James Vassallo
Paediatric traumatic cardiac arrest: The development of an algorithm to guide recognition, management and decisions to terminate resuscitation
Vassallo, James; Nutbeam, Tim; Rickard, Annette C; Lyttle, Mark D; Scholefield, Barney; Maconochie, Ian K; Smith, Jason E
Authors
Tim Nutbeam
Annette C Rickard
Mark Lyttle mark.lyttle@uwe.ac.uk
Barney Scholefield
Ian K Maconochie
Jason E Smith
Abstract
© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ. Introduction Paediatric traumatic cardiac arrest (TCA) is a high acuity, low frequency event. Traditionally, survival from TCA has been reported as low, with some believing resuscitation is futile. Within the adult population, there is growing evidence to suggest that with early and aggressive correction of reversible causes, survival from TCA may be comparable with that seen from medical out-of-hospital cardiac arrests. Key to this survival has been the adoption of a standardised approach to resuscitation. The aim of this study was, by a process of consensus, to develop an algorithm for the management of paediatric TCA for adoption in the UK. Methods A modified consensus development meeting of UK experts involved in the management of paediatric TCA was held. Statements discussed at the meeting were drawn from those that did not reach consensus (positive/negative) from a linked three-round online Delphi study. 19 statements relating to the diagnosis, management and futility of paediatric TCA were initially discussed in small groups before each participant anonymously recorded their agreement with the statement using 'yes', 'no' or 'don't know'. In keeping with our Delphi study, consensus was set a priori at 70%. Statements reaching consensus were included in the proposed algorithm. Results 41 participants attended the meeting. Of the 19 statements discussed, 13 reached positive consensus and were included in the algorithm. A single statement regarding initial rescue breaths reached negative consensus and was excluded. Consensus was not reached for five statements, including the use of vasopressors and thoracotomy for haemorrhage control in blunt trauma. Conclusion In attempt to standardise our approach to the management of paediatric TCA and to improve outcomes, we present the first consensus-based algorithm specific to the paediatric population. While this algorithm was developed for adoption in the UK, it may be applicable to similar healthcare systems internationally.
Journal Article Type | Article |
---|---|
Acceptance Date | Aug 4, 2018 |
Online Publication Date | Aug 28, 2018 |
Publication Date | Nov 1, 2018 |
Deposit Date | Sep 6, 2018 |
Publicly Available Date | Sep 6, 2018 |
Journal | Emergency Medicine Journal |
Print ISSN | 1472-0205 |
Electronic ISSN | 1472-0213 |
Publisher | BMJ Publishing Group |
Peer Reviewed | Peer Reviewed |
Volume | 35 |
Issue | 11 |
Pages | 669-674 |
DOI | https://doi.org/10.1136/emermed-2018-207739 |
Keywords | paediatric, traumatic cardiac arrest |
Public URL | https://uwe-repository.worktribe.com/output/859775 |
Publisher URL | http://dx.doi.org/10.1136/emermed-2018-207739 |
Additional Information | Additional Information : This is the author's accepted manuscript. The final published version is available here: http://dx.doi.org/10.1136/emermed-2018-207739. |
Contract Date | Sep 6, 2018 |
Files
Algorithm Resubmission_2.pdf
(431 Kb)
PDF
PTCA algorithm Submission.jpg
(486 Kb)
Image
Algorithm Resubmission_2.docx
(73 Kb)
Document
You might also like
Trends in admission and death rates due to paediatric head injury in England, 2000-2011
(2015)
Journal Article
Assessing the impacts of the first year of rotavirus vaccination in the United Kingdom
(2015)
Journal Article
Downloadable Citations
About UWE Bristol Research Repository
Administrator e-mail: repository@uwe.ac.uk
This application uses the following open-source libraries:
SheetJS Community Edition
Apache License Version 2.0 (http://www.apache.org/licenses/)
PDF.js
Apache License Version 2.0 (http://www.apache.org/licenses/)
Font Awesome
SIL OFL 1.1 (http://scripts.sil.org/OFL)
MIT License (http://opensource.org/licenses/mit-license.html)
CC BY 3.0 ( http://creativecommons.org/licenses/by/3.0/)
Powered by Worktribe © 2024
Advanced Search