Circumstances and Outcomes of Out-Of-Hospital Cardiac Arrest in Elementary and Middle School Students in the Era of Public-Access Defibrillation - Implications for Emergency Preparedness in Schools
Circumstances and Outcomes of Out-Of-Hospital Cardiac Arrest in Elementary and Middle School Students in the Era of Public-Access Defibrillation - Implications for Emergency Preparedness in Schools
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DOI：
10.1253/circj.cj-13-1162
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发表时间：
2014-03-01
影响因子：
3.3
通讯作者：
Sumitomo, Naokata
中科院分区：
文献类型：
--
作者：
Mitani, Yoshihide;Ohta, Kunio;Sumitomo, Naokata
背景资料：情况和结果的院外心脏骤停（OHCA）在小学和中学的学生，而在学校的时代，公共访问defibrillation.Methods和结果：我们进行了一项全国性的医院为基础的调查，小学和中学的学生谁有OHCA的心脏起源，并在2005-2009年接受院前复苏。在招募的58例病例中，90%由旁观者目睹; 86%以室颤为初始心律; 74%由旁观者复苏; 24%由旁观者除颤; 55%发生在学校; 66%与运动有关; 48%在事件发生前进行了随访; 67%患有结构性心脏病。总体而言，53%的患者和79%的最初由旁观者除颤的患者具有良好的神经学结局。与其他地点相比，患者更有可能被旁观者除颤（38%比8%，P=0.012），并且在学校（69%比35%，P=0.017）的神经系统结局更有利。学校里的大多数逮捕都与运动有关（84% vs. 42%，P=0.001），发生在体育场馆，学生由老师复苏;一半的病例发生在学校的患者与事件前的后续行动。在OHCA之后，儿童更有可能被旁观者除颤，并且在学校的结果比其他地方更好，这可能与事件的情况有关。
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.Methods and 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.