Tisherman Presents Treatment Options for Exsanguinating Patients in Cardiac Arrest at EMS Today 2016

For patients who suffer a cardiac arrest from exsanguinating blood loss, survival rate is only 5–10%, even with rapid, advanced prehospital care, fluid resuscitation, and an emergency department thoracotomy. In his clinical session titled Saving Exsanguinating Trauma Patients with Hypothermia and Cardiopulmonary Bypass, which was held Friday, Feb. 26 at EMS Today 2016, Sam Tisherman, MD, said, “CPR just doesn’t work for trauma.” Because of these dismal results, guidelines for withholding or discontinuing resuscitative efforts in such patients have been developed and adopted by many EMS agencies. Dr. Peter Safar, known as the father of CPR, and Col. Ron Bellamy of the U.S. Army, reviewed data from the Vietnam War that suggested some soldiers died over a period of 30–60 minutes with injuries that were technically repairable. They developed the concept that is now known as Emergency Preservation and Resuscitation (EPR) to, as Safar put it, “pickle” the patient long enough for a surgeon to stop the bleeding. Tisherman reviewed the development of EPR. Very deep hypothermia (10oC) seems to be the best way to preserve the patient for up to one hour until hemostasis. But in the trauma world, Tisherman said, “people think this is blasphemy,” since colder trauma patients tend to do worse than those who stay warm. Tisherman pointed out, however, that there is a big difference between uncontrolled, exposure hypothermia and the controlled hypothermia used for EPR. Tisher...
Source: JEMS: Journal of Emergency Medical Services News - Category: Emergency Medicine Authors: Tags: News EMS Today Source Type: news