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What information can we use to help determine futility in paediatric patients presenting in traumatic cardiac arrest?
  1. Victoria Currie1,
  2. Andrew Tagg2,3,
  3. Constantinos Kanaris4,5
  1. 1Paediatrics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
  2. 2Emergency, Western Hospital, Footscray, Melbourne, Australia
  3. 3School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
  4. 4Paediatric Intensive Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  5. 5Blizard Institute, Queen Mary University of London, London, UK
  1. Correspondence to Dr Victoria Currie, Paediatrics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, Birmingham, UK; vickijanecurrie{at}gmail.com

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Scenario

A 2-year-old child presents to the emergency department (ED) after running into traffic. He chased a ball into the road and was struck by a car. An ambulance is dispatched to transport him to hospital, but he arrests en route. By the time he reaches your facility, he has been without a pulse for 10 min.

He is in cardiac arrest. There is an endotracheal (ET) tube in situ and bilateral finger thoracostomies have been performed. The paramedics placed a pelvic binder prior to transportation. Tibial intraosseous (IO) access has been obtained and he is receiving 10 mL/kg of balanced crystalloid. No pre-hospital blood products were available. A Code Red was put out prior to his arrival. On examination, you are informed that both of his pupils are fixed and dilated. He has not received any other interventions.

Structured clinical question

In a paediatric patient in traumatic cardiac arrest (TCA) (patient), are there …

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Footnotes

  • Twitter @DrVickiCurrie1, @andrewjtagg, @DrKanaris

  • Contributors VC produced initial piece of work based on a literature search by CK. CK, AT and VC edited work to produce final article.

  • 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 None declared.

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

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