Abstract
Purpose The aim of this study is to assess the applicability to a pediatric population of
adult guidelines for withholding or terminating traumatic cardiopulmonary resuscitation
(CPR).
Method Using a trauma registry database and patient data from May 2001 to February 2011,
a retrospective cohort study was conducted for all trauma patients less than 18 years
of age who arrived at the emergency department (ED) with no pulse at King Abdulaziz
Medical City in Riyadh. The clinical criteria of the adult guidelines were applied
to the study population; these criteria include an absence of pulse, apnea, unorganized
electrocardiogram and fixed pupils (all observed at the scene). Then the outcomes
of the studied patients were interpreted based on these guidelines; this analysis
highlighted the relationship between the outcomes and the four clinical criteria of
the adult guidelines.
Results During the study period, 104 patients arrived at the ED with no pulse. CPR was initiated
for only 44 of these patients. Unfortunately, every patient in this group died within
24 hours of ED arrival. Out of these 104 patients, 92 met the four clinical criteria
of the adult guidelines, 11 met only three criteria, and one met only two criteria.
Conclusion The clinical criteria of the previously published adult guidelines for terminating
or withholding resuscitation correctly predicted 100% of the patient mortality when
all criteria were met.
Keywords
prehospital traumatic cardiopulmonary arrest - guidelines - resuscitation - terminating
- trauma registry
