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Pediatric Out-of-Hospital Cardiac Arrest in Rhode Island: Concepts and Controversies.

Pediatric out-of-hospital cardiac arrest (POHCA) is an infrequently encountered event by emergency medical providers, both across Rhode Island and nationally. The etiologies of these events differ from those in adult cardiac arrests and overall outcomes remain poor. The skills required by emergency medical providers to care for these patients are performed and practiced infrequently. Pediatric patients are also at further risk of serious adverse events secondary to challenges with airway management and variation in equipment sizing and weight-based medication dosing. Recent changes to Rhode Island Emergency Medical Services protocols, particularly the requirement for all non-traumatic cardiac arrests to be managed on scene for a minimum of 30 minutes, have led to discussion and controversy. As we aim to improve the quality of care delivered during these resuscitations through education, research and collaborative protocol development, it is important to recognize and remain focused on the unique aspects of these pediatric patients.