Association between patient age and pediatric cardiac arrest recognition by emergency medical dispatchers

Abstract

Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is an important prognostic factor in pediatric out-of-hospital cardiac arrest (OHCA). The recognition of cardiac arrest by dispatcher is a key factor for successful DA-CPR. In this study, we evaluated the association between pediatric age and dispatcher recognition.

Methods: A retrospective observational study was designed using a nationwide OHCA registry. Patients under 19 years of age were enrolled. Patients were categorized into four groups according to age (<1 year, 1-6 years, 7-13 years, and 14-18 years). The primary outcome was cardiac arrest recognition by dispatcher. A multivariable logistic regression analysis was performed.

Results: A total of 2754 pediatric OHCA patients were enrolled. A negative trend was observed between age and dispatcher performance (p < 0.01). The rate of cardiac arrest recognition was highest in patients under one year of age (61.5%) and lowest in patients ages 14-18 years old (47.1%). Patients in the 7-13 years and 14-18 years age groups were both associated with a decreased rate of recognition (adjusted odds ratio with 95% confidence interval: 0.55 (0.41-0.74) and 0.44 (0.34-0.57), respectively). In the interaction analysis, the association between age and outcomes was more prominent in patients with non-medical causes.

Conclusion: Patients ages 7-18 years old were negatively associated with cardiac arrest recognition and DA-CPR instruction provision within optimal timeframes compared to those younger than one year old. Development of a tailored protocol could be considered according to age and cause of arrest for better dispatcher performance in pediatric OHCA patients.

Keywords: Cardiac arrest; Dispatcher-assisted cardiopulmonary resuscitation; Emergency dispatch center; Pediatric.