Pediatric Cardiac Arrest Due to Trauma

Area of Science:

• Emergency Medicine
• Pediatric Critical Care
• Trauma Surgery

Background:

• Pediatric cardiac arrest (PCA) due to trauma has a poor survival rate, often considered futile.
• Traumatic airway obstruction presents unique challenges in pre-hospital and in-hospital resuscitation.
• Successful outcomes in severe pediatric traumatic arrest cases are rare but possible with advanced interventions.

Observation:

• A 3-5-year-old child sustained cardiac arrest from external traumatic airway obstruction by a garage door.
• Rapid extrication using a car jack was followed by immediate basic life support and intubation.
• Initial oxygen saturation (SaO2) was critically low (<50%) despite 100% fraction of inspired oxygen (FiO2).

Findings:

• Restoration of Spontaneous Circulation (ROSC) was achieved after 30 minutes of resuscitation.
• The patient required veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for 5.5 days.
• The child experienced a 100% recovery with no physical or mental sequelae at long-term follow-up.

Implications:

• This case highlights the importance of prompt and effective interventions in pediatric traumatic cardiac arrest.
• Advanced techniques like ECMO can be life-saving in select pediatric trauma cases.
• Successful resuscitation and recovery challenge the notion that trauma-related PCA is always futile.