Cardiac arrest & resuscitation
Adverse Safety Events in Emergency Medical Services Care of Children With Out-of-Hospital Cardiac Arrest
Authors' conclusion
In this large geographically diverse cohort of children with EMS-treated OHCA, 60% of all patients experienced at least 1 severe ASE. The odds of a severe ASE were higher for neonates than adolescents and even higher when the cardiac arrest was birth related.
Study context
- Population
- Children <18 years with out-of-hospital cardiac arrest (OHCA) with emergency medical services (EMS)-attempted resuscitation, 51 EMS agencies in California, Georgia, Oregon, Pennsylvania, Texas and Wisconsin, 2013–2019
- Participants
- 1,019 encounters
- Outcome
- Severe adverse safety events (ASEs) during the patient encounter (eg, failure to give an indicated medication, 10-fold medication overdose)
Methodological detailspopulation-based, multicentre (51 EMS agencies), Medical record review January 2019 to April 2022; data analysis October 2022 to February 2023
- Population-based
- Multicentre (51 EMS agencies)
- Medical record review January 2019 to April 2022; data analysis October 2022 to February 2023
Main finding
As reported in the abstract
At least 1 severe ASE
At least 1 severe ASE
610
60%
2 or more severe ASEs
310
30%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Factors associated with severe ASEs (multivariable logistic regression)Neonates, birth-related OHCA vs Adolescents | 7.0 (3.1–16.1) | |
| Factors associated with severe ASEs (multivariable logistic regression)Neonates, non-birth-related OHCA vs Adolescents | 3.4 (1.2–9.6) | |
| 0.050.21520Odds ratio (log scale) |
Most common severe ASEs
- Epinephrine administration
- 332 [30%]
- Vascular access
- 212 [19%]
- Ventilation
- 160 [14%]
Factors associated with severe ASEs (multivariable logistic regression)
- Only factor associated with severe ASEs was young age
Original publication
Adverse Safety Events in Emergency Medical Services Care of Children With Out-of-Hospital Cardiac Arrest. JAMA Netw Open. Published 2 January 2024. doi:10.
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