Cardiac arrest in a 14-year-old at overnight camp

A case of a 14-year-old girl who had a cardiac arrest at an overnight camp provides a roadmap of how to plan for a rare but often fatal event. The practice article is published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211796.

“[P]reparation for low-frequency, high-acuity emergencies are needed and should account for remote geography and prolonged EMS response times,” writes Dr. Herbert Brill, McMaster University, Hamilton, Ontario, with coauthors. “Pediatric out-of-hospital cardiac arrest is uncommon but may be under-reported owing to inadequate surveillance systems, publication bias or legal concerns.”

A previously healthy 14-year-old girl became unresponsive in her cabin, and a fellow camper who noticed began chest compressions after not finding a pulse. Emergency medical services (EMS) arrived and used an automated external defibrillator before transporting her to hospital. The teenaged patient had myocarditis, a common cause of cardiac arrest in the community and of sudden cardiac deaths in children. It peaks in early infancy and middle teenage years.

Thanks to an observant, conscientious camper who took immediate action and a quick EMS response, the girl survived and has a good prognosis.

“This case highlights the importance of early recognition and prompt initiation of effective compressions in the resuscitation of out-of-hospital cardiac arrest, regardless of age,” write the authors.

Medical emergencies at summer camps are rare but should be anticipated as they can be life-threatening.

“The societal benefits of widespread CPR training for youth and young adults are exemplified by this case, as the camper who recognized and started the resuscitation had received first aid training previously,” they write.

The authors recommend widespread CPR training for camp employees and older youth and automated external defibrillators in accessible locations to improve outcomes of cardiac arrest in camps.