Transcutaneous cardiac pacing in the treatment of out-of-hospital pediatric cardiac arrests.
OBJECTIVE
To evaluate the effectiveness of transcutaneous cardiac pacing in out-of-hospital treatment of cardiac arrests in pediatric patients.


METHODS
We describe the outcome of patients treated during a prospective trial of transcutaneous cardiac pacing in the field. We compare their outcome with that of out-of-hospital arrests in submersion patients who were not paced. We identified patients from Seattle and King County Emergency Medical Services reports, hospitals, and medical examiner's registries.


RESULTS
Nine patients in cardiac arrest caused by drowning (six) and sudden infant death syndrome (three) were paced in the field. All were less than 6 years old. The one survivor was severely neurologically impaired and died six months later. Transcutaneous cardiac pacing produced electrical capture in two patients but no detectable pulse or blood pressure. Ten submersion patients less than 6 years old in cardiac arrest were not paced. One survived, with mild neurologic impairment at hospital discharge.


CONCLUSIONS
Transcutaneous cardiac pacing was not effective and was not associated with improved survival.
Quan
L
L
Department of Pediatrics, University of Washington, Seattle.
Graves
J R
JR
Kinder
D R
DR
Horan
S
S
Cummins
R O
RO
D002304:Cardiac Pacing, Artificial / Q000379:methods; D002675:Child, Preschool; D004332:Drowning / Q000401:mortality; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D013398:Sudden Infant Death; D016896:Treatment Outcome