Out-of-hospital ventricular fibrillation in children and adolescents: causes and outcomes.
OBJECTIVE
To compare causes and outcomes of patients younger than 20 years with an initial rhythm of ventricular fibrillation versus asystole and pulseless electrical activity.


METHODS
Retrospective cohort study.


METHODS
Urban/suburban prehospital system.


METHODS
Pulseless, nonbreathing patients less than 20 years who underwent out-of-hospital resuscitation. Patients with lividity or rigor mortis or who were less than 6 months old and died of sudden infant death syndrome were excluded.


RESULTS
Ventricular fibrillation was the initial rhythm in 19% (29 of 157) of the cardiac arrests. Rhythm assessment was performed by the first responder in only 44% (69 of 157) of patients. All three rhythm groups were similar in age distribution, frequency of intubation (96%), and vascular access (92%); 93% of ventricular fibrillation patients were defibrillated. The causes of ventricular fibrillation were distributed evenly among medical illnesses, overdoses, drownings, and trauma, only two patients had congenital heart defects. Seventeen percent were discharged with no or mild disability, compared with 2% of asystole/pulseless electrical activity patients (P = .003).


CONCLUSIONS
Ventricular fibrillation is not rare in child and adolescent prehospital cardiac arrest, and these patients have a better outcome than those with asystole or pulseless electrical activity. Earlier recognition and treatment of ventricular fibrillation might improve pediatric cardiac arrest survival rates.
Mogayzel
C
C
Department of Pediatrics, University of Washington School of Medicine, Seattle.
Quan
L
L
Graves
J R
JR
Tiedeman
D
D
Fahrenbruch
C
C
Herndon
P
P
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012151:Resuscitation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000628:therapy*; D014861:Washington