Ventricular Fibrillation Proportion Increases Significantly in Older Children

Strategic Insights -

A study from the United States, published in Academic Emergency Medicine, investigated the frequency of ventricular fibrillation (VF) among children presenting to EMS with cardiac arrest. The researchers found that the proportion of patients presenting with VF increased significantly with age, with the greatest increase occurring in children older than 12 years. The study's findings have implications for the initial EMS resuscitation approach in a two-tiered system.

Key Takeaways:

  • The proportion of ventricular fibrillation (VF) among children presenting to EMS with cardiac arrest increased with age, with the greatest increase occurring in children older than 12 years.
  • Among children aged 1-7 years, 7.6% (10/131) presented with VF, compared to 27.0% (38/141) among children aged 8-18 years.
  • The proportion of VF among children older than 12 years was significantly higher than among younger children, suggesting that the initial EMS resuscitation approach may need to be adjusted for older children.
  • The study's findings are in accordance with the 2005 guidelines, which recommend including witness status in the decision process for younger children to more efficiently allocate AED use.
  • The research was conducted as a retrospective cohort study of EMS-treated, nontraumatic, out-of-hospital cardiac arrest among persons aged 1-18 years in King County, Washington, between April 1, 1976, and December 31, 2003.

Statistics:

  • 17.6% of cases (48/272) presented with ventricular fibrillation.
  • 7.6% (10/131) of children aged 1-7 years presented with VF.
  • 27.0% (38/141) of children aged 8-18 years presented with VF.
  • The proportion of VF among older children (27.0%) was significantly higher than among younger children (7.6%).

Sources:

  • Smith BT, et al. Ventricular fibrillation in pediatric cardiac arrest. Acad Emerg Med, 2006;13(5):525-529.
  • Health & Medicine Week editors. Ventricular Fibrillation Proportion Increases Significantly in Older Children. Health & Medicine Week, 2006.