Paediatric cardiac arrests in the northern Emirates, United Arab Emirates

Objectives: The objective of this study was to identify the incidence and clinical characteristics of paediatric out-of-hospital cardiac arrest (OHCA) cases in the emirates of Al-Sharjah, Ras-al-Khaimah, Umm Al-Quwain, Al-Fujairah and Ajman (collectively referred to as the Northern Emirates) in the United Arab Emirates (UAE). Methods: This study was a prospective cohort study of all OHCA incidents treated or transported by National Ambulance LLC ambulance crews between February 2014 and March 2015. A subgroup analysis was performed on all paediatric OHCA patients (defined as less than 18 years old) presenting during this period. Results: The subgroup comprised of 14 patients (3.6% of the overall cardiac arrest population). There were six male (43%) and eight female (57%) patients, with a median age of four years (interquartile range [IQR] 0.63-8.75). The majority of paediatric cardiac arrests occurred in patients from the Indian subcontinent (n=6, 43%) with UAE Nationals accounting for three cases (21%). Trauma induced cardiac arrest accounted for six cases (43%) with three of these (21%) as a result of traffic related incidents and two as a result of drowning (14%). The median response time was nine (9:00) minutes from receipt of emergency medical call to arrival of crew at scene (IQR 7:45-11:30). Bystander Cardiopulmonary resuscitation (CPR) was attempted in five cases (36%). Two patients (14%) presented in a shockable rhythm on first analysis. An overall out-of-hospital (at scene or en-route) return-of-spontaneous-circulation (ROSC) rate of two patients (14%) was observed in the paediatric population. Conclusion: A low ROSC rate for paediatric cardiac arrest was identified in the population studied, in line with previous studies. This highlights the need for public education addressing prevention of paediatric cardiac arrest, particularly prevention of trauma induced cardiac arrest. In addition, providing education to the public surrounding the early recognition of paediatric cardiac arrest and subsequent actions to be undertaken, including early Emergency Medical Services activation and provision of bystander CPR is an identified priority action arising from this study. Determining the baseline data presented in this study is essential in recommending and implementing strategies to reduce mortality from paediatric OHCA.