UMEM Educational Pearls

Category: Trauma

Title: How we can better approach traumatic cardiac arrest

Keywords: cardiac arrest, trauma, termination, blood, epinephrine (PubMed Search)

Posted: 8/19/2023 by Robert Flint, MD (Emailed: 8/27/2023) (Updated: 4/24/2024)
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The authors of this paper suggest the following changes, supported by evidence, to the management of traumatic cardiac arrest:

1.    Epinephrine, bicarbonate and calcium have limited if no role in traumatic cardiac arrest.

2.    CPR may be harmful in traumatic cardiac arrest. Hypovolemia is the cause of death for most trauma patients and CPR cannot correct this.

3.    Blood is the resuscitative fluid to be given and all other fluids do not have a role in traumatic cardiac arrest.

4.    Correct hypoxia immediately.

5.    Finger thoracostomy to decompress penumothoracies, not needles.

6.    Utilize termination of resuscitation protocols to end resuscitations in the field.

References

Traumatic Cardiac Arrest (TCA): Maybe We Could Do Better?

Prehospital trauma care and outcomes have improved little in the past 50 years, the authors write. It’s time to change that.

Bryan E. Bledsoe, DO, FACEP, FAEMSJeffrey P. Salomone, MD, FACS  Jpournal fo Emergency Medical Services 01.12.2023

https://www.jems.com/patient-care/traumatic-cardiac-arrest-tca-maybe-we-could-do-better/