trauma tor pediatrics
Joint multi-society position statement (Annals of Emergency Medicine 2014) reviewing literature on withholding/termination of resuscitation (TOR) for pediatric out-of-hospital traumatic cardiopulmonary arrest. It evaluates studies through 2011, defines pediatric as ≤18 years, reports pooled survival to discharge ~5.4% (60/1114 in reviewed series; 51/812 in subset with outcomes reported = 6.3% in one table), documents that most survivors after prolonged CPR are neurologically devastated, and issues evidence-graded recommendations (Level 2–3) including clear signs incompatible with life, consider withholding when >30 minutes unsuccessful resuscitation and long transport, and to involve families when futility is evident.
Questions this document answers
18 years of age or younger.
Approximately 5.4% (60/1114 across reviewed articles); Table 1 subset reports 51 survivors among 812 trauma victims (6.3%).
If resuscitation has exceeded 30 minutes and the nearest facility is more than 30 minutes away, involve parents/family in decision-making.