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The impact of public access defibrillation on outcomes for children experiencing out-of-hospital cardiac arrest: a 25-year retrospective study
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DOI：10.1016/j.resplu.2026.101278.png)
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Abstract
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Aim: To evaluate the impact of public access defibrillation (PAD) on outcomes for children experiencing out-of-hospital cardiac arrest (OHCA). Methods: This retrospective cohort study analysed paediatric (age <18 years), non-traumatic OHCA cases with an initial shockable rhythm from Victorian Ambulance Cardiac Arrest Registry between 1 January 2000 and 31 December 2024. Cases witnessed to arrest by emergency medical services (EMS) were excluded. Cases were categorised based on the initial shock provider, either PAD or EMS. The association between PAD patient outcomes was assessed in multivariable logistic regression models. Results: The study identified 140 shockable OHCA cases meeting the eligibility criteria, of which 23 (16.4%) received their first defibrillation PAD. PAD use increased over the study period, from 0% in 2000-04 to 35.7% in 2020-24 across all locations and from 0% to 66.7% in public locations (p trend <0.001 for both). PAD use was significantly associated with improved unadjusted odds of ROSC (OR: 6.33; 95% CI: 1.42-28.30; p = 0.016), event survival (OR: 3.80; 95% CI: 1.22-11.86; p = 0.022), and survival to hospital discharge (OR: 5.11; 95% CI: 1.63-15.99; p = 0.005). However, these associations were not statistically significant after adjusting for confounders including the temporal trend. Survival hospital discharge improved significantly over time (OR: 10.44; 95% CI: 2.26-48.15 for 2020-24 vs. 2000-04). Conclusion: PAD in children increased significantly in our region over 25 years and was associated with a marked reduction in the time to defibrillation.
Keywords:
Public access defibrillation
Paediatrics
OHCA
Cardiac arrest
AED
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