You are here

Article Text

Article menu
Download PDFPDF
Original article
Epidemiology and aetiology of paediatric traumatic cardiac arrest in England and Wales
  1. James Vassallo1,2,3,
  2. Melanie Webster4,
  3. Edward B G Barnard3,
  4. Mark D Lyttle4,5,
  5. Jason E Smith3
  6. On behalf of PERUKI (Paediatric Emergency Research in the UK and Ireland)
  1. 1 Division of Emergency Medicine, University of Cape Town, Cape Town, South Africa
  2. 2 Institute of Naval Medicine, Gosport, UK
  3. 3 Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK
  4. 4 Emergency Department, Bristol Royal Hospital for Children, Bristol, UK
  5. 5 Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
  1. Correspondence to Dr James Vassallo, Institute of Naval Medicine, Gosport PO12 2DL, UK; vassallo{at}doctors.org.uk

Abstract

Objective To describe the epidemiology and aetiology of paediatric traumatic cardiac arrest (TCA) in England and Wales.

Design Population-based analysis of the UK Trauma Audit and Research Network (TARN) database.

Patients and setting All paediatric and adolescent patients with TCA recorded on the TARN database for a 10-year period (2006–2015).

Measures Patient demographics, Injury Severity Score (ISS), location of TCA (‘prehospital only’, ‘in-hospital only’ or ‘both’), interventions performed and outcome.

Results 21 710 paediatric patients were included in the database; 129 (0.6%) sustained TCA meeting study inclusion criteria. The majority, 103 (79.8%), had a prehospital TCA. 62.8% were male, with a median age of 11.7 (3.4–16.6) years, and a median ISS of 34 (25–45). 110 (85.3%) had blunt injuries, with road-traffic collision the most common mechanism (n=73, 56.6%). 123 (95.3%) had severe haemorrhage and/or traumatic brain injury. Overall 30-day survival was 5.4% ((95% CI 2.6 to 10.8), n=7). ‘Pre-hospital only’ TCA was associated with significantly higher survival (n=6) than those with TCA in both ‘pre-hospital and in-hospital’ (n=1)—13.0% (95% CI 6.1% to 25.7%) and 1.2% (95% CI 0.1% to 6.4%), respectively, p<0.05. The greatest survival (n=6, 10.3% (95% CI 4.8% to 20.8%)) was observed in those transported to a paediatric major trauma centre (MTC) (defined as either a paediatric-only MTC or combined adult-paediatric MTC).

Conclusions Survival is possible from the resuscitation of children in TCA, with overall survival comparable to that reported in adults. The highest survival was observed in those with a pre-hospital only TCA, and those who were transported to an MTC. Early identification and aggressive management of paediatric TCA is advocated.

  • paediatric trauma
  • epidemiology
  • paediatric traumatic cardiac arrest
  • cardiac arrest

https://doi.org/10.1136/archdischild-2018-314985

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter @jamievassallo, @DefProfEM, @mdlyttle, @PERUKItweep

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JV, EB and JES are serving members of the Royal Navy.

    • Provenance and peer review Not commissioned; externally peer reviewed.