Paediatric out-of-hospital resuscitation in an area with scattered population (Galicia-Spain)
1 Melide's Primary Care Center, Servicio Galego de Saúde (SERGAS), Melide, Coruña, Spain
2 Arzúa's Primary Care Center, Servicio Galego de Saúde (SERGAS), Arzúa, Coruña, Spain
3 Pediatric Emergency and Critical Care Division, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Servicio Galego de Saúde (SERGAS) and Universidad de Santiago de Compostela, Santiago de Compostela, Spain
4 Public Foundation Emergency Medical System of Galicia-061, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
BMC Emergency Medicine 2007, 7:3 doi:10.1186/1471-227X-7-3Published: 14 May 2007
Cardiorespiratory arrest (CRA) is a rare event in childhood. Our objective was to determine the characteristics of paediatric CRA and the immediate results of cardiopulmonary resuscitation (CPR) in Galicia, a community with a very scattered population.
All children (aged from newborn to 16 years old) who suffered an out-of-hospital CRA in Galicia and were assisted by the Public Foundation Medical Emergencies of Galicia-061 staff, from June 2002 to February 2005, were included in the study. Data were prospectively recorded following the Utstein's style guidelines.
Thirty-one cases were analyzed (3.4 CRA annual cases per 100.000 paediatric population). The arrest was respiratory in 16.1% and cardiac in 83.9% of cases. CRA occurred at home in 58.1% of instances. Time CRA to initiation of CPR was shorter than 10 minutes in 32.2% and longer than 20 minutes in 29.0% of cases. 22.6% of children received bystander CPR. The first recorded rhythm was asystole in 67.7% of cases. Bag-mask ventilation was used in 67.7% and in 83.8% oro-tracheal intubation was done. A peripheral venous access was achieved in 67.7% and intraosseous access was used in 16.1% of patients. 93.5% of children were treated with adrenaline. After initial CPR, sustained restoration of spontaneous circulation was achieved in 38.7% of cases. Six children (19.4%) survived until hospital discharge. Four of 5 children with respiratory arrest survived, whereas only 2 of 26 children with cardiac arrest survived until hospital discharge.
Despite the handicap of a highly disseminated population, paediatric CRA characteristics and CPR results in Galicia are comparable to references from other communities. Programs to increase bystander CPR, equip laypeople with basic CPR skills and to update life support knowledge of health staff are needed to improve outcomes.