Prehospital cardiopulmonary resuscitation in the pediatric trauma patient

J Pediatr Surg. 2010 Jul;45(7):1413-9. doi: 10.1016/j.jpedsurg.2009.12.020.


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.

MeSH terms

  • Adolescent
  • Cardiopulmonary Resuscitation*
  • Child
  • Child, Preschool
  • Emergency Medical Services*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Medical Futility
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / therapy*