This publication contains the pediatric and neonatal sections of the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (COSTR). The consensus process that produced this document was sponsored by the International Liaison Committee on Resuscitation (ILCOR). ILCOR was formed in 1993 and consists of representatives of resuscitation councils from all over the world. Its mission is to identify and review international science and knowledge relevant to cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) and to generate consensus on treatment recommendations. ECC includes all responses necessary to treat life-threatening cardiovascular and respiratory events. The COSTR document presents international consensus statements on the science of resuscitation. ILCOR member organizations are each publishing resuscitation guidelines that are consistent with the science in this consensus document, but they also take into consideration geographic, economic, and system differences in practice and the regional availability of medical devices and drugs. The American Heart Association (AHA) pediatric and the American Academy of Pediatrics/AHA neonatal sections of the resuscitation guidelines are reprinted in this issue of Pediatrics (see pages e978-e988). The 2005 evidence evaluation process began shortly after publication of the 2000 International Guidelines for CPR and ECC. The process included topic identification, expert topic review, discussion and debate at 6 international meetings, further review, and debate within ILCOR member organizations and ultimate approval by the member organizations, an Editorial Board, and peer reviewers. The complete COSTR document was published simultaneously in Circulation (International Liaison Committee on Resuscitation. 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2005;112(suppl):73-90) and Resuscitation (International Liaison Committee on Resuscitation. 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2005;67:271-291). Readers are encouraged to review the 2005 COSTR document in its entirety. It can be accessed through the CPR and ECC link at the AHA Web site: www.americanheart.org. The complete publication represents the largest evaluation of resuscitation literature ever published and contains electronic links to more detailed information about the international collaborative process. To organize the evidence evaluation, ILCOR representatives established 6 task forces: basic life support, advanced life support, acute coronary syndromes, pediatric life support, neonatal life support, and an interdisciplinary task force to consider overlapping topics such as educational issues. The AHA established additional task forces on stroke and, in collaboration with the American Red Cro...

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The total percentage of exitus was 5.1%, higher than the common standards. Mortality causes coincide with other series. Ratio of exitus due to hospital problems was according to recommended objectives. The number of autopsies was very small. A correct completing and revision of the clinical recording is indispensable to spot a shortage in the hospitalized patientś assistance.

Suggested citation: Schvartsman C, Carrera R, Abramovici S. Initial assessment and transportation of an injured child. J Pediatr (Rio J). 2005;81(5 Suppl):S223-S229. AbstractObjectives: Since trauma has a great impact on mortality and preventable morbidity among children and adolescents, in addition to its social consequences, the aim of this study is to evaluate peculiarities regarding prehospital, in-hospital, and interhospital assessment of injured pediatric patients. Sources of data:The Cochrane database was searched for systematic reviews and controlled trials, the MEDLINE and LILACS databases were used for the last 5 years, and review of older reference sections in significant publications using trauma, pediatric trauma, primary survey, secondary survey, in-hospital assessment, prehospital and transportation as keywords.Summary of the findings: There are different strategies that constitute the systematic assessment of the injured pediatric patient. Nevertheless, almost all strategies involve knowing the peculiarities about the pediatric population, with regard to age, to the growth and development process, and finally, to the minimally acceptable and available resources. Conclusions:The most important principle is to do no further harm. If the peculiarities about airway maintenance, ventilation, circulation with hemorrhage control, disability, exposure up to secondary survey and preparation of prehospital and interhospital transportation are properly taken care of, better results will certainly be obtained.J Pediatr (Rio J). 2005;81(5 Suppl):S223-S229: Trauma, pediatric trauma, primary survey, secondary survey, inhospital assessment, prehospital and interhospital transportation.

Objective:To identify the factors that determine unintentional injuries in children living in the community of Paraisopolis, in the city of São Paulo, Brazil.Methods:A cross-sectional and non-controlled study. Data collected during 4 consecutive months through questionnaires filled out for the Einstein Program in Paraisopolis Community included identification of the patient and his/her family, scholarity level, housing conditions, storage of hazardous products, access to the streets and concrete slab ceilings, supervision, and trauma mechanism involved. The observed data were treated as absolute and relative frequencies; χ2, Fisher's exact test, Student's t test, and Mann-Whitney's tests were implemented, with a significance level of 5% (p<0.05).Results:A total of 1,490 questionnaires were analyzed. There was a predominance of trauma within boys (59.6%) and the medium age was 5.2 years. The predominant educational level of the parents was incomplete junior school education. The main caregiver identified was the mother (69.4%). Among the children that suffered trauma, 56.4% belonged to large families (≥6 people), lived in houses up to three rooms, and a family income up to R$ 1,000.00 (76.6%). Easy access to hazardous materials was considerable and free access to concrete slab ceilings was reported in 92.8% of the cases. The main trauma mechanisms were falls and burns. In this study, the child victim of a fall was aged under 5 years.Conclusion:Small children that live in a hazardous environment have a significant tendency to suffering trauma