There is very little evidence to guide the optimal prehospital treatment for children who suffer cardiac arrest outside of hospital and to improve upon their extremely poor survival and morbidity. Each year in the U.S., 15,000 children collapse and lose effective heartbeat (cardiac arrest) outside of hospital and 95% of them will not survive to leave hospital alive. Of those who do survive, physical and cognitive disabilities are common and severe. If a child suffers cardiac arrest outside of hospital and does not receive immediate and effective treatment, we believe that he/she has very little chance of survival or of going home without significant disability. The four links in the American Heart Association (AHA) Adult Chain of Survival for prehospital treatment of cardiac arrest have been well studied in adults, in part due to the large Canadian Ontario Prehospital Advanced Life Support (OPALS) Study. Very little research has been done for the analogous Pediatric Chain of Survival, which has different priorities than for adults. Much is now known, for adults, about the relative value of cardiopulmonary resuscitation (CPR) by citizen bystanders, optimized defibrillation programs by first responders, and advanced life support (ALS) measures by the Emergency Medical Services (EMS) paramedic providers. Prehospital ALS measures include airway management, intravascular access, and drug therapy. Unfortunately, very few methodologically sound studies have been conducted regarding management of prehospital pediatric cardiac arrest, particularly prior to arrival at hospital. It is accurate to say that very little is known about the best timing, intensity, and duration of EMS treatment for this problem. There are considerable barriers to conducting methodologically robust clinical studies outside of hospital, for children who have suffered cardiac arrest and careful planning is required in order to research important unanswered questions about prehospital management.
The overall goal of our group is to improve the survival and morbidity of pediatric patients who suffer cardiac arrest outside of hospital.
Ottawa Team
Dr. Ian Stiell
Principal Investigator
Dr. Martin Osmond
Co-Investigator
osmond@cheo.on.ca
Dr. George Wells
Co-Investigator
Cathy Clement
Senior Research Program Manager / Associate
EMS Partners
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