Prehospital fluid therapy in pediatric trauma patients.

In order to evaluate the impact of prehospital intravenous fluid therapy on the outcome of pediatric trauma patients and to evaluate the effect of such therapy on the on-scene interval, we performed a retrospective chart review of 50 pediatric trauma patients less than 18 years old transported directly from the field by Emergency Medical Services personnel with an intravenous catheter in place and admitted to the Trauma Service of a level I urban pediatric trauma center. As judged by an expert panel using a new grading system, prehospital intravenous fluid therapy was inconsequential to outcome in 47 of 50 patients, possibly beneficial in two of 50 patients, and possibly detrimental in one of 50 patients. Patients who received their catheters at the scene had significantly longer on-scene intervals than those who received them in the ambulance (15.4 vs 11.4 minutes, P < 0.05). The mean volume of fluid administered was 4.4 ml/kg body weight. Placement of the catheter (at the scene vs in the ambulance) and prehospital fluid volume administered were independent of the Injury Severity Score. The role of prehospital fluid therapy in pediatric trauma patients in an urban setting requires reevaluation.