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Three Part Question

In [children in traumatic cardiac arrest], is [ventilation with chest compressions better than ventilation alone] at [improving survival].

Clinical Scenario

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).

Search Strategy

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].

Search Outcome

Forty-eight papers were identified, of which none were relevant to the three-part question.

Comment(s)

There is no direct evidence that can assist in answering this question

Clinical Bottom Line

Local guidelines should be followed.