Policy Statement — Withholding or Terminating Resuscitation in Pediatric Out-of-Hospital Traumatic Arrests

A multispecialty group of investigators reviewed literature from 1980 to 2011 to provide recommendations for termination of out-of-hospital resuscitation in children ≤18 years of age with traumatic cardiopulmonary arrest. Victims of drowning, hypothermia, burns, and electrocution were excluded from the analysis.

Twenty-seven articles met inclusion criteria. Of 1114 children with traumatic cardiopulmonary arrest, 60 (5%) survived to hospital discharge, and of these, 19 had good or full neurologic recovery. Of 36 patients with penetrating trauma, 30 underwent thoracotomy, and none survived.

The recommendations are to consider:

—Withholding resuscitative efforts in the following circumstances:

• Conditions obviously incompatible with life, such as d…