K_Z
Verified Anesthetist
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Hi Carioca. Yes, the head trauma, IMO, caused the cardiac arrest. The murmur was likely just a benign childhood murmur. There is no indication, given the circumstances, that this healthy 6 yo had any kind of medical cardiac event. If he had dropped into a cardiac arrest while, for example, playing soccer (a low impact event), the situation would be vastly different. This is a case of major head trauma.
Max sustained a 10+ foot fall pretty much directly onto his head, and in the process sustained a 7 1/2 inch sagittal skull fracture. That is major trauma, by any definition. Please see many of the links I put in the EMS thread from a while back, and google "tramautic cardiac arrest secondary to head trauma". Essentially, cardiac arrest at the scene in a child with blunt force head trauma is a death sentence in nearly every situation, and in the very few cases of survival, the child is profoundly neurologically devastated. I have at least a half dozen or more links explaining this dismal outcome in the EMS thread. Those links are very large outcome studies of children's blunt force trauma with cardiac arrest, thousands of cases in the study, and one of the major studies was done using San Diego data. Statistics were, at best 1-2% survival, depending on the study. (Some studies put survival at less than 1%.) Max was in the best place he could be to attempt to survive his devastating injuries. Max was not in any kind of a shockable rhythm on arrival of the EMS crew (according to the EMS report)-- he was in asystole.
Here are a few quick links for a general overview (I'm a bit short on time at the moment):
http://www.trauma.org/archive/archives/arres1.html
http://circ.ahajournals.org/content/112/24_suppl/IV-146.full
http://bctg.bcas.ca/Condition/Principles/15
Also, the positive benzodiazepine is from medically administered benzos in the stabilization and intubation process. Nothing malicious there.
Max sustained a 30-45 min cardiac arrest. His heart was not suitable for donation due to the cardiac arrest.
Max sustained a 10+ foot fall pretty much directly onto his head, and in the process sustained a 7 1/2 inch sagittal skull fracture. That is major trauma, by any definition. Please see many of the links I put in the EMS thread from a while back, and google "tramautic cardiac arrest secondary to head trauma". Essentially, cardiac arrest at the scene in a child with blunt force head trauma is a death sentence in nearly every situation, and in the very few cases of survival, the child is profoundly neurologically devastated. I have at least a half dozen or more links explaining this dismal outcome in the EMS thread. Those links are very large outcome studies of children's blunt force trauma with cardiac arrest, thousands of cases in the study, and one of the major studies was done using San Diego data. Statistics were, at best 1-2% survival, depending on the study. (Some studies put survival at less than 1%.) Max was in the best place he could be to attempt to survive his devastating injuries. Max was not in any kind of a shockable rhythm on arrival of the EMS crew (according to the EMS report)-- he was in asystole.
Here are a few quick links for a general overview (I'm a bit short on time at the moment):
http://www.trauma.org/archive/archives/arres1.html
http://circ.ahajournals.org/content/112/24_suppl/IV-146.full
http://bctg.bcas.ca/Condition/Principles/15
Also, the positive benzodiazepine is from medically administered benzos in the stabilization and intubation process. Nothing malicious there.
Max sustained a 30-45 min cardiac arrest. His heart was not suitable for donation due to the cardiac arrest.