Ann Emerg Med. 2014 Apr;63(4):504-15. doi: 10.1016/j.annemergmed.2014.01.013.
This multiorganizational literature review was undertaken to provide an evidence base for determining whether or not recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care, because the evidence suggests that either death or a poor outcome is inevitable.
本多机构文献回顾旨在为确定是否可以对遭受创伤性心肺骤停的儿童提出院外终止复苏的建议提供证据基础。尽管在没有良好预后期望的情况下，成人创伤性心肺骤停的院外终止复苏越来越被接受，但儿童通常被排除在州终止复苏协议之外。在特定情况下（斩首或依赖性发绀、尸僵等），决定不进行复苏是合理的。如果对创伤性心肺骤停的情况或时间有任何疑问，根据目前大多数州将现场终止复苏限制在 18 岁以上的人的现状，应启动并继续复苏，直到到达适当的设施。如果患者已经停止呼吸，复苏已经超过 30 分钟，并且最近的设施超过 30 分钟，应考虑让这些儿童的父母和家人参与决策过程，并在医疗专业人员的协助和指导下，因为证据表明，死亡或不良预后是不可避免的。
