Robert M Sutton1, Erin Case2, Siobhan P Brown3, Dianne L Atkins4, Vinay M Nadkarni5, Jonathan Kaltman6, Clifton Callaway7, Ahamed Idris8, Graham Nichol9, Jamie Hutchison10, Ian R Drennan11, Michael Austin12, Mohamud Daya13, Sheldon Cheskes14, Jack Nuttall15, Heather Herren16, James Christenson17, Dug Andrusiek18, Christian Vaillancourt19, James J Menegazzi20, Thomas D Rea21, Robert A Berg22. 1. The Children's Hospital of Philadelphia, 34th Street, Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: suttonr@chop.edu. 2. Resuscitations Outcome Consortium, 1107 NE 45th Street, Suite 505, Seattle, WA 98105-4680, United States. Electronic address: ecase@uw.edu. 3. Resuscitations Outcome Consortium, 1107 NE 45th Street, Suite 505, Seattle, WA 98105-4680, United States. Electronic address: spes@uw.edu. 4. University of Iowa Carver College of Medicine, Stead Family Department of Pediatrics, Iowa City, IA 52242, United States. Electronic address: dianne-atkins@uiowa.edu. 5. The Children's Hospital of Philadelphia, 34th Street, Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: nadkarni@chop.edu. 6. National Heart, Lung, and Blood Institute, 6701 Rockledge Drive, Bethesda, MD 20817, United States. Electronic address: kaltmanj@nhlbi.nih.gov. 7. University of Pittsburgh, 400A Iroquois, 3600 Forbes Avenue, Pittsburgh, PA 15260, United States. Electronic address: callawaycw@upmc.edu. 8. University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8579, United States. Electronic address: ahamed.idris@utsouthwestern.edu. 9. Resuscitation Outcome Consortium Clinical Trial Center, University of Washington, Seattle, WA 98104, United States. Electronic address: grahamnichol@icloud.com. 10. The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8. Electronic address: jamie.hutchison@sickkids.ca. 11. Rescu, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada M5B 1W8. Electronic address: DrennanI@smh.ca. 12. University of Ottawa, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON, Canada K1Y 4E9. Electronic address: tassiemlm@yahoo.com.au. 13. Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode CDW-EM, Portland, OR 97239-3098, United States. Electronic address: dayam@ohsu.edu. 14. Sunnybrook Center for Prehospital Medicine, 77 Browns Line, Toronto, ON, Canada M8W 3S2. Electronic address: Sheldon.Cheskes@sunnybrook.ca. 15. Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States. Electronic address: nuttallj@ohsu.edu. 16. Resuscitations Outcome Consortium, 1107 NE 45th Street, Suite 505, Seattle, WA 98105-4680, United States. Electronic address: hherren@uw.edu. 17. Department of Emergency Medicine, University of British Columbia Faculty of Medicine, Room 3300 3rd Floor, 910 West 10th Avenue, Vancouver, BC, Canada V5Z 1M9. Electronic address: jim.christenson@ubc.ca. 18. School of Medical Sciences, Faculty of Health, Engineering and Science, Edith Cowan University, Building 19, Room 129d, 270 Joondalup Dr. Joondalup, Western Australia 6023, Australia. Electronic address: dug.andrusiek@alumni.ubc.ca. 19. University of Ottawa, The Ottawa Hospital Research Institute, The Ottawa Hospital, Civic Campus, Room F649, 1053 Carling Avenue, Ottawa, ON, Canada K1Y 4E9. Electronic address: cvaillancourt@ohri.ca. 20. University of Pittsburgh, 3600 Forbes Avenue, Pittsburgh, PA 15261, United States. Electronic address: menegazzijj@upmc.edu. 21. University of Washington, 206 3rd Avenue South, Seattle, WA 98104, United States. Electronic address: rea123@u.washington.edu. 22. The Children's Hospital of Philadelphia, 34th Street, Civic Center Boulevard, Philadelphia, PA 19104, United States. Electronic address: bergra@chop.edu.
Abstract
AIM: High-quality cardiopulmonary resuscitation (CPR) may improve survival. The quality of CPR performed during pediatric out-of-hospital cardiac arrest (p-OHCA) is largely unknown. The main objective of this study was to describe the quality of CPR performed during p-OHCA resuscitation attempts. METHODS: Prospective observational multi-center cohort study of p-OHCA patients ≥ 1 and < 19 years of age registered in the Resuscitation Outcomes Consortium (ROC) Epistry database. The primary outcome was an a priori composite variable of compliance with American Heart Association (AHA) guidelines for both chest compression (CC) rate and CC fraction (CCF). Event compliance was defined as a case with 60% or more of its minute epochs compliant with AHA targets (rate 100-120 min(-1); depth ≥ 38 mm; and CCF ≥ 0.80). In a secondary analysis, multivariable logistic regression was used to evaluate the association between guideline compliance and return of spontaneous circulation (ROSC). RESULTS: Between December 2005 and December 2012, 2564 pediatric events were treated by EMS providers, 390 of which were included in the final cohort. Of these events, 22% achieved AHA compliance for both rate and CCF, 36% for rate alone, 53% for CCF alone, and 58% for depth alone. Over time, there was a significant increase in CCF (p < 0.001) and depth (p = 0.03). After controlling for potential confounders, there was no significant association between AHA guideline compliance and ROSC. CONCLUSIONS: In this multi-center study, we have established that there are opportunities for professional rescuers to improve prehospital CPR quality. Encouragingly, CCF and depth both increased significantly over time.
AIM: High-quality cardiopulmonary resuscitation (CPR) may improve survival. The quality of CPR performed during pediatric out-of-hospital cardiac arrest (p-OHCA) is largely unknown. The main objective of this study was to describe the quality of CPR performed during p-OHCA resuscitation attempts. METHODS: Prospective observational multi-center cohort study of p-OHCA patients ≥ 1 and < 19 years of age registered in the Resuscitation Outcomes Consortium (ROC) Epistry database. The primary outcome was an a priori composite variable of compliance with American Heart Association (AHA) guidelines for both chest compression (CC) rate and CC fraction (CCF). Event compliance was defined as a case with 60% or more of its minute epochs compliant with AHA targets (rate 100-120 min(-1); depth ≥ 38 mm; and CCF ≥ 0.80). In a secondary analysis, multivariable logistic regression was used to evaluate the association between guideline compliance and return of spontaneous circulation (ROSC). RESULTS: Between December 2005 and December 2012, 2564 pediatric events were treated by EMS providers, 390 of which were included in the final cohort. Of these events, 22% achieved AHA compliance for both rate and CCF, 36% for rate alone, 53% for CCF alone, and 58% for depth alone. Over time, there was a significant increase in CCF (p < 0.001) and depth (p = 0.03). After controlling for potential confounders, there was no significant association between AHA guideline compliance and ROSC. CONCLUSIONS: In this multi-center study, we have established that there are opportunities for professional rescuers to improve prehospital CPR quality. Encouragingly, CCF and depth both increased significantly over time.
Authors: Robert M Sutton; Dana Niles; Benjamin French; Matthew R Maltese; Jessica Leffelman; Joar Eilevstjønn; Heather Wolfe; Akira Nishisaki; Peter A Meaney; Robert A Berg; Vinay M Nadkarni Journal: Resuscitation Date: 2013-08-29 Impact factor: 5.262
Authors: Peter A Meaney; Bentley J Bobrow; Mary E Mancini; Jim Christenson; Allan R de Caen; Farhan Bhanji; Benjamin S Abella; Monica E Kleinman; Dana P Edelson; Robert A Berg; Tom P Aufderheide; Venu Menon; Marion Leary Journal: Circulation Date: 2013-06-25 Impact factor: 29.690
Authors: Ian G Stiell; Siobhan P Brown; Graham Nichol; Sheldon Cheskes; Christian Vaillancourt; Clifton W Callaway; Laurie J Morrison; James Christenson; Tom P Aufderheide; Daniel P Davis; Cliff Free; Dave Hostler; John A Stouffer; Ahamed H Idris Journal: Circulation Date: 2014-09-24 Impact factor: 29.690
Authors: Robert M Sutton; Benjamin French; Dana E Niles; Aaron Donoghue; Alexis A Topjian; Akira Nishisaki; Jessica Leffelman; Heather Wolfe; Robert A Berg; Vinay M Nadkarni; Peter A Meaney Journal: Resuscitation Date: 2014-05-16 Impact factor: 5.262
Authors: Ahamed H Idris; Danielle Guffey; Tom P Aufderheide; Siobhan Brown; Laurie J Morrison; Patrick Nichols; Judy Powell; Mohamud Daya; Blair L Bigham; Dianne L Atkins; Robert Berg; Dan Davis; Ian Stiell; George Sopko; Graham Nichol Journal: Circulation Date: 2012-05-23 Impact factor: 29.690
Authors: Robert M Sutton; Heather Wolfe; Akira Nishisaki; Jessica Leffelman; Dana Niles; Peter A Meaney; Aaron Donoghue; Matthew R Maltese; Robert A Berg; Vinay M Nadkarni Journal: Resuscitation Date: 2013-08-15 Impact factor: 5.262
Authors: Heather Wolfe; Carleen Zebuhr; Alexis A Topjian; Akira Nishisaki; Dana E Niles; Peter A Meaney; Lori Boyle; Rita T Giordano; Daniela Davis; Margaret Priestley; Michael Apkon; Robert A Berg; Vinay M Nadkarni; Robert M Sutton Journal: Crit Care Med Date: 2014-07 Impact factor: 7.598
Authors: Tom P Aufderheide; Gardar Sigurdsson; Ronald G Pirrallo; Demetris Yannopoulos; Scott McKnite; Chris von Briesen; Christopher W Sparks; Craig J Conrad; Terry A Provo; Keith G Lurie Journal: Circulation Date: 2004-04-05 Impact factor: 29.690
Authors: Allan R de Caen; Marc D Berg; Leon Chameides; Cheryl K Gooden; Robert W Hickey; Halden F Scott; Robert M Sutton; Janice A Tijssen; Alexis Topjian; Élise W van der Jagt; Stephen M Schexnayder; Ricardo A Samson Journal: Circulation Date: 2015-11-03 Impact factor: 29.690
Authors: Ericka L Fink; David K Prince; Jonathan R Kaltman; Dianne L Atkins; Michael Austin; Craig Warden; Jamie Hutchison; Mohamud Daya; Scott Goldberg; Heather Herren; Janice A Tijssen; James Christenson; Christian Vaillancourt; Ronna Miller; Robert H Schmicker; Clifton W Callaway Journal: Resuscitation Date: 2016-08-24 Impact factor: 5.262
Authors: Ian K Maconochie; Richard Aickin; Mary Fran Hazinski; Dianne L Atkins; Robert Bingham; Thomaz Bittencourt Couto; Anne-Marie Guerguerian; Vinay M Nadkarni; Kee-Chong Ng; Gabrielle A Nuthall; Gene Y K Ong; Amelia G Reis; Stephen M Schexnayder; Barnaby R Scholefield; Janice A Tijssen; Jerry P Nolan; Peter T Morley; Patrick Van de Voorde; Arno L Zaritsky; Allan R de Caen Journal: Resuscitation Date: 2020-10-21 Impact factor: 5.262
Authors: Theresa M Olasveengen; Mary E Mancini; Gavin D Perkins; Suzanne Avis; Steven Brooks; Maaret Castrén; Sung Phil Chung; Julie Considine; Keith Couper; Raffo Escalante; Tetsuo Hatanaka; Kevin K C Hung; Peter Kudenchuk; Swee Han Lim; Chika Nishiyama; Giuseppe Ristagno; Federico Semeraro; Christopher M Smith; Michael A Smyth; Christian Vaillancourt; Jerry P Nolan; Mary Fran Hazinski; Peter T Morley Journal: Resuscitation Date: 2020-10-21 Impact factor: 5.262
Authors: Gene Yong-Kwang Ong; Aloysius Jian Feng Ang; Amirzeb S O Aurangzeb; Elisabeth Sue Shuen Fong; Jun Yuan Tan; Zhao Jin Chen; Yiong Huak Chan; Phua Hwee Tang; Jen Heng Pek; Ian Maconochie; Kee Chong Ng; Vinay Nadkarni Journal: Resusc Plus Date: 2021-03-27
Authors: Robert M Sutton; Ron W Reeder; William Landis; Kathleen L Meert; Andrew R Yates; John T Berger; Christopher J Newth; Joseph A Carcillo; Patrick S McQuillen; Rick E Harrison; Frank W Moler; Murray M Pollack; Todd C Carpenter; Daniel A Notterman; Richard Holubkov; J Michael Dean; Vinay M Nadkarni; Robert A Berg Journal: Resuscitation Date: 2018-07-18 Impact factor: 6.251
Authors: Jorge López; Sarah N Fernández; Rafael González; María J Solana; Javier Urbano; Jesús López-Herce Journal: PLoS One Date: 2016-09-12 Impact factor: 3.240