Acute cardiac care & resuscitationCohort study
Paediatric out-of-hospital cardiac arrest occurring before and after emergency medical service arrival: a retrospective study
- retrospective cohort study
Authors' conclusion
Paediatric OHCA witnessed by EMS is associated with significantly higher adjusted odds of survival compared with bystander witnessed events. These findings highlight the importance of early professional intervention and support the need for paediatric-specific strategies to improve recognition and response to these events.
Study context
- Population
- Paediatric (<18 years) OHCA cases attended by emergency medical services (EMS) between 1 January 2000 and 31 December 2024, identified from the Victorian Ambulance Cardiac Arrest Registry (VACAR)paediatric OHCAs attended by EMS, 1891 (71.5%) received a resuscitation attempt
- Participants
- 2,645 participants
- Exposure
- EMS witnessed arrests compared with bystander witnessed arrests
Main finding
As reported in the abstract
Witness status among EMS-treated cases
Observational data: associations, not effects.
Further findings
| Outcome | AOR (95% CI) | |
|---|---|---|
| Survival to hospital discharge | 1.91 (1.04–3.52) | |
| Prehospital ROSC | 1.83 (1.20–2.77) | |
| 0.20.5125Adjusted odds ratio (log scale) |
- Survival to hospital discharge: adjusted for age, sex, arrest location, region, aetiology, initial rhythm and year
Incidence over the 25-year period
- Incidence of unwitnessed and bystander witnessed OHCA declined
- P < 0.001
- EMS witnessed incidence remained stable
Survival outcomes, unwitnessed arrests
- unwitnessed arrests had substantially lower survival across all outcomes
Original publication
Paediatric out-of-hospital cardiac arrest occurring before and after emergency medical service arrival: a retrospective study. Resuscitation. Published 15 August 2026. doi:10.1016/j.resuscitation.2026.111267
Summarised from the published abstract; every number is checked against it