title: Paediatric traumatic out-of-hospital cardiac arrests in Melbourne, Australia.
abstract: BACKGROUND
  Many consider attempted resuscitation for traumatic out-of-hospital cardiac arrest (OHCA) futile. This study aims to describe the characteristics and profile of paediatric traumatic OHCA.
  
  
  METHODS
  The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all trauma related cases of OHCA in patients aged less than 16 years of age. Cases were linked with their coronial findings.
  
  
  RESULTS
  Between 2000 and 2009, EMS attended 33,722 OHCAs including 2187 adult traumatic OHCAs. There were 538 (1.6%) OHCAs in children less than 16 years of age of which n=64 were due to trauma. The median age (IQR) of paediatric traumatic OHCA was 7 (4.5-13) years and 44 were male (69%). Bystander CPR was performed in 22 cases (34.4%). The first recorded rhythm by EMS was asystole seen in 42 (66%), PEA in 14 (22%) cases and VF in 2 cases (3%). Cardiac output was present in 7 (11%) cases who subsequently had an EMS witnessed OHCA. EMS attempted resuscitation in 35 (55%) patients of whom 7 (20%) achieved ROSC and were transported, and 1 (3%) survived to hospital discharge with severe neurological sequelae; 14(40%) were transported with CPR of whom none survived. Coronial cause of death was multiple injuries in 35%, head injury in 33%, head and neck injury in 10%, chest injuries in 10% and other causes (12%).
  
  
  CONCLUSIONS
  Traumatic aetiology of OHCA when compared to the incidence of adult traumatic OHCAs is uncommon. Resuscitation efforts are seldom effective and associated with poor neurological outcome.
authors: Ambulance Victoria, Australia. conordeasy@hotmail.com
authors: C
authors: C
authors: Deasy
authors: J
authors: J
authors: Bray
authors: K
authors: K
authors: Smith
authors: D
authors: D
authors: Hall
authors: C
authors: C
authors: Morrison
authors: S A
authors: SA
authors: Bernard
authors: P
authors: P
authors: Cameron
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D015984:Causality; D002423:Cause of Death; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D004632:Emergency Medical Services / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome; D019037:Urban Health Services; D014739:Victoria / Q000453:epidemiology; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology*