Bystander CPR on kids has increased, survival odds improve for some

American Heart Association Meeting Report – Abstract 496 (Room 110B)

November 10, 2015 Categories: Scientific Conferences & Meetings

Study Highlights:

  • Just under half of children that had an out of hospital cardiac arrest received CPR from bystanders.
  • Survival rates improved among children but not among infants.
  • Bystander CPR was more common in white children than in black or Hispanic children.
  • Compression only CPR occurred in 50% of cardiac arrests.

Embargoed until 3:45 p.m. ET, Tuesday, Nov. 10, 2015

ORLANDO, Florida, Nov. 10, 2015 — Bystander CPR on kids is increasing and is improving survival from cardiac arrest outside the hospital, according to research presented at the American Heart Association’s Scientific Sessions 2015.

Researchers analyzed 2,176 children (infants to age 18) with cardiac arrest, drawn from a key national registry of 80 million people representing 55 communities in 23 states in the United States.  The Cardiac Arrest Registry to Enhance Survival (CARES) registry tracks characteristics and impact of out-of-hospital cardiac arrests.

Just under half (49 percent) of children who had a cardiac arrest between January 2013 and December 2014 received bystander CPR. This is higher than previous published reports from the United States. This was associated with an 11 percent likelihood of neurologically favorable survival compared to 7 percent for children who did not receive CPR from a bystander.

The majority of children in the study were infants (62 percent) or adolescents (19 percent).  Eighty-six percent of cardiac arrests occurred at home, 75 percent were not witnessed and 93 percent had a non-shockable rhythm. 

Most bystander CPR was performed by a family member.  Bystander CPR was more common for white children (60 percent) than for African-American children (42 percent) and Hispanic children (44 percent).

Compression only CPR occurred in 50% of cardiac arrests.

Bystander CPR was associated with improved outcome most notably for adolescents, arrests that were witnessed had a shockable rhythm and were outside the home.  

“Our results are very encouraging, We observed a higher rate of bystander CPR that previously reported from the United States in children that may be an impact of compression only CPR that was recommended as an alternative to compressions and ventilations for bystanders who are unwilling or unable to perform rescue breathing in the 2010 AHA guidelines. We also observed a higher survival than previously reported with 11% of children surviving an out of hospital cardiac arrest and 80% having favorable neurologic outcome.

 Though infants represent the largest age group, bystander CPR had no effect on survival. 

“Many infants have sudden infant death syndrome. The lack of an impact of bystander CPR on this population suggests the need for a public health strategy to prevent cardiac arrest in this population” said Maryam Naim, M.D., the study’s lead author and assistant professor of anesthesiology and critical care at the Children’s Hospital of Philadelphia at the University of Pennsylvania.

The CARES registry involves a number of organizations for funding and tracking including the American Heart Association, American Red Cross, Emory University, the Centers for Disease Control and Prevention, and two device companies, Medtronic and Zoll.

Co-authors are Rita V. Burke, M.P.H.; Brian F. McNally, M.D.; Robert A. Berg, M.D.; Kimberly Vellano, M.P.H.; David Markenson, M.D.; Richard Bradley, M.D.; and Joseph Rossano, M.D. Author disclosures are on the manuscript.

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