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Unexpected cardiac arrest among children during surgery: a North American registry to elucidate the incidence and causes of anesthesia related cardiac arrest
  1. K L Posner1,
  2. J Geiduschek2,
  3. C M Haberkern3,
  4. C Ramamoorthy4,
  5. A Hackel5,
  6. J P Morray6
  1. 1Research Associate Professor, Departments of Anesthesiology and Anthropology (adjunct), University of Washington, Seattle, WA, USA
  2. 2Associate Professor, Department of Anesthesiology, University of Washington, and Director, Clinical Anesthesia Services, Children's Hospital and Regional Medical Center, Seattle, WA, USA
  3. 3Clinical Professor, Department of Anesthesiology, University of Washington, and Children's Hospital and Regional Medical Center, Seattle, WA, USA
  4. 4Associate Professor, Department of Anesthesiology, Stanford University Medical Center, and Director, Pediatric Cardiac Anesthesia, Lucile Packard Children's Hospital, Stanford, CA, USA
  5. 5Professor of Anesthesia and Pediatrics Emeritus (Active), Stanford University, Stanford, CA, USA
  6. 6Medical Director of Perioperative Services, Phoenix Children's Hospital, Phoenix, AZ, USA
  1. Correspondence to:
 Dr K Posner, Department of Anesthesiology, Box 356540, University of Washington, Seattle, WA 98195-6540, USA;


Relatively rare adverse events, such as unexpected cardiac arrest, are difficult to study in the clinical setting. These events are often unpredictable in their occurrence (prompting interest in their investigation) and do not occur with sufficient frequency in any single institution to provide an adequate sample for analysis. A disease-specific registry is an epidemiological technique that can be used to collect data on a set of relatively rare unpredictable events. This approach was adopted for investigation of cardiac arrest in children when it became apparent from analysis of malpractice claims that a significant clinical problem existed. This report provides a brief historical account of the development of the Pediatric Peri-Operative Cardiac Arrest (POCA) Registry and elaborates on the methodology including strengths, weaknesses, and practical implementation issues.

  • anaesthesia
  • cardiac arrest
  • patient safety
  • Pediatric Peri-Operative Cardiac Arrest (POCA) Registry
  • children

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