Crewdson K, Lockey D, Davies G
London Helicopter Emergency Medical Service, Royal London Hospital, London E1 1BB, UK.
Resuscitation. 2007 Oct;75(1):29-34. doi: 10.1016/j.resuscitation.2007.02.018. Epub 2007 Apr 8.
To examine survival rates for paediatric trauma patients requiring cardiopulmonary resuscitation (CPR) in the pre-hospital setting, and to identify characteristics that may be associated with survival.
Ten-year retrospective trauma database review.
An urban physician-led pre-hospital trauma service serving a population of approximately 7.5 million, in the United Kingdom.
Eighty paediatric trauma patients (15 years or less) who received pre-hospital resuscitation following cardiorespiratory arrest between July 1994 and June 2004.
Pre-hospital cardiopulmonary resuscitation.
Survival to hospital discharge.
Eighty children met inclusion criteria for the study. Nineteen (23.8%) were discharged alive from the emergency department and seven children (8.75%) survived to hospital discharge. Of the seven survivors, one had spinal cord injury. Two suffered asphyxial injury associated with blunt trauma and three sustained hypoxic insults following drowning or burns/smoke inhalation. In one patient with known congenital cardiac disease the cause of cardiac arrest was likely to have been medical.
This study confirms the poor outcome for children requiring pre-hospital CPR following trauma. However, the results are better in this physician-attended group than in other studies where physicians were not present. They also suggest that cardiac arrest associated with trauma in children has a better outcome than in adults. In common with adults treated in this system, those patients with hypovolaemic cardiac arrest did not survive (Ann Emerg Med 2006;48:240-4). A large proportion of the survivors suffered hypoxic or asphyxial injuries. Targeted aggressive out-of-hospital resuscitation in certain patient groups can produce good outcomes.
研究在院前环境中需要进行心肺复苏（CPR）的儿科创伤患者的存活率，并确定可能与存活相关的特征。
十年回顾性创伤数据库审查。
英国一个由医生主导的城市院前创伤服务机构，服务人口约750万。
1994年7月至2004年6月期间，80名15岁及以下的儿科创伤患者在心肺骤停后接受了院前复苏。
院前心肺复苏。
存活至出院。
80名儿童符合该研究的纳入标准。19名（23.8%）从急诊科存活出院，7名儿童（8.75%）存活至出院。在这7名幸存者中，1名有脊髓损伤。2名因钝性创伤导致窒息性损伤，3名在溺水、烧伤或吸入烟雾后遭受缺氧性损伤。在1名已知患有先天性心脏病的患者中，心脏骤停的原因可能是内科疾病。
本研究证实了创伤后需要院前CPR的儿童预后较差。然而，在这个有医生参与的组中结果比其他没有医生在场的研究要好。研究结果还表明，儿童创伤相关心脏骤停的预后比成人要好。与在该系统中接受治疗的成人一样，那些因低血容量导致心脏骤停的患者未能存活（《急诊医学杂志》2006年；48:240 - 244）。很大一部分幸存者遭受了缺氧或窒息性损伤。对某些患者群体进行有针对性的积极院外复苏可以产生良好的效果。
