Understanding Pediatric Cardiac Arrest

What causes cardiac arrest in a child?

A cardiac arrest affects the whole body. Though treatment for cardiac arrest is complex and varies, it is important to understand what cardiac arrest is, what it is caused by, and how it can impact a child’s body. In this section, we will provide a general overview of cardiac arrest in a child.

What is cardiac arrest?

Cardiac arrest is a life-threatening condition in which the heart stops beating or beats too fast, too slow, or irregularly. As a result, the heart cannot pump blood around the body to deliver oxygen and nutrients to the body’s vital organs.

Is the body injured after a cardiac arrest?

When the heart cannot pump blood around the body, the body’s organs can become damaged. The extent of damage to the body’s organs is different for each individual but is usually more significant when the cardiac arrest lasts a longer period of time. The brain and heart are the organs most sensitive to damage.

Who can have a cardiac arrest?

Cardiac arrest can happen to anyone at any time. Even infants, children, teenagers, or seemingly healthy people without any history of heart issues can experience cardiac arrest. Pediatric cardiac arrest occurs much less commonly than adult cardiac arrest. 

What causes cardiac arrest in children?

The cause of cardiac arrest in children is different than in adults. In many cases, the cause is unknown. Cardiac arrest can occur in children due to:

• • Breathing difficulties: choking, drowning, suffocation, severe asthma attacks 
  • Severe injuries: trauma, burns, smoke inhalation 
  • Severe infections 
  • Poisoning: accidental ingestions, drug overdoses
  • Abnormal heart rhythms: can be acquired or congenital (can be born with it and not know until a cardiac arrest occurs)

You may have heard of a “heart attack.” It is important to know that a cardiac arrest and a heart attack are not the same thing. A cardiac arrest is an electrical problem when the heart stops beating or beats irregularly, causing inadequate blood circulation. A heart attack is a physical blockage in the heart’s blood vessels that disrupts blood flow. If left untreated, a heart attack CAN cause the heart to stop beating, and the person will then go into cardiac arrest. This is not typically a cause of cardiac arrest in children. 

Why is it important to be able to identify a cardiac arrest?

Cardiac arrest can lead to death. The chances of survival improve if:  

1. The cardiac arrest is witnessed by someone else  
2. The person experiencing cardiac arrest receives early initiation of high-quality chest compressions or cardiopulmonary resuscitation (CPR) 
3. A life-threatening heart rhythm (when present) is reversed using a machine called an “automatic external defibrillator” (AED) 

If you are worried that a child is having a cardiac arrest, you should call 911 and start chest compressions immediately to keep oxygenated blood pumping through the body. Quick action can help improve the chances that the child survives. Calling 911 brings medical help in the form of trained responders. They may give medications or bring the child to a hospital, where other important treatments can be given. 

How do you know someone is having a cardiac arrest?

It can be hard to identify a cardiac arrest. It ultimately comes down to two questions:

1. Is the child responsive?  
2. Is the child breathing normally?

Is the child responsive? Checking responsiveness is as simple as tapping the child and checking for a normal reaction. 

Is the child breathing normally? If you notice the child’s breathing is not normal or is not present at all, start CPR immediately.  

Do not worry about performing CPR on someone who does not need it. If you attempt CPR on a child who does not need it, they will quickly wake up and no harm is done. If you do not start CPR on someone who does need it, it almost always leads to death. 

Everyone should learn how to do CPR. If you are interested in learning how to do CPR, there are many classes in the community. Check with your local community center to see if they host any courses. You can also take a class through organizations like:

• • Red Cross CPR Training 
  • American Heart Association

Sources

Atkins, D. L., Everson-Stewart, S., Sears, G. K., Daya, M., Osmond, M. H., Warden, C. R., Berg, R. A., & Resuscitation Outcomes Consortium Investigators. (2009). Epidemiology and outcomes from out-of-hospital cardiac arrest in children: The Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Circulation, 119(11), 1484–1491. https://doi.org/10.1161/CIRCULATIONAHA.108.802678 

Topjian, A. A., de Caen, A., Wainwright, M. S., Abella, B. S., Abend, N. S., Atkins, D. L., Bembea, M. M., Fink, E. L., Guerguerian, A.-M., Haskell, S. E., Kilgannon, J. H., Lasa, J. J., & Hazinski, M. F. (2019). Pediatric post-cardiac arrest care: A scientific statement from the American Heart Association. Circulation, 140(6), e194–e233. https://doi.org/10.1161/CIR.0000000000000697

Thank you to our contributors

Megan McSherry & Neethi Pinto