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Prehospital and Resuscitation

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A comparison of high-dose and standard-dose epinephrine in children with cardiac arrest.
Perondi MB1, Reis AG, Paiva EF, Nadkarni VM, Berg RA.
N Engl J Med. 2004 Apr 22;350(17):1722-30.

Rationale for inclusion: This prospective, randomized, double-blind study of 68 children showed that patients in the high-dose group (0.1 mg/kg) had no difference in return of spontaneous circulation and worse 24-hour mortality and survival to discharge compared to standard dose (0.01 mg/kg) epinephrine. 

Citations - 247 (as of July 2017)

Predicting survival in pediatric trauma patients receiving cardiopulmonary resuscitation in the prehospital setting.
Perron AD, Sing RF, Branas CC, Huynh T.
Prehosp Emerg Care. 2001 Jan-Mar;5(1):6-9.

Rationale for inclusion: This study was a large, retrospective registry review of 729 pediatric trauma patients receiving CPR in the field from 1998-2005. The authors found that prehospital intubation, penetrating mechanism, and receiving additional CPR at the trauma center were predictors of mortality. Overall mortality was 29%.

CAVEAT: Retrospective, trauma registry

Citations - 47 (as of July 2017)

Early fluid resuscitation improves outcomes in severely burned children.
Barrow RE, Jeschke MG, Herndon DN.
Resuscitation. 2000 Jul;45(2):91-6.

Rationale for inclusion: This single institution, retrospective review of 133 children with greater than 50% TBSA burns showed that sepsis, acute kidney injury, and overall mortality was significantly increased when initiation of fluid resuscitation was delayed by two hours or more.

CAVEAT: Single institution, retrospective

Citations - 133 (as of July 2017)

Effect of out-of-hospital pediatric endotracheal intubation on survival and neurological outcome: a controlled clinical trial.
Gausche M, Lewis RJ, Stratton SJ, Haynes BE, Gunter CS, Goodrich SM, Poore PD, McCollough MD, Henderson DP, Pratt FD, Seidel JS.
JAMA. 2000 Feb 9;283(6):783-90.

Rationale for inclusion: This prospective, randomized (by odd/even date of arrest), observational, multi-center evaluation of 830 pediatric patients requiring advanced airway management from 1994-1997 compared prehospital endotracheal intubation (N=420) to bag mask ventilation (BVM) (N=410) and found no difference in survival or neurologic outcome.  This suggests that BVM is sufficient for prehospital management of the pediatric airway.

Citations - 762 (as of July 2017)

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