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Flat lines in survival from out-of-hospital pediatric cardiac arrest: making the case for bold reform in prehospital care and resuscitation

Pediatric Research (2025)Cite this article

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Out-of-hospital cardiac arrest (OHCA) remains a devastating event with poor prognosis across all age groups, but its occurrence in children carries unique challenges for recognition, treatment, and survival. In this issue of Pediatric Research, Chen et al. present a 25-year retrospective analysis from National Taiwan University Hospital, evaluating the impact of emergency medical services (EMS) transport on outcomes in non-traumatic OHCA among pediatric and young adult populations.1 The study provides a rare longitudinal lens into a persistently understudied, yet critical topic, and contributes valuable insights into patterns of EMS utilization, temporal trends in survival, and implications for prehospital care practices.

In this article, Chen et al. aimed to evaluate the utilization and impact of EMS transport on outcomes in both pediatric (<18 years old) and young adult (18–<35 years old) patients with non-traumatic OHCA over a 25-year period. The authors found that EMS utilization was lower in pediatric patients than in young adults – only 44% of children were transported via EMS, compared to 83% of young adults. The lowest rate of EMS use occurred among children aged 1 to 5 years, with just 30% arriving via EMS. Many pediatric patients were brought to the hospital by private vehicle, potentially due to caregiver perception of faster access to care or underestimation of clinical severity.

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References

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Authors and Affiliations

  1. Boston Combined Residency Program, Boston Children’s Hospital, Boston, MA, USA

    Kendall J. Donohue

  2. Pediatric Emergency Medicine, Boston Children’s Hospital, Boston, MA, USA

    Andrew M. Fine

Authors
  1. Kendall J. Donohue
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  2. Andrew M. Fine
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Correspondence to Andrew M. Fine.

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Donohue, K.J., Fine, A.M. Flat lines in survival from out-of-hospital pediatric cardiac arrest: making the case for bold reform in prehospital care and resuscitation. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04477-0

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