Circumstances and outcomes of out-of-hospital cardiac arrest in elementary and middle school students in the era of public-access defibrillation.
BACKGROUND
Circumstances and outcomes of out-of-hospital cardiac arrest (OHCA) in elementary and middle school students while at school in the era of public-access defibrillation are unknown.


RESULTS
We conducted a nationwide hospital-based survey of elementary and middle school students who had had OHCA of cardiac origin and received prehospital resuscitation in 2005-2009. Among 58 cases recruited, 90% were witnessed by bystanders; 86% had ventricular fibrillation as the initial rhythm; 74% were resuscitated by bystanders; 24% were defibrillated by bystanders; 55% occurred at school; 66% were exercise-related; 48% were followed up before the event; 67% had structural heart disease. In total, 53% of overall patients and 79% of those initially defibrillated by bystanders had a favorable neurological outcome. Patients were more likely to be defibrillated by bystanders (38% vs. 8%, P=0.012) and had a more favorable neurological outcome in schools (69% vs. 35%, P=0.017) than in other locations. The majority of arrests in schools were exercise-related (84% vs. 42%, P=0.001), occurred at sports venues, and students were resuscitated by teachers; half of the cases at school occurred in patients with a pre-event follow-up.


CONCLUSIONS
After OHCA, children were more likely to be defibrillated by bystanders and had a better outcome in schools than in other locations, which may be relevant to the circumstances of events.
Department of Pediatrics, Mie University Graduate School of Medicine.
Yoshihide
Y
Mitani
Kunio
K
Ohta
Fukiko
F
Ichida
Masaki
M
Nii
Yoshio
Y
Arakaki
Hiroya
H
Ushinohama
Tsutomu
T
Takahashi
Hiroyuki
H
Ohashi
Noriko
N
Yodoya
Eitaro
E
Fujii
Ken
K
Ishikura
Shigeru
S
Tateno
Seiichi
S
Sato
Tsugutoshi
T
Suzuki
Takashi
T
Higaki
Mari
M
Iwamoto
Masao
M
Yoshinaga
Masami
M
Nagashima
Naokata
N
Sumitomo
D000293:Adolescent; D002648:Child; D047548:Defibrillators; D005260:Female; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D012151:Resuscitation; D013334:Students; D014693:Ventricular Fibrillation / Q000401:mortality* / Q000628:therapy*