A Nationwide Retrospective Analysis of Out-of-Hospital Pediatric Cardiopulmonary Resuscitation Treated by Helicopter Emergency Medical Service in the Netherlands

Moors, Xavier R.J.; Alink, Michelle Oude; Bouman, Stef J.M.; Schober, Patrick; Leeuw, Maureen; Hoogerwerf, Nico; Bergsma, Margot; Hartog, Dennis den; Houmes, Robert Jan; Stolker, Robert Jan

doi:10.1016/j.amj.2021.08.004

Cited by 6 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The EMS policies for resuscitating and transporting these children have not changed over the study period. Our corrected incidence is similar to Victoria, Australia (4.9/100,000, period: 2000–2016), 10 higher than The Netherlands (3.5/100,000, period: 2015–17), 11 and lower than a North American cohort (8.3/100,00, period: 2007–12). 1 The Dutch study included traumatic POHCA and may have missed some cases and the North American study included patients who did not receive resuscitation efforts by Emergency Medical Services (EMS) and reflected 11 subregions of North America, including 2 urban Southern Ontario regions.…”

Section: Discussionsupporting

confidence: 67%

Epidemiology of paediatric out-of-hospital cardiac arrest in Ontario, Canada

et al. 2023

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 67%

Epidemiology of paediatric out-of-hospital cardiac arrest in Ontario, Canada

et al. 2023

View full text Add to dashboard Cite

“…The available body of evidence focusing on physician-staffed HEMS mainly constitutes data on traumatic injuries, paediatric emergencies, cardiac arrests, or winch operations. [22][23][24][25][26][27] The drowning population treated by the Danish Air Ambulance had a median age of 50 years with a bimodal pattern concentrating on ages one to six and beyond 60 years. For the paediatric subpopulation below six years, the 30-day survival was 75% compared to only 22.7% in the elderly individuals above 65 years.…”

Section: Results Compared To the Existing Literaturementioning

confidence: 99%

“…There was no signi cant difference in total mission or response time between fatal and non-fatal drowning missions. The Danish Air Ambulance spent signi cantly more time providing medical care on-scene in the group with a fatal outcome (median [IQR] 28 [21][22][23][24][25][26][27][28][29][30][31][32] minutes vs 19 [16-29] minutes, p = 0.01). Legend: Information on 30-day follow-up was missing for 16 patients who survived prehospital due to missing CPR number.…”

Section: Operational Data From the Danish Air Ambulancementioning

confidence: 99%

Characteristics and critical care interventions in drowning patients treated by the Danish Air Ambulance from 2016-2021: a nationwide registry-based study with 30-day follow-up

Breindahl,

Wolthers,

Møller

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Improving oxygenation and ventilation in drowning patients early in the field is critical and may be lifesaving. The critical care interventions performed by physicians in drowning management are poorly described. The aim was to describe patient characteristics and critical care interventions with 30-day mortality as the primary outcome in drowning patients treated by the Danish Air Ambulance.Methods This retrospective cohort study with 30-day follow-up identified drowning patients treated by the Danish Air Ambulance from January 1, 2016, through December 31, 2021. Drowning patients were identified using a text-search algorithm (Danish Drowning Formula) followed by manual review and validation. Operational and medical data were extracted from the Danish Air Ambulance database. Descriptive analyses were performed comparing non-fatal and fatal drowning incidents with 30-day mortality as the primary outcome.Results Of 16,841 dispatches resulting in a patient encounter in the six years, the Danish Drowning Formula identified 138 potential drowning patients. After manual validation, 98 drowning patients were included in the analyses, and 82 completed 30-day follow-up. The prehospital and 30-day mortality rates were 28% and 67%, respectively. The National Advisory Committee for Aeronautics (NACA) severity scores from 4–7, indicating a critical emergency, were observed in 90% of the total population. They were significantly higher in the fatal vs non-fatal group (p < 0.01). At least one critical care intervention were performed in 68% of all drowning patients, with endotracheal intubation (62%), use of an automated chest compression device (41%), and intraosseous cannulation (39%) as the most frequently performed interventions. More interventions were generally performed in the fatal group (p = 0.01), including intraosseous cannulation and automated chest compressions.Conclusions The Danish Air Ambulance rarely treated drowning patients, but those treated were severely ill, with a 30-day mortality rate of 67% and frequently required critical care interventions. The most frequent interventions were endotracheal intubation, automated chest compressions, and intraosseous cannulation.

show abstract

“…Various epidemiologic studies investigated the causes of pre-hospital cardiac arrest in children and showed age-dependent risks exist: While infants die from sudden infant death syndrome, toddlers and small children are at risk for severe respiratory failure and upper airway obstruction. With increasing age, the risk for major trauma events raises ( 15 – 17 ). The patients in the presented cohort offered various causes for cardiac arrest, which are explainable given the extensive age range and the heterogeneity of the underlying diseases.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary resuscitation in pediatric patients under palliative home care – A multicenter retrospective study

et al. 2023

View full text Add to dashboard Cite

Introduction: Patients under palliative home care have special needs for their end-of-life support, which in general does not automatically include cardiopulmonary resuscitation. However, emergency medical services (EMS) respond to emergencies in children under palliative care that lead to cardiopulmonary resuscitation. To understand the underlying steps of decision-making, this retrospective, cross-sectional, multicenter study aimed to analyze pediatric patients under palliative home care who had been resuscitated. Methods: This study included patients from three spezialized pediatric palliative home care (SHPC) teams. The primary study parameters were the prevalence of cardiopulmonary resuscitation and the decision-making for carrying out pediatric advanced life support (PALS). Further analyses included the causes of cardiac arrest, the type of CPR (basic life support, advanced life support), the patient´s outcome, and involvement of the SHPC in the resuscitation. Descriptive statistical analysis was performed. Results: In total, 880 pediatric patients under palliative home care were included over 8.5 years, of which 17 patients were resuscitated once and two patients twice (overall, 19 events with CPR, 21.6 per 1,000 cases). In 10 of the 19 incidents (52.6%), cardiac arrest occurred suddenly without being predictable. The causes of cardiac arrest varied widely. PALS was performed in 78.9% of the cases by EMS teams. In 12 of 19 events (63.2%) resuscitation was performed on explicit wish of the parents. However, from a medical point of view, only four resuscitation attempts were reasonable. In total 7 of 17 (41.2%) patients survived cardiac arrest with a comparable quality of life. Discussion: Overall, resuscitation attempts were rare events in children under home palliative therapy, but if they occur, EMS are often the primary caregivers. Most resuscitation attempts occurred on explicit wish of the parents independently of the meaningfulness of the medical procedure. Despite the presence of a life-limiting disease, survival with a similar quality was achieved in one third of all resuscitated patients. This study indicates that EMS should be trained for advanced life support in children under home palliative therapy and SHPC should address the scenario of cardiac arrest also in early stages of palliative treatment. These results underline that advance care planning for these children is urgently needed.

show abstract

A Nationwide Retrospective Analysis of Out-of-Hospital Pediatric Cardiopulmonary Resuscitation Treated by Helicopter Emergency Medical Service in the Netherlands

Cited by 6 publications

References 18 publications

Epidemiology of paediatric out-of-hospital cardiac arrest in Ontario, Canada

Epidemiology of paediatric out-of-hospital cardiac arrest in Ontario, Canada

Characteristics and critical care interventions in drowning patients treated by the Danish Air Ambulance from 2016-2021: a nationwide registry-based study with 30-day follow-up

Cardiopulmonary resuscitation in pediatric patients under palliative home care – A multicenter retrospective study

Contact Info

Product

Resources

About