Abstract 254: the Epidemiology of Paediatric Out-of-hospital Cardiac Arrest in Australia and New Zealand

Introduction: Adult OHCA has been well described in Australasian studies, however little is known about paediatric OHCA in our region. This study describes the epidemiology of paediatric OHCA across Australia and New Zealand. Method: Data for paediatric OHCA were extracted from the Aus-ROC Epistry for the period 2017-2019. The Aus-ROC Epistry captures data nationwide across Australia and New Zealand covering a target population of roughly 30 million people. Paediatric OHCA was defined as an OHCA occurring in persons aged less than 18 years and classified as < 1 year, 1-5 years, 6-11 years and 12-17 years. Results: There were 2008 paediatric OHCA during the study: 701 aged below 1 year, 363 aged 1-5 years, 217 aged 6-11 years and 728 aged 12-17 years. There was considerable variation across age groups with respect to core arrest features, including home arrests (range: 61% to 89%), witnessed arrests (range: 22%-51%), arrests of medical aetiologies (range: 33%-95%) and arrests with a shockable initial rhythm (range: 1% to 10%). Bystander CPR in non-EMS witnessed cases was 63% and ranged from 58% in 12-17 year-olds to 73% in 1-5 year-olds.Resuscitation was attempted in 1319 cases (65.7%): 490 aged <1 year, 267 aged 1-5 years, 154 aged 6-11 years and 408 aged 12-17 years. Resuscitation rates varied across age groups ranging from 56% amongst 12-17 year-olds to 73% amongst 1-5 year-olds. In EMS treated cases, 28% had a return of spontaneous circulation (ROSC) in the prehospital setting (range: 19% to 38%) and 24% had ROSC on hospital arrival (range: 17%-33%). Rates of survival to hospital discharge/30 days was 6.8% overall, and ranged from 6.1% in infants (<1 year) to 11.8% in children aged 6-11 years. Conclusion: There is considerable heterogeneity in paediatric OHCA, characterised by differences on key measures across age groups.