ABSTRACT
PURPOSE: Children requiring prehospital cardiopulmonary resuscitation (CPR) after traumatic injury have been shown to have poor survival. However, outcome of children still receiving CPR on-arrival by emergency medical service to the emergency department (ED) has not been demonstrated in a published clinical series. METHODS: An 11-year retrospective analysis from a level I pediatric trauma center of the outcomes of children requiring prehospital CPR after traumatic injury was undertaken. Outcome variables were stratified by survival, death, and CPR on-arrival. RESULTS: Of 169 children requiring prehospital CPR, there were 28 survivors and 141 deaths. Of 69 children requiring CPR on-arrival to the ED, there were no survivors. There were 70 females and 99 males. Mean age of survivors was 3.4 years; nonsurvivors, 8.8 years; and 4.6 years for CPR on-arrival. Thirty-nine percent of all injuries were sustained in motor vehicle collisions; 20%, motor pedestrian collisions; 19%, assaults; 7%, falls; 4%, all terrain vehicle/motorcycle/bicycle; and 4%, gunshot wounds. Forty-two percent of all patients expired in the ED, whereas 34% expired in the intensive care unit. Eighty-seven percent of CPR on-arrival patients expired in the ED. Fifty-five percent of survivors had full neurologic recovery. CONCLUSION: Although mortality was extremely high for children requiring CPR in the field After traumatic injury, it was absolute for those arriving at the ED still undergoing CPR.
Subject(s)
Cardiopulmonary Resuscitation , Emergency Medical Services , Wounds and Injuries/mortality , Wounds and Injuries/therapy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Medical Futility , Retrospective Studies , Survival Rate , Time Factors , Treatment Outcome , United States/epidemiologyABSTRACT
Annually, there are more than 54,000 visits to nationwide emergency departments as a result of injuries sustained while riding all-terrain vehicles. Of those visits, nearly one-half involve children younger than 16 years. Children's Medical Center Dallas admitted 211 patients over a 5-year period from March 2002 until May 2007 as a result of all-terrain vehicle-related incidents with 207 of those patients aged 13 years or younger. The primary mechanisms of these injuries were secondary to collision with stationary objects, rolling of the vehicles, and falling from the vehicles.
