TY  - JOUR
PY  - 2019//
TI  - A descriptive analysis of the epidemiology and management of paediatric traumatic out-of-hospital cardiac arrest
JO  - Resuscitation
A1  - Alqudah, Zainab
A1  - Nehme, Ziad
A1  - Williams, Brett
A1  - Oteir, Alaa
A1  - Bernard, Stephen
A1  - Smith, Karen
SP  - 127
EP  - 134
VL  - 140
IS  - 
N2  - AIM: Paediatric traumatic out-of-hospital cardiac arrest (OHCA) is a rare event with few survivors. We examined long-term trends in the incidence and outcomes of paediatric traumatic OHCA and explored the frequency and timing of intra-arrest interventions. <br><br>METHODS: We retrospectively analysed data from the Victorian Ambulance Cardiac Arrest Registry for cases involving traumatic OHCA in patients aged ≤16 years arresting between January 2000 to December 2017. Trends were assessed using linear regression and a non-parametric test for trend. <br><br>RESULTS: A total of 292 cases were attended by emergency medical services (EMS), of which 166 (56.9%) received an attempted resuscitation. The overall incidence of EMS-attended cases was 1.4 cases per 100,000 person-years, with no significant changes over time. Unadjusted outcomes also remained unchanged, with 23.5% achieving return of spontaneous circulation and 3.7% surviving to hospital discharge. The frequency of trauma-specific interventions increased between 2000-05 and 2012-17, including needle thoracostomy from 10.5% to 51.0% (p trend <0.001), crystalloid administration from 31.6% to 54.9% (p trend = 0.004) and blood administration from 0.0% to 6.3% (p trend = 0.01). The median time from emergency call to the delivery of interventions were: 12.9 minutes (IQR: 8.5, 20.0) for cardiopulmonary resuscitation, 19.7 minutes (IQR: 10.7, 39.6) for external haemorrhage control, 29.8 minutes (IQR: 22.0, 35.4) for crystalloid administration and 31.5 minutes (IQR: 21.0, 38.0) for needle thoracostomy. <br><br>CONCLUSION: The incidence and outcomes of paediatric traumatic OHCA remained unchanged over an 18 year period. Early correction of reversible causes by reducing delays to the delivery of trauma-specific interventions may yield additional survivors.<br><br>Copyright © 2019 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0300-9572
UR  - http://dx.doi.org/10.1016/j.resuscitation.2019.05.020
ID  - ref1
ER  -