Abstract
In order to better train pediatric personnel and direct preventive care in rural areas, cases of RA or CRA, as well as serious illnesses requiring advanced life support (ALS) were examined. The data was obtained from 5 years of pediatric records at each of 4 rural hospital Emergency Rooms (>55,000 pts.). The primary etiologies leading to RA or CRA were pulmonary 27%, neuro 24%, SIDS 22%, with only 7% cardiac, 6% drowning, and 14% other. Grouping this data (Table I) shows that although trauma is very important, nontraumatic disease is equally prominent. Table II demonstrates the high survival rate of respiratory arrests in these rural hospitals.
Seriously ill but not arresting patients who required ALS had a similar distribution: nontraumatic disease 67% and trauma 33%. The nontraumatic disease breakdown showed a predominance of pulmonary 38%, with neuro 18%, ingestion 7%, sepsis 4%.
In conclusion, although more children will die from trauma, pediatric ALS training programs for rural areas should emphasize that the greatest proportion of salvageable patients have nontraumatic illnesses. The ongoing push for prevention and better management of trauma and accidents should be broadened to stress the appropriate preventive and management skills to treat children with nontraumatic disease.
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Bonner, B., Zaiim, L. & Thompson, J. PEDIATRIC RESPIRATORY ARRESTS (RA) OR CARDIORESPIRATORY ARRESTS (CRA) IN RURAL COMMUNITY HOSPITALS. Pediatr Res 21 (Suppl 4), 282 (1987). https://doi.org/10.1203/00006450-198704010-00692
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DOI: https://doi.org/10.1203/00006450-198704010-00692