PREHOSPITAL FLUID THERAPY IN PEDIATRIC TRAUMA PATIENTS

In order to evaluate the impact of prehospital intravenous fluid thera py on the outcome of pediatric trauma patients and to evaluate the eff ect of such therapy on the on-scene interval, we performed a retrospec tive chart review of 50 pediatric trauma patients less than 18 years o ld transported directly from the field by Emergency Medical Services p ersonnel with an intravenous catheter in place and admitted to the Tra uma Service of a level I urban pediatric trauma center. As judged by a n expert panel using a new grading system, prehospital intravenous flu id therapy was inconsequential to outcome in 47 of 50 patients, possib ly beneficial in two of 50 patients, and possibly detrimental in one o f 50 patients. Patients who received their catheters at the scene had significantly longer onscene intervals than those who received them in the ambulance (15.4 vs 11.4 minutes, P < 0.05). The mean volume of fl uid administered was 4.4 ml/kg body weight. Placement of the catheter (at the scene vs in the ambulance) and prehospital fluid volume admini stered were independent of the Injury Severity Score. The role of preh ospital fluid therapy in pediatric trauma patients in an urban setting requires reevaluation.