Dr Joelle D'Onofrio discusses pediatric cardiac arrest response at San Diego EMS lecture

On July 11, 2025, a significant government meeting took place in San Diego City, focusing on pediatric out-of-hospital cardiac arrest (OHCA). The session, part of a series on evidence-based medicine, featured Dr. Joelle D'Onofrio, a leading expert in emergency medical services (EMS) for children. Dr. D'Onofrio, who holds multiple prestigious positions, including associate professor at UCSD and EMS medical director for Rady Children's Hospital, emphasized the critical need for improved prehospital care for children experiencing cardiac arrest.

The meeting highlighted the alarming statistics surrounding pediatric cardiac arrest, noting that out of over 55,000 OHCA cases recorded in a major registry, fewer than 1,000 involved children. This stark figure underscores the challenges in studying pediatric cardiac events due to the small sample sizes and the diverse age-related factors affecting outcomes. Dr. D'Onofrio pointed out that the leading causes of cardiac arrest in children include hypoxia, drowning, and trauma, with prevention strategies being essential to reducing these incidents.

A key focus of the discussion was the importance of bystander intervention. Dr. D'Onofrio noted that children have better survival rates when CPR is administered by bystanders, particularly in public settings. The ongoing "Revive and Survive" initiative aims to train a million people in CPR, with 500,000 already trained, highlighting community engagement in improving emergency response.

The meeting also addressed the need for tailored CPR techniques for children. Unlike adults, where hands-only CPR is often recommended, Dr. D'Onofrio advocated for conventional CPR with rescue breaths for pediatric patients, particularly for those aged 1 to 7, as studies indicate this method leads to better survival outcomes.

Dr. D'Onofrio concluded by stressing the necessity of preparedness in emergency medical systems, advocating for the establishment of pediatric emergency care coordinators to enhance the quality of care provided to children in crisis situations. The meeting served as a crucial platform for discussing strategies to improve pediatric cardiac arrest outcomes, emphasizing the importance of community involvement and specialized training in emergency response.