Paediatric out-of-hospital cardiac arrests in Melbourne, Australia: improved reporting by adding coronial data to a cardiac arrest registry

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Abstract

We describe improved reporting of paediatric out-of-hospital cardiac arrest (OHCA) by adding coronial findings to a cardiac arrest registry. Methods: Non-traumatic OHCA occurring in paediatric patients aged less than 16 years were identified using the Victorian Ambulance Cardiac Arrest Registry and available coronial findings reviewed. Results: Between the years 2001 and 2009, emergency medical services (EMS) attended 26 974 non-traumatic OHCA of which 390 (1.4 ) occurred in children less than 16 years of age. We successfully linked 301 patients with the coronial registry; excluding patients discharged alive from hospital (n=22) and patients with terminal illness (n=16), this represents 86 of OHCA attended by the ambulance. Agreement between the paramedic cause of OHCA and the coronial cause of death was 66.5 (? 0.16) for presumed cardiac, 74.4 (? 0.43) for sudden infant death syndrome (SIDS), 81.1 (? 0.17) for respiratory, 92.7 (? 0.18) for neurological and 98.3 (? 0.27) for drug overdose precipitants to OHCA. Undiagnosed congenital heart disease was a rare cause of OHCA (n=3, 1 ). Intentional injury was found on autopsy in 13 cases; six cases were clinically thought to be SIDS and two cases presumed cardiac. Co-sleeping was found in 35 cases (39 ) of SIDS. Conclusions: This study highlights the limitations associated with ascribing the cause of OHCA on the basis of clinical details. Improved reporting is possible by linkage with coronial data. Such robust data inform EMS service providers but also the wider healthcare system where preventive, diagnostic and treatment strategies can be maximised.
Original languageEnglish
Pages (from-to)740 - 744
Number of pages5
JournalEmergency Medicine Journal
Volume30
Issue number9
DOIs
Publication statusPublished - 2013

Cite this

@article{a348b611f04a438b8d1cdc3c3c65c0a7,
title = "Paediatric out-of-hospital cardiac arrests in Melbourne, Australia: improved reporting by adding coronial data to a cardiac arrest registry",
abstract = "We describe improved reporting of paediatric out-of-hospital cardiac arrest (OHCA) by adding coronial findings to a cardiac arrest registry. Methods: Non-traumatic OHCA occurring in paediatric patients aged less than 16 years were identified using the Victorian Ambulance Cardiac Arrest Registry and available coronial findings reviewed. Results: Between the years 2001 and 2009, emergency medical services (EMS) attended 26 974 non-traumatic OHCA of which 390 (1.4 ) occurred in children less than 16 years of age. We successfully linked 301 patients with the coronial registry; excluding patients discharged alive from hospital (n=22) and patients with terminal illness (n=16), this represents 86 of OHCA attended by the ambulance. Agreement between the paramedic cause of OHCA and the coronial cause of death was 66.5 (? 0.16) for presumed cardiac, 74.4 (? 0.43) for sudden infant death syndrome (SIDS), 81.1 (? 0.17) for respiratory, 92.7 (? 0.18) for neurological and 98.3 (? 0.27) for drug overdose precipitants to OHCA. Undiagnosed congenital heart disease was a rare cause of OHCA (n=3, 1 ). Intentional injury was found on autopsy in 13 cases; six cases were clinically thought to be SIDS and two cases presumed cardiac. Co-sleeping was found in 35 cases (39 ) of SIDS. Conclusions: This study highlights the limitations associated with ascribing the cause of OHCA on the basis of clinical details. Improved reporting is possible by linkage with coronial data. Such robust data inform EMS service providers but also the wider healthcare system where preventive, diagnostic and treatment strategies can be maximised.",
author = "Conor Deasy and David Hall and Bray, {Janet E} and Smith, {Karen Louise} and Bernard, {Stephen Anthony} and Peter Cameron",
year = "2013",
doi = "10.1136/emermed-2012-201531",
language = "English",
volume = "30",
pages = "740 -- 744",
journal = "Emergency Medicine Journal",
issn = "1472-0205",
publisher = "BMJ Publishing Group Ltd",
number = "9",

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TY - JOUR

T1 - Paediatric out-of-hospital cardiac arrests in Melbourne, Australia: improved reporting by adding coronial data to a cardiac arrest registry

AU - Deasy, Conor

AU - Hall, David

AU - Bray, Janet E

AU - Smith, Karen Louise

AU - Bernard, Stephen Anthony

AU - Cameron, Peter

PY - 2013

Y1 - 2013

N2 - We describe improved reporting of paediatric out-of-hospital cardiac arrest (OHCA) by adding coronial findings to a cardiac arrest registry. Methods: Non-traumatic OHCA occurring in paediatric patients aged less than 16 years were identified using the Victorian Ambulance Cardiac Arrest Registry and available coronial findings reviewed. Results: Between the years 2001 and 2009, emergency medical services (EMS) attended 26 974 non-traumatic OHCA of which 390 (1.4 ) occurred in children less than 16 years of age. We successfully linked 301 patients with the coronial registry; excluding patients discharged alive from hospital (n=22) and patients with terminal illness (n=16), this represents 86 of OHCA attended by the ambulance. Agreement between the paramedic cause of OHCA and the coronial cause of death was 66.5 (? 0.16) for presumed cardiac, 74.4 (? 0.43) for sudden infant death syndrome (SIDS), 81.1 (? 0.17) for respiratory, 92.7 (? 0.18) for neurological and 98.3 (? 0.27) for drug overdose precipitants to OHCA. Undiagnosed congenital heart disease was a rare cause of OHCA (n=3, 1 ). Intentional injury was found on autopsy in 13 cases; six cases were clinically thought to be SIDS and two cases presumed cardiac. Co-sleeping was found in 35 cases (39 ) of SIDS. Conclusions: This study highlights the limitations associated with ascribing the cause of OHCA on the basis of clinical details. Improved reporting is possible by linkage with coronial data. Such robust data inform EMS service providers but also the wider healthcare system where preventive, diagnostic and treatment strategies can be maximised.

AB - We describe improved reporting of paediatric out-of-hospital cardiac arrest (OHCA) by adding coronial findings to a cardiac arrest registry. Methods: Non-traumatic OHCA occurring in paediatric patients aged less than 16 years were identified using the Victorian Ambulance Cardiac Arrest Registry and available coronial findings reviewed. Results: Between the years 2001 and 2009, emergency medical services (EMS) attended 26 974 non-traumatic OHCA of which 390 (1.4 ) occurred in children less than 16 years of age. We successfully linked 301 patients with the coronial registry; excluding patients discharged alive from hospital (n=22) and patients with terminal illness (n=16), this represents 86 of OHCA attended by the ambulance. Agreement between the paramedic cause of OHCA and the coronial cause of death was 66.5 (? 0.16) for presumed cardiac, 74.4 (? 0.43) for sudden infant death syndrome (SIDS), 81.1 (? 0.17) for respiratory, 92.7 (? 0.18) for neurological and 98.3 (? 0.27) for drug overdose precipitants to OHCA. Undiagnosed congenital heart disease was a rare cause of OHCA (n=3, 1 ). Intentional injury was found on autopsy in 13 cases; six cases were clinically thought to be SIDS and two cases presumed cardiac. Co-sleeping was found in 35 cases (39 ) of SIDS. Conclusions: This study highlights the limitations associated with ascribing the cause of OHCA on the basis of clinical details. Improved reporting is possible by linkage with coronial data. Such robust data inform EMS service providers but also the wider healthcare system where preventive, diagnostic and treatment strategies can be maximised.

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U2 - 10.1136/emermed-2012-201531

DO - 10.1136/emermed-2012-201531

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SP - 740

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JO - Emergency Medicine Journal

JF - Emergency Medicine Journal

SN - 1472-0205

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ER -