An Evidence-Based Review of Prehospital Traumatic Cardiac Arrest

"Medic 1, please respond to 123 Maple Tree Drive for a gunshot wound." After a short drive, you arrive at a scene that has been secured by police to see a young male lying supine in the middle of the road with several gunshot wounds to his chest. He yells "help me" several times before going unresponsive. You check for a pulse and find none. What interventions should be considered? Are advanced cardiac life support (ACLS) medications and guidelines appropriate to follow? Should you transport the patient in cardiac arrest if the nearest trauma center is five minutes away? What about 20 minutes away? Current Guidelines Unintentional injuries are the fourth most common cause of death among all, and the most common among children and young adults.1 Although many systems have established trauma care guidelines, the management of traumatic cardiac arrest often is inconsistent and variable. The issue of futility in the resuscitation of a traumatic cardiac arrest is one that is often brought up when discussing the merits of resuscitation. The National Association of EMS Medical Directors and the American College of Surgeons Committee on Trauma (NAEMSP/ASCOT) stated in their consensus guidelines in 2012 that "termination of resuscitation may be considered when there are no signs of life and there is no return of spontaneous circulation despite appropriate field EMS treatment that includes minimally interrupted cardiopulmonary resuscitation (CPR)."2 Airway...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Trauma Cardiac & Resuscitation Source Type: news