Pediatric emergency medicine trisk 0195 0195
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threatening condition that has furthered recent work. Research experts have
developed the Utstein Criteria which includes standard definitions and
terminology to enable more robust comparisons among patient groups. Large,
prospective studies with rigorous data collection of actual CPR events are needed
to further guide interventions that could ultimately improve patient outcomes.
TABLE 9.3
OUTCOME FOR OUT-OF-HOSPITAL PEDIATRIC
CARDIOPULMONARY ARREST
PROGNOSIS
Despite advances in medical care of the critically ill child and improved EMS
systems, pediatric OHCA survival remains poor and has shown little
improvement over time. Less than 15% of children who suffer an OHCA survive,
usually with significant neurologic injury ( Table 9.3 ). Unfortunately, about 70%
of OHCAs are unwitnessed events and only about 50% of children receive
bystander CPR, which contributes to their poor prognosis. However, if a
hospitalized child has respiratory arrest that is recognized rapidly and managed
skillfully, immediate survival may be as high as 90%. Overall, children
resuscitated after an in-hospital arrest (IHA) have a more favorable outcome with
more than 30% to 40% of children surviving to hospital discharge ( Table 9.4 ).
Earlier recognition of prearrest phases, advances in medical care and education,
and rapid response teams have likely contributed to the improved survival over
time seen in IHA.
CLINICAL MANIFESTATIONS
The clinical manifestations of persons requiring immediate life support are most
often related to failure of oxygen delivery to the skin, brain, kidneys, and
cardiovascular system. One can identify most potential or existing life-threatening
