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Paediatric traumatic cardiac arrest: data from the Joint Theatre Trauma Registry
Christopher M Hillman1, A Rickard2, M Rawlins3
1Paediatric Emergency Department, St Mary's Hospital, London, UK.
Insights
Outcomes for pediatric traumatic cardiac arrest (TCA) in military field hospitals showed a 14.8% survival rate. This survival rate for pediatric traumatic cardiac arrest is similar to civilian and adult military studies.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Military Medicine
Background:
- Pediatric traumatic cardiac arrest (TCA) has poor survival and neurological outcomes.
- Over 600 children with severe injuries were treated in UK military facilities during Iraq and Afghanistan conflicts.
- Some of these children experienced cardiac arrest due to traumatic injuries.
Purpose of the Study:
- To define outcomes for pediatric traumatic cardiac arrest (TCA) in a cohort of children treated in UK military medical facilities.
- To analyze survival and neurological outcomes in pediatric TCA patients.
- To compare outcomes with existing civilian and military studies.
Main Methods:
- Retrospective database review using the UK Joint Theatre Trauma Registry.
- Inclusion criteria: Patients under 18 years old between January 2003 and April 2014 who underwent cardiopulmonary resuscitation.
- Focus on local national children treated in deployed UK military medical facilities.
Main Results:
- Twenty-seven children with pediatric traumatic cardiac arrest (TCA) were included in the study.
- Four children (14.8%) survived to discharge from the medical treatment facility.
- Limited data were available on the long-term neurological outcomes for survivors.
Conclusions:
- Outcomes for pediatric TCA in military field hospitals were comparable to civilian and adult military studies.
- Severe blast injuries did not significantly alter outcomes compared to other studies.
- Further research is required to establish optimal management strategies for pediatric TCA.
Background:
Traumatic cardiac arrest (TCA) in children is associated with a low probability of survival and poor neurological outcome in survivors. Since 2003, over 600 seriously injured local national children have been treated at deployed UK military medical treatment facilities during the Iraq and Afghanistan conflicts. A number of these were in cardiac arrest after sustaining traumatic injuries. This study defined outcomes from paediatric TCA in this cohort.
Methods:
A retrospective database review was undertaken using the UK Joint Theatre Trauma Registry. This includes UK military, coalition military, civilians and local security forces personnel who prompted trauma team activation. All children in this series were local nationals. Patients aged less than 18 years who presented between January 2003 and April 2014, and who underwent cardiopulmonary resuscitation, were included.
Results:
27 children with TCA were included. Four children survived to discharge from the medical treatment facility (14.8%), though limited data are available regarding the long-term neurological outcome in these patients.
Conclusions:
This study demonstrates that the outcomes for paediatric TCA in our military field hospitals were similar to other paediatric civilian and adult military studies, despite patients being injured by severe blast injuries. Further work is needed to define the optimal management of paediatric TCA.
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