Banner Health team improves pediatric cardiac arrest survival rates in out-of-hospital settings

In a groundbreaking discussion at the San Diego City government meeting on July 11, 2025, experts emphasized the urgent need for improved protocols in pediatric out-of-hospital cardiac arrest (OHCA) cases. The meeting highlighted a significant shift in emergency medical services (EMS) practices, particularly regarding the use of medications during resuscitation efforts.

Key findings from recent studies revealed no statistically significant differences in outcomes between the use of lidocaine and amiodarone for shock-refractory ventricular fibrillation. As a result, local pediatric cardiologists have recommended prioritizing lidocaine due to its fewer side effects. This change in protocol aims to enhance the effectiveness of on-scene resuscitation efforts.

The meeting also showcased the success of a new "pit crew" approach to pediatric resuscitation, which involves a dedicated team member to support families during emergencies. This method has reportedly increased the rate of return of spontaneous circulation (ROSC) and improved neuro outcomes for young patients. Notably, one group reported a jump from just two ROSC cases with no survivors to 13 neuro-intact survivors and 17 total ROSC cases, alongside a reduction in time to administer epinephrine from 16 minutes to just 7 minutes.

The San Diego Fire-Rescue Department (SDFD) has been instrumental in implementing these changes, training over 600 paramedics since 2019. The training emphasizes the importance of staying on scene for resuscitation, quality CPR, and effective communication with families. However, challenges remain, as some EMS providers feel pressured to transport patients quickly rather than focus on on-scene care.

As the city moves forward with these enhanced protocols, the hope is to significantly improve survival rates and outcomes for children experiencing cardiac emergencies. The ongoing commitment to training and protocol refinement reflects a proactive approach to pediatric emergency care in San Diego.