BLUNT CARDIAC INJURIES IN CHILDREN - A POSTMORTEM STUDY

We reviewed the records of the Chief Coroner for all pediatric (<16 ye ars of age) trauma fatalities in Ontario (pediatric population of 2 mi llion) for the period January 1, 1988 through December 31, 1990, Forty -one (14.5%) of 282 patients for which complete autopsy data mere avai lable had sustained cardiac injuries, Nineteen patients (46%) died at the scene of the accident, 15 patients (37%) died in an emergency depa rtment, and seven patients (17%) died during hospitalization. Rupture of a cardiac chamber occurred in 16 cases; it was the main cause of de ath in eight cases and a contributing factor in the remainder. Cardiac contusion without chamber rupture was present in 25 cases, but in non e of the cases mas it the cause of death, Brain injury was the cause o f death in 16 (64%) of the cases of cardiac contusion. Cardiac injurie s are more common among children who die from blunt trauma than previo us reports have suggested, However, because these injuries are often r apidly fatal, many patients die before they reach a hospital, With imp rovements in emergency medical services and the resulting reduction in transit time, more patients may reach trauma centers alive, A high in dex of suspicion and rapid diagnosis and treatment of these injuries c an save the lives of some of these patients.