JOURNAL ARTICLE
MULTICENTER STUDY

Circumstances and outcomes of out-of-hospital cardiac arrest in elementary and middle school students in the era of public-access defibrillation

Yoshihide Mitani, Kunio Ohta, Fukiko Ichida, Masaki Nii, Yoshio Arakaki, Hiroya Ushinohama, Tsutomu Takahashi, Hiroyuki Ohashi, Noriko Yodoya, Eitaro Fujii, Ken Ishikura, Shigeru Tateno, Seiichi Sato, Tsugutoshi Suzuki, Takashi Higaki, Mari Iwamoto, Masao Yoshinaga, Masami Nagashima, Naokata Sumitomo
Circulation Journal: Official Journal of the Japanese Circulation Society 2014, 78 (3): 701-7
24463758

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. 

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