• Ali Yurtseven, Caner Turan, AkarcaFunda KarbekFKFunda Karbek Akarca, MD. Associate Professor, Department of Emergency Medicine, Ege University School of Medicine, Izmir, Turkey., and Eylem Ulas Saz.
• Ali Yurtseven, MD. Department of Pediatrics, Division of Emergency Medicine, Ege University School of Medicine, Izmir, Turkey.
• Pak J Med Sci. 2019 Sep 1; 35 (5): 1434-1440.

ObjectivesNights and weekends represent a potentially high-risk time for pediatric cardiac arrest (CA) patients in emergency departments. Data regarding night or weekend arrest and its impact on outcomes is controversial. The purpose of this study was to determine the relationship between cardiopulmonary resuscitation during the various emergency department shifts and survival to discharge.MethodsWe conducted a retrospective, observational study of patients who had visited our Emergency Department for CAs from January 2014 to December 2016. Medical records and patient characteristics of 67 children with CA were retrieved from patient admission files.ResultsThe mean age was 54.7±7.3 months and 59% were male. Rates of survival to discharge 35% (11/31) within working hours' vs. out of working hours 3% (1/36). Among the CAs presenting to the emergency department, the survival rates were higher for working hours than for non-working hours (OR: 37.6 (2.62-539.7), p: 008). The rate of return of spontaneous circulation within working hours was higher than that of non-working hours (71% vs.19%) (p<0.001). Patients who received chest compression for more than 10 minutes had the lowest survival rate (2%) (p<0.001), whereas better outcome was associated with in-hospital CA, younger age (less than 12 months) and respiratory failure.ConclusionSurvival rates from pediatric CAs were significantly lower during non-working hours. Poor outcome was associated with prolonged cardiopulmonary resuscitation, out of hospital CA and older age.

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