The efficacy of chest compressions in paediatric traumatic arrest
Report By: Fiona Bowles - ST7 Paediatric in Emergency Medicine
Search checked by Kat Rawlinson - ST2 Emergency Medicine
Institution: Wessex Deanery
Date Submitted: 2nd January 2016
Date Completed: 25th May 2016
Last Modified: 10th February 2017
Status: Green (complete)
Three Part Question
In [children in traumatic cardiac arrest], is [ventilation with chest compressions better than ventilation alone] at [improving survival].
You are put on standby by the paramedic emergency service for a cardiac arrest in a 2-year-old boy hit by a car. As you send for the ‘CPR step’, you wonder whether you really should give chest compressions as per ALS-teaching or whether they are ineffective in hypovolaemic or obstructive shock due to trauma (as recent opinion has suggested).
MEDLINE 1946–26/01/2016 using the NHS library interface. [(exp Cardiopulmonary Resuscitation OR exp Heart Arrest OR cardiopulmonary resuscitation.ti,ab OR heart arrest.ti,ab OR CPR.ti,ab) AND (chest compression$.ti,ab OR exp Heart Massage OR cardiac compression$.ti,ab) AND (exp wounds and injuries OR injur$.ti,ab OR trauma$.ti,ab)] Limit to: [(Age group Infant,newborn OR Infant OR Child,preschool OR Child OR Adolescent) AND Humans].
Forty-eight papers were identified, of which none were relevant to the three-part question.
There is no direct evidence that can assist in answering this question
Clinical Bottom Line
Local guidelines should be followed.