Fortunately, out-of-hospital cardiac arrest (OHCA) in childhood is a rare event. Studies of OHCA in children and adolescents (excluding infants under one year old) report an incidence between 3 and 9 per 100,000 per year. The rates reported in infants are generally much higher (between 11 and 72 per 100,000 infants per year). The cause in this latter group is often attributed to the Sudden Infant Death Syndrome (SIDS).
The incidence of cardiac arrest from a primarily cardiac cause (which includes cases referred to as “sudden cardiac arrest” or SCA) has been reported to be 2 – 3 per 100,000 per year in children and adolescents. SCA is more common in boys than girls, and more likely to occur during or just after sporting activity. Warning symptoms for future SCA may include previous episodes of collapse or near-collapse, dizziness, palpitations, chest pain, shortness of breath or unexplained episodes of brief seizure-like activity. Such symptoms may not always be present however, and can be difficult to interpret in the setting of sporting activity, where those participating may often be pushing themselves to the point of exhaustion. A family history of cardiovascular disease and unexplained death at a young age may also be highly relevant.
Survival rates of 1.9 – 11.1% following attempted resuscitation have been reported, with good neurological outcome in many. Survival is more likely with witnessed events and a shockable rhythm on first ECG analysis -conditions often seen when an arrest occurs in a public location like a school.
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