Citation

Brindis SL, Gausche-Hill M, Young KD, Putnam B. Pediatr. Emerg. Care 2011; 27(7): 616-621.

Affiliation

Department of Emergency Medicine, Harbor UCLA Medical Center; Department of Medicine, David Geffen School of Medicine at UCLA; Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center; §Department of Pediatrics, David Geffen School of Medicine at UCLA; and Department of Surgery, Harbor UCLA Medical Center, Torrance, CA.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0b013e31822255c9

PMID

21712745

Abstract

OBJECTIVE:: Few data are available on traumatic cardiopulmonary arrest in children. Efforts at resuscitation typically result in heavy utilization of finite resources with little understanding of which characteristics, if any, may be associated with success. The objectives of this study were to describe the outcome of children in traumatic cardiac arrest and to identify patients for whom aggressive resuscitation may or may not be warranted. METHODS:: Data were analyzed from a previous study of prehospital pediatric airway management in Los Angeles and Orange Counties, Calif, over a 33-month period. Patients included in this secondary analysis were younger than 13 years and found pulseless and apneic after having had an injury. Data sources included prospective, phone interviews with paramedics after transfer of care to the receiving facility, and chart review to determine outcome. Two main outcomes were assessed: survival and neurological function as measured by the Pediatric Cerebral Performance Category. RESULTS:: The emergency medical services responded to 118 traumatic arrests during the study period. Of these victims, only 6 (5%) survived. Median Injury Severity Score was 25 with an interquartile range of 16 to 75. The survivors all were neurologically impaired with a median Pediatric Cerebral Performance Category of 5 (interquartile range, 4-5). CONCLUSIONS:: Children who had trauma resulting in cardiac arrest have universally poor outcomes, and survivors have severe neurological compromise. We are unable to identify a subset of patients for whom aggressive resuscitation is indicated. This is the largest prospective study of pediatric traumatic arrest to date.

Language: en