Round consensus reached | Number of respondents (% consensus)* | Median (IQR) score† | |
Concept/definition of paediatric TCA | |||
Blunt and penetrating trauma should be treated differently‡ | Round 1 | 91 (72.5) | 4 (1) |
Absent palpable pulses or no signs of life should trigger a paediatric TCA algorithm | Round 2 | 82 (92.7) | 2 (1) |
The absence of cardiac activity on ultrasound should trigger a paediatric TCA algorithm | Round 2 | 80 (72.5) | 2 (2) |
Process | |||
Whole blood therapy improves survival | Round 1 | 90 (74.4) | 2 (1) |
Warmed blood/fluids improves survival | Round 1 | 91 (72.5) | 2 (1) |
Rapid volume replacement improves survival | Round 3 | 73 (74.0) | 2 (1) |
Thoracotomy in penetrating trauma improves survival | Round 1 | 91 (72.5) | 2 (1) |
Pericardiocentesis should not be performed in paediatric TCA‡ | Round 3 | 73 (76.7) | 4 (1) |
Ensuring oxygenation (via an endotracheal tube or supraglottic device) improves survival | Round 2 | 83 (78.3) | 2 (0) |
Providing ventilatory support improves survival. | Round 3 | 73 (77.8) | 2 (0) |
Decision to stop | |||
Duration of arrest in paediatric TCA is helpful in determining the futility of continued resuscitation | Round 2 | 83 (84.3) | 2 (0) |
The lack of response to any intervention is helpful in determining the futility of continued resuscitation | Round 2 | 83 (90.4) | 2 (1) |
If all invasive procedures have been completed and there is no ROSC, this is helpful in determining the futility of continued resuscitation | Round 2 | 83 (95.2) | 2 (1) |
Cardiac standstill on ultrasound is helpful in determining the futility of continued resuscitation, in the presence of appropriate resources and a trained operator | Round 3 | 73 (72.6) | 2 (1) |
All statements were preceded by the phrase “In paediatric TCA…”.
*Figure showing % agree/strongly agree for positive consensus, and % disagree/strongly disagree for negative consensus.
†Median (IQR) depends on a 5-point Likert scale, with 1=Strongly agree, 2=Agree, 3=Neutral/Don’t know, 4=Disagree, 5=Strongly disagree.
‡These statements reached negative consensus—the statements used in the Delphi study were “blunt and penetrating trauma should be treated the same” and “pericardiocentesis is an essential procedure to perform in paediatric TCA”.
TCA, traumatic cardiac arrest.