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Acute Med Surg. 2016 Apr 18;3(4):356-359. doi: 10.1002/ams2.194. eCollection 2016 Oct.

Targeted age, device deployment, and problems associated with pediatric defibrillation in pediatric prehospital emergency medical care settings in Japan.

Acute medicine & surgery

Noriyuki Kaku, Masahiko Nitta, Takashi Muguruma, Kohei Tsukahara, Emily Knaup, Nobuyuki Nosaka, Yuki Enomoto

Affiliations

  1. Emergency and Critical Care Center Kyushu University Hospital Fukuoka Japan.
  2. Department of Pediatrics Graduate School of Medical Sciences Kyushu University Fukuoka Japan.
  3. Department of Emergency Medicine Osaka Medical College Osaka Japan.
  4. Department of Pediatrics Osaka Medical College Osaka Japan.
  5. Department of Emergency MedicineSchool of Medicine Yokohama City University Yokohama Japan.
  6. Advanced Emergency and Critical Care Medical Center Okayama University Hospital Okayama Japan.
  7. Department of Pediatrics Graduate School of Medicine Dentistry and Pharmaceutical Sciences Okayama University Okayama Japan.
  8. Department of Emergency and Critical Care Medicine University of Tsukuba Hospital Tsukuba Japan.

PMID: 29123812 PMCID: PMC5667327 DOI: 10.1002/ams2.194

Abstract

AIM: The use of automated external defibrillators was expanded to include infants according to the 2010 cardiopulmonary resuscitation guidelines in Japan. However, deployment has been slower for pediatric patients in Japan, because there are fewer appropriate pediatric patients for automated external defibrillators than adults. This study aimed to investigate the targeted age range for pediatric defibrillation and device deployment of defibrillators for pediatric patients in prehospital emergency medical care settings in Japan, and present the issues associated with automated external defibrillators.

METHODS: We administered a web-based survey to the fire defense headquarters in Japan regarding prehospital emergency medical care for pediatric patients in June 2013. We extracted and analyzed some parts of the data related to pediatric defibrillation.

RESULTS: Eighty-eight percent of the fire defense headquarters responded to the survey. Sixty-two percent of the fire defense headquarters applied the expanded indication protocol for pediatric defibrillation, which included infants. Forty-three percent of the fire defense headquarters replied that their emergency medical service personnel were using semi-automatic defibrillators without a pediatric mode, whereas 21% of them were using automated external defibrillators that were not equipped with pediatric attenuators. Moreover, many of the semi-automatic defibrillators are not designed for pediatric defibrillation in patients aged <8 years.

CONCLUSIONS: Pediatric prehospital emergency medical care in Japan is inadequately equipped for pediatric defibrillation. It will be necessary to use age-appropriate defibrillators as the targeted age range for automated external defibrillators rapidly expands to include infants.

Keywords: Automated external defibrillators; emergency medicine; pediatrics; prehospital care/medical control

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