A critical analysis of outcome for children sustaining cardiac arrest after blunt trauma☆
Section snippets
Patients
Children (age <16) who underwent CPR in the field or in the emergency department (ED) after blunt trauma were identified from the trauma registry of a regional pediatric trauma center over a 3-year period (1997 to 2000). Injured children are met on arrival to the pediatric emergency department by a pediatric surgery fellow or a general surgical resident (postgraduate year 4), a senior pediatric emergency medicine fellow (postgraduate year 4 or 5), and an attending pediatric emergency medicine
Patient demographics
There were 311 patients ≤ 16 years of age with an ISS greater than 15 consecutively evaluated by the trauma service over the 3-year period studied. During this time, 25 children (8%) were identified with a history of cardiac arrest after blunt injury. The mean age of the study population was 3.3 years (range, 0.1 to 10). Boys accounted for two thirds of the study population (16 boys, 9 girls).
Injury mechanism and severity
In this population of children sustaining cardiac arrest after blunt trauma, the largest percentage of
Discussion
Whereas the Sudden Infant Death Syndrome (SIDS) accounts for the majority of cardiopulmonary arrest in children less than 1 year of age,8 injury is the leading cause of cardiac arrest in children older than 1 year. Previous studies suggest that children who require CPR in the field after trauma, burns, or near drowning rarely survive to hospital discharge.3, 4, 5, 9 However, recently published data have suggested that pediatric survival rates after CPR performed after any traumatic insult are
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Address reprint requests to Casey M. Calkins, MD, Department of Surgery, University of Colorado Health Sciences Center, 4200 East Ninth Ave, Campus Box C-320, Denver, CO 80262.