Incidence, characteristics, and outcomes of pediatric out-of-hospital cardiac arrest in nursery schools and kindergartens in Japan

Kiyohara, Kosuke; Kitamura, Tetsuhisa; Ayusawa, Mamoru; Nitta, Masahiko; Iwami, Taku; Nakata, Ken; Matsui, Satoshi; Sobue, Tomotaka

doi:10.1016/j.jjcc.2020.06.003

Cited by 8 publications

(9 citation statements)

References 29 publications

(32 reference statements)

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“…Immediate and high-quality resuscitation is associated with improvement in otherwise poor survival and neurologic outcome (1)(2)(3)(4)(5). An evaluation of the nationwide registry of pediatric OHCA in Japan revealed an incidence of out of hospital cardiac arrests in nursery schools and kindergartens of 0.13 per 100,000 children per year (18). The causes of cardiac arrest of non-medical origins were suffocation, drowning, and severe traumatic brain injury.…”

Section: Discussionmentioning

confidence: 99%

“…This study confirmed our choice of three simulated emergencies that frequently occur in daycare centers. In the Japanese evaluation, a large proportion of patients were also found unconscious during naptime ( 18 ). These situations require rapid recognition of cardiac arrest and immediate action, which must also be highlighted in BLS courses.…”

Section: Discussionmentioning

confidence: 99%

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Implementation and Evaluation of Resuscitation Training for Childcare Workers

et al. 2022

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Background and ObjectiveChildren spend a large amount of time in daycare centers or schools. Therefore, it makes sense to train caregivers well in first-aid measures in children. The aim of this study is to evaluate whether a multimodal resuscitation training for childcare workers can teach adherence to resuscitation guidelines in a sustainable way.Materials and MethodsCaregivers at a daycare center who had previously completed a first-aid course received a newly developed multimodal resuscitation training in small groups of 7–8 participants by 3 AHA certified PALS instructors and providers. The 4-h focused retraining consisted of a theoretical component, expert modeling, resuscitation exercises on pediatric manikins (Laerdal Resusci Baby QCPR), and simulated emergency scenarios. Adherence to resuscitation guidelines was compared before retraining, immediately after training, and after 6 months. This included evaluation of chest compressions per round, chest compression rate, compression depth, full chest recoil, no-flow time, and success of rescue breaths. For better comparability and interpretation of the results, the parameters were evaluated both separately and summarized in a resuscitation score reflecting the overall adherence to the guidelines.ResultsA total of 101 simulated cardiopulmonary resuscitations were evaluated in 39 participants. In comparison to pre-retraining, chest compressions per round (15.0 [10.0–29.0] vs. 30.0 [30.0–30.0], p < 0.001), chest compression rate (100.0 [75.0–120.0] vs. 112.5 [105–120.0], p < 0.001), correct compression depth (6.7% [0.0–100.0] vs. 100.0% [100.0–100.0], p < 0.001), no-flow time (7.0 s. [5.0–9.0] vs. 4.0 s. [3.0–5.0], p < 0.001), success of rescue breaths (0.0% [0.0–0.0] vs. 100.0% [100.0–100.0], p < 0.001), and resuscitation score were significantly improved immediately after training (3.9 [3.2–4.9] vs. 6.3 [5.6–6.7], p < 0.001). At follow-up, there was no significant change in chest compression rate and success of rescue breaths. Chest compressions per round (30.0 [15.0–30.0], p < 0.001), no-flow time (5.0 s. [4.0–8.0], p < 0.001), compression depths (100.0% [96.7–100.0], p < 0.001), and resuscitation score worsened again after 6 months (5.7 [4.7–6.4], p = 0.03). However, the results were still significantly better compared to pre-retraining.ConclusionOur multimodal cardiopulmonary resuscitation training program for caregivers is effective to increase the resuscitation performance immediately after training. Although the effect diminishes after 6 months, adherence to resuscitation guidelines was significantly better than before retraining.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Implementation and Evaluation of Resuscitation Training for Childcare Workers

et al. 2022

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“…Nous avons ensuite mis Nontraumatic sudden cardiac arrest (SCA) in children is rare, with an incidence of fewer than 2.1 per 100,000 personyears. [1][2][3][4] However, the outcome is often poor and the consequences are devastating for both the family and the community. 4,5 Sudden cardiac death is responsible for approximately 5%-10% of all deaths in children 5-19 of age.…”

Section: R Esum Ementioning

confidence: 99%

“…[1][2][3][4] However, the outcome is often poor and the consequences are devastating for both the family and the community. 4,5 Sudden cardiac death is responsible for approximately 5%-10% of all deaths in children 5-19 of age. 6 During a pediatric SCA, rapid access to an automated external defibrillator (AED) is critical, 7 because the survival rate of SCA in educational institutions without an action plan is as low as 10%.…”

Section: R Esum Ementioning

confidence: 99%

Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study

Blanchard

Graham

Gauvin

et al. 2022

CJC Pediatric and Congenital Heart Disease

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“…Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS) is a study that constructs and analyzes a nationwide registry of pediatric OHCAs occurring in school settings in Japan [23][24][25]. In the present study, we aimed to (1) clarify how the types of bystander-initiated CPR (i.e., CCCPR or CCRB) for OHCA among students have changed in recent years, and (2) to investigate the association between the two types of bystander-CPR and survival after OHCA using data from the SPIRITS registry.…”

Section: Introductionmentioning

confidence: 99%

Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation by Bystanders for Out-of-Hospital Cardiac Arrest in Students: A Nationwide Investigation in Japan

Kiyohara

Ayusawa

Nitta

et al. 2022

JCM

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We aimed to investigate how the types of bystander-initiated cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) among students have changed recently. We also determined the association between two types of bystander-CPRs (i.e., chest compression-only CPR [CCCPR] and conventional CPR with rescue breathing [CCRB]) and survival after OHCA. From a nationwide registry of pediatric OHCAs occurring in school settings in Japan, the data of 253 non-traumatic OHCA patients (elementary, junior high, and high school/technical college students) receiving bystander-CPR between April 2008 and December 2017 were analyzed. Multivariable logistic regression analysis was conducted to assess the impact of different types of bystander-CPR on 30-day survival with favorable neurological outcomes. The proportion of patients receiving CCCPR increased from 25.0% during 2008–2009 to 55.3% during 2016–2017 (p for trend < 0.001). Overall, 53.2% (50/94) of patients receiving CCCPR and 46.5% (74/159) of those receiving CCRB survived for 30 days with favorable neurological outcomes. Multivariable analysis showed no significant difference in outcomes between the two groups (adjusted odds ratio: 1.23, 95% confidence interval: 0.67–2.28). In this setting, CCCPR is a common type of bystander-CPR for OHCA in students, and the effectiveness of CCCPR and CCRB on survival outcomes seems comparable.

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Incidence, characteristics, and outcomes of pediatric out-of-hospital cardiac arrest in nursery schools and kindergartens in Japan

Cited by 8 publications

References 29 publications

Implementation and Evaluation of Resuscitation Training for Childcare Workers

Implementation and Evaluation of Resuscitation Training for Childcare Workers

Reducing Barriers to Optimal Automated External Defibrillator Use: An Elementary School Intervention Study

Dissemination of Chest Compression-Only Cardiopulmonary Resuscitation by Bystanders for Out-of-Hospital Cardiac Arrest in Students: A Nationwide Investigation in Japan

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