation (n=12,944 [57.6%]), intravenous epinephrine (n=3,566 [15.9 %]) and endotracheal intubation (n=2,186 [9.7 %]).
Conclusion: In 2016, there were over 20,000 reported pediatric OHCA in the US. These data provide key insights of national characteristics of pediatric OHCA. EMS systems and communities must be prepared for pediatric OHCA.