Outcome from paediatric cardiac arrest associated with trauma

Resuscitation. 2007 Oct;75(1):29-34. doi: 10.1016/j.resuscitation.2007.02.018. Epub 2007 Apr 8.


Objective: To examine survival rates for paediatric trauma patients requiring cardiopulmonary resuscitation (CPR) in the pre-hospital setting, and to identify characteristics that may be associated with survival.

Design: Ten-year retrospective trauma database review.

Setting: An urban physician-led pre-hospital trauma service serving a population of approximately 7.5 million, in the United Kingdom.

Patients: Eighty paediatric trauma patients (15 years or less) who received pre-hospital resuscitation following cardiorespiratory arrest between July 1994 and June 2004.

Intervention: Pre-hospital cardiopulmonary resuscitation.

Main outcome measure: Survival to hospital discharge.

Results: Eighty children met inclusion criteria for the study. Nineteen (23.8%) were discharged alive from the emergency department and seven children (8.75%) survived to hospital discharge. Of the seven survivors, one had spinal cord injury. Two suffered asphyxial injury associated with blunt trauma and three sustained hypoxic insults following drowning or burns/smoke inhalation. In one patient with known congenital cardiac disease the cause of cardiac arrest was likely to have been medical.

Conclusion: This study confirms the poor outcome for children requiring pre-hospital CPR following trauma. However, the results are better in this physician-attended group than in other studies where physicians were not present. They also suggest that cardiac arrest associated with trauma in children has a better outcome than in adults. In common with adults treated in this system, those patients with hypovolaemic cardiac arrest did not survive (Ann Emerg Med 2006;48:240-4). A large proportion of the survivors suffered hypoxic or asphyxial injuries. Targeted aggressive out-of-hospital resuscitation in certain patient groups can produce good outcomes.

MeSH terms

  • Cardiopulmonary Resuscitation
  • Child, Preschool
  • Databases, Factual
  • Emergency Service, Hospital
  • Heart Arrest / etiology*
  • Heart Arrest / mortality*
  • Hospital Mortality
  • Humans
  • Retrospective Studies
  • Survival Rate
  • United Kingdom
  • Wounds and Injuries / complications*
  • Wounds and Injuries / mortality
  • Wounds and Injuries / therapy