Challenging the Dogma of Pediatric Cardiac Arrest
Challenging the Dogma of Pediatric Cardiac Arrest
March 1, 2023
Pediatric emergencies are scary – and pediatric cardiac arrest tops the list of those scary scenes. After spending a couple decades honing his PEM skills, Peter Antevy, MD, has narrowed down some key tips he shares with EMRA*Cast host Chris Reilly, MD.
Host
Christopher Reilly, MD
Maimonides Medical Center Medical Education Fellowship
@docreilles | Instagram: docreilles
EMRA*Cast Episodes
Guest
Peter Antevy, MD
- Medical director of Davie Fire-Rescue, Coral Springs-Parkland Fire Department, Southwest Ranches Fire-Rescue, MCT Express
- Founder and CMO, Handtevy Pediatric Emergency Standards
- PEM physician, Joe DiMaggio Children's Hospital
Overview
Pediatric emergencies are scary – and pediatric cardiac arrest tops the list of those scary scenes. After spending a couple decades honing his PEM skills, Peter Antevy, MD, has narrowed down some key tips he shares with EMRA*Cast host Chris Reilly, MD.
Take-Home Points
The American Heart Association calls out-of-hospital cardiac arrest a significant public health concern, and studies show that outcomes are poorer for pediatric patients, even when ROSC is achieved. What strategies can help improve survival and return to full function?
- Use the same out-of-hospital cardiac arrest management with children as you do with adults – which means training, equipping, and trusting EMS teams for pediatric emergencies.
- Employ System 1 thinking and System 2 thinking to overcome inherent roadblocks when thinking through cardiac arrest care for children.
- Practice using a child’s age to estimate weight, and thus prepare your thinking, dosing, and management before the patient arrives in the ED.
- MOST IMPORTANT: Give EMS their moment. Treat them with respect, listen to their full reports.
RESOURCES
- Chang CDI, Padlipsky P, Young KD. Eds. EMRA PEM Fundamentals: The Essential Handbook for Pediatric Emergencies. Dallas, Texas: Emergency Medicine Residents’ Association;2021.
- Kahneman D. Thinking, Fast and Slow. Farrar, Straus and Giroux;2013.
- Holmberg MJ, Ross CE, Fitzmaurice G, et al. Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States. Circ Cardiovasc Qual Outcomes. 2020;12(7):e005580.
- Mir T, Shafi OM, Uddin M, Nadiger M, Tul Llah FS, Qureshi WT. Pediatric Cardiac Arrest Outcomes in the United States: A Nationwide Database Cohort Study. Cureus. 2022;14(7):e26505.
- Donoghue AJ, Nadkarni V, Berg RA, et al. Out-of-hospital pediatric cardiac arrest: An epidemiologic review and assessment of current knowledge. Ann Emerg Med. 2005;46(6):512-522.
