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Traumatic Arrest

Date Last Search Run: Feb 01, 2022
Table last updated: Sep 29, 2022
Data last added: Sep 25, 2022

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)      
2 (fair evidence exists)
3 (weak evidence exists)    


Interventions

Advanced airway
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Survival to hospital discharge Patient PH-Paramedic Alqudah Z, Nehme Z, Williams B, Oteir A, Bernard S, Smith K. Impact of a trauma-focused resuscitation protocol on survival outcomes after traumatic out-of-hospital cardiac arrest: An interrupted time series analysis. Resuscitation 2021; 162:104-11. Medline
II Neutral (Yellow) ED survival Patient ED-Paramedic & MD Cera S, Mostafa G, Sing R, Sarafin J. Physiologic predictors of survival in post-traumatic arrest. The American Surgeon. 2003; 69(2):140–4. Medline
II Neutral (Yellow) Survival to hospital discharge Patient PH-Paramedic Evans CC., Petersen A., Meier EN., Buick JE., Schreiber M., Kannas D, et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry-trauma and PROPHET registries. The journal of trauma and acute care surgery 2016; 81(2):285-93. Medline
III Opposes (Red) survival Patient ED-MD Seamon MJ, Fisher CA, Gaughan J, Lloyd M, Bradley KM, Santora TA, Pathak AS, Goldberg AJ. Prehospital procedures before emergency department thoracotomy: “scoop and run” saves lives. J Trauma. 2007; 63(1):113–20. Medline

Blood transfusion
Level Direction Primary Outcome Patient/Process Setting Reference
X Not Yet Graded (White) - Benhamed A, Canon V, Mercier E, Heidet M, Gossiome A, Savary D, et al. Prehospital predictors for return of spontaneous circulation in traumatic cardiac arrest. J Trauma Acute Care Surg 2022; 92(3):553–60. Medline

BVM
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Survival to hospital discharge Patient PH-Paramedic Evans CC., Petersen A., Meier EN., Buick JE., Schreiber M., Kannas D, et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry-trauma and PROPHET registries. The journal of trauma and acute care surgery 2016; 81(2):285-93. Medline

Epinephrine
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Survival to discharge Patient PH-Paramedic Alqudah Z, Nehme Z, Williams B, Oteir A, Bernard S, Smith K. Impact of a trauma-focused resuscitation protocol on survival outcomes after traumatic out-of-hospital cardiac arrest: An interrupted time series analysis. Resuscitation 2021; 162:104-11. Medline
II Neutral (Yellow) 1-month survival Patient PH-Paramedic Aoki M, Abe T, Oshima K. Association of Prehospital Epinephrine Administration With Survival Among Patients With Traumatic Cardiac Arrest Caused By Traffic Collisions. Sci Rep 2019 Jul 9;9(1):9922-019-46460-w. Medline
II Opposes (Red) Survival to hospital discharge Patient PH-Paramedic & CCT Irfan FB., Consunji R., El-Menyar A., George P., Peralta R., Al-Thani H., et al. Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar A nationwide population-based study. Int J Cardiol 2017; 240 438-43. Medline
II Opposes (Red) Survival 7 days after injury Patient PH-Paramedic Yamamoto R, Suzuki M, Hayashida K, Yoshizawa J, Sakurai A, Kitamura N, et al. Epinephrine during resuscitation of traumatic cardiac arrest and increased mortality: a post hoc analysis of prospective observational study. Scand J Trauma Resusc Emerg Med 2019 Aug 16;27(1):74. Medline

Hemorrhage control
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Survival to hospital discharge Patient PH-Paramedic Alqudah Z, Nehme Z, Williams B, Oteir A, Bernard S, Smith K. Impact of a trauma-focused resuscitation protocol on survival outcomes after traumatic out-of-hospital cardiac arrest: An interrupted time series analysis. Resuscitation 2021; 162:104-11. Medline
II Supportive (Green) Sustained ROSC Process PH-Paramedic & MD Benhamed A, Canon V, Mercier E, Heidet M, Gossiome A, Savary D, et al. Prehospital predictors for return of spontaneous circulation in traumatic cardiac arrest. J Trauma Acute Care Surg 2022; 92(3):553–60. Medline
II Supportive (Green) Survival to discharge Patient PH-Paramedic & CCT Irfan FB., Consunji R., El-Menyar A., George P., Peralta R., Al-Thani H., et al. Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar A nationwide population-based study. Int J Cardiol 2017; 240 438-43. Medline
II Neutral (Yellow) Survival to hospital discharge Patient PH-Paramedic Evans CC., Petersen A., Meier EN., Buick JE., Schreiber M., Kannas D, et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry-trauma and PROPHET registries. The journal of trauma and acute care surgery 2016; 81(2):285-93. Medline
III Neutral (Yellow) Survival Patient ED-MD & CCP Balian F, Garner AA, Weatherall A, Lee A. First experience with the abdominal aortic and junctional tourniquet in prehospital traumatic cardiac arrest. Resuscitation 2020 Nov;156:210-214. Medline

HEMS
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Survival to admission Patient PH-Paramedic & CCT Barnard EBG, Sandbach DD, Nicholls TL, Wilson AW, Ercole A. Prehospital determinants of successful resuscitation after traumatic and non-traumatic out-of-hospital cardiac arrest. Emerg Med J 2019 Jun;36(6):333-339. Medline
II Supportive (Green) ROSC on scene Patient PH-Paramedic & CCT Ter AE, Griggs J., Prentice C., Jeyanathan J., Lyon RM. Out-of-hospital cardiac arrest following trauma What does a helicopter emergency medical service offer? Resuscitation 2019; 135 73-79. Medline
II Neutral (Yellow) Survival to discharge post ROSC Patient PH-Paramedic & CCT Houwen T, Popal Z, de Bruijn MAN, Leemeyer A-MR, Peters JH, Terra M, van Lieshout EMM, Verhofstad MHJ, van Vledder MG. Outcomes after Prehospital Traumatic Cardiac Arrest in the Netherlands: A Retrospective Cohort Study. Injury 2021; 52(5):1117–22. Medline
III Supportive (Green) Sustained ROSC Patient PH-Paramedic & CCT Ter AE, Griggs J., Prentice C., Jeyanathan J., Lyon RM. Out-of-hospital cardiac arrest following trauma What does a helicopter emergency medical service offer? Resuscitation 2019; 135 73-79. Medline

Needle Decompression
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Survival to hospital discharge Patient PH-Paramedic Evans CC., Petersen A., Meier EN., Buick JE., Schreiber M., Kannas D, et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry-trauma and PROPHET registries. The journal of trauma and acute care surgery 2016; 81(2):285-93. Medline
II Neutral (Yellow) Survival Patient PH-Paramedic Alqudah Z, Nehme Z, Williams B, Oteir A, Bernard S, Smith K. Impact of a trauma-focused resuscitation protocol on survival outcomes after traumatic out-of-hospital cardiac arrest: An interrupted time series analysis. Resuscitation 2021; 162:104-11. Medline
II Neutral (Yellow) Survival Patient PH-Paramedic & CCT Irfan FB., Consunji R., El-Menyar A., George P., Peralta R., Al-Thani H., et al. Cardiopulmonary resuscitation of out-of-hospital traumatic cardiac arrest in Qatar A nationwide population-based study. Int J Cardiol 2017; 240 438-43. Medline

Optimal Trip Destination
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) In-hospital mortality Process ED-Paramedic & MD Martin TJ, Stephen AH, Adams CA, Lueckel, Kheirbek T. Impact of Direct Transport vs. Transfer on Out-of-Hospital Traumatic Cardiac Arrest. R I Med J 2021; 104(10):31–5. Medline

Pelvic Binding
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) 30 day survival with good neurological outcome Patient PH-Paramedic & MD Savary D, Morin F, Douillet D, Drouet A, Ageron FX, Charvet R, Carneiro B, Metton P, Fadel M, Descatha A. Impact of Specific Emergency Measures on Survival in Out-of-Hospital Traumatic Cardiac Arrest. Prehosp Disaster Med 2022; 37(1):51–6. Medline

POCUS
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Predictor of death Process PH-Paramedic Lalande E, Burwash-Brennan T, Burns K, Harris T, Thomas S, MY W, et al. Is point-of-care ultrasound a reliable predictor of outcome during traumatic cardiac arrest? A systematic review and meta-analysis from the SHoC investigators. Resuscitation 2021; 167:128–36. Medline

Spinal immobilization
Level Direction Primary Outcome Patient/Process Setting Reference
II Opposes (Red) Survival to discharge Patient PH-Paramedic Tsutsumi Y., Fukuma S., Tsuchiya A., Ikenoue T., Yamamoto Y., Shimizu S., et al. Association between spinal immobilization and survival at discharge for on-scene blunt traumatic cardiac arrest A nationwide retrospective cohort study. Injury 2018; 49(1) 124-9. Medline

Termination of Resuscitation (Blunt)
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Survival Patient Beck B, Bray JE, Cameron P, Straney L, Andrew E, Bernard S, et al. Predicting outcomes in traumatic out-of-hospital cardiac arrest: The relevance of Utstein factors. EMJ 2017; 34(12):786-92. Medline
II Supportive (Green) In-hospital death Process ED-Paramedic & MD Chiang WC, Huang YS, Hsu SH, Chang AM, Ko PC, Wang HC, et al. Performance of a simplified termination of resuscitation rule for adult traumatic cardiopulmonary arrest in the prehospital setting. EMJ 2017; 34(1):39-45. Medline
II Neutral (Yellow) Survival Patient PH-Paramedic Huber-Wagner S., et al. Outcome of 757 severely injured patients with traumatic cardiorespiratory arrest. Resus 2007; 75:276-85. Medline
II Neutral (Yellow) ROSC Patient Konesky KL., Guo WA. Revisiting traumatic cardiac arrest: should CPR be initiated? Eur J Trauma Emerg Surg 2018; 44(6):903-908 Medline
II Neutral (Yellow) Functional survival Patient PH-Paramedic Stratton SJ., Brickett K., Crammer T. Prehospital pulseless, unconscious penetrating trauma victims: Field assessments associated with survival. J of Trauma, Injury, Infection and Critical Care 1998; 45:96-100. Medline
II Neutral (Yellow) Survival to discharge Patient PH-Paramedic Willis CD., Cameron PA., Bernard SA., Fitzgerald M. CPR after traumatic cardiac arrest is not always futile. Injury Int J In 2006; 37:448-454. Medline
II Opposes (Red) Survival Patient Evans CC., Petersen A., Meier EN., Buick JE., Schreiber M., Kannas D, et al. Prehospital traumatic cardiac arrest: Management and outcomes from the resuscitation outcomes consortium epistry-trauma and PROPHET registries. The journal of trauma and acute care surgery 2016; 81(2):285-93. Medline
III Supportive (Green) Survival Patient PH-Paramedic Israr S, Cook AD, Chapple KM, Jacobs JV, McGeever KP, Tiffany BR, et al. Pulseless electrical activity following traumatic cardiac arrest: Sign of life or death? Injury 2019 Sep;50(9):1507-1510. Medline
III Supportive (Green) Sensitivity, specificity and predictive value Patient ED-MD Lee JH, Kim YW, Kim TY, Lee S, Do HH, Seo JS, et al. Prehospital Factors Associated with Refractory Traumatic Arrest. Emerg Med Int 2021; 4624746. Medline
III Neutral (Yellow) Survival to discharge Patient Chien CY., Su YC., Lin CC., Kuo CW., Lin SC., Weng YM. Is 15 minutes an appropriate resuscitation duration before termination of a traumatic cardiac arrest? A case-control study. Am J Emerg Med 2016; 34(3):505-9. Medline
III Neutral (Yellow) 6 month neurological outcome Patient Duchateau FX., Hamada S., Raux M., Gay M., Mantz J., Paugam BC., et al. Long-term prognosis after out-of-hospital resuscitation of cardiac arrest in trauma patients: prehospital trauma-associated cardiac arrest. EMJ 2017; 34(1):34-8. Medline

Termination of Resuscitation (Penetrating)
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) ROSC Patient Konesky KL., Guo WA. Revisiting traumatic cardiac arrest: should CPR be initiated? Eur J Trauma Emerg Surg 2018; 44(6):903-908 Medline
II Neutral (Yellow) Functional survival Patient PH-Paramedic Stratton SJ., Brickett K., Crammer T. Prehospital pulseless, unconscious penetrating trauma victims: Field assessments associated with survival. J of Trauma, Injury, Infection and Critical Care 1998; 45:96-100. Medline
II Neutral (Yellow) Survival to discharge Patient PH-Paramedic Willis CD., Cameron PA., Bernard SA., Fitzgerald M. CPR after traumatic cardiac arrest is not always futile. Injury Int J In 2006; 37:448-454. Medline
X Not Yet Graded (White) - Lee JH, Kim YW, Kim TY, Lee S, Do HH, Seo JS, et al. Prehospital Factors Associated with Refractory Traumatic Arrest. Emerg Med Int 2021; 4624746. Medline

Thoracostomy
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Survival rates Patient PH-Paramedic Alqudah Z, Nehme Z, Williams B, Oteir A, Bernard S, Smith K. Impact of a trauma-focused resuscitation protocol on survival outcomes after traumatic out-of-hospital cardiac arrest: An interrupted time series analysis. Resuscitation 2021; 162:104-11. Medline
II Supportive (Green) On-scene ROSC Patient PH-Paramedic & MD Benhamed A, Canon V, Mercier E, Heidet M, Gossiome A, Savary D, et al. Prehospital predictors for return of spontaneous circulation in traumatic cardiac arrest. J Trauma Acute Care Surg 2022; 92(3):553–60. Medline
II Supportive (Green) 30 Days survival of OOHCA Process PH-Paramedic & MD Savary D, Morin F, Douillet D, Drouet A, Ageron FX, Charvet R, Carneiro B, Metton P, Fadel M, Descatha A. Impact of Specific Emergency Measures on Survival in Out-of-Hospital Traumatic Cardiac Arrest. Prehosp Disaster Med 2022; 37(1):51–6. Medline
III Supportive (Green) Feasibility Process PH-Paramedic Dickson RL., Gleisberg G., Aiken M., Crocker K., Patrick C., Nichols T., et al. Emergency Medical Services Simple Thoracostomy for Traumatic Cardiac Arrest Postimplementation Experience in a Ground-based Suburban/Rural Emergency Medical Services Agency. J Emerg Med 2018; 55(3) 366-71. Medline
III Supportive (Green) Complications Patient PH-Paramedic & CCT Hannon L, St Clair T, Smith K, Fitzgerald M, Mitra B, Olaussen A, et al. Finger thoracostomy in patients with chest trauma performed by paramedics on a helicopter emergency medical service. Emerg Med Australas 2020 Aug;32(4):650-656. Medline

Thoracotomy
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) ROSC Patient PH-Paramedic & MD Almond P, Morton S, OMeara M, Durge N. A 6-year case series of resuscitative thoracotomies performed by a helicopter emergency medical service in a mixed urban and rural area with a comparison of blunt versus penetrating trauma. Scand J Trauma Resusc Emerg Med 2022; 30:1-8. Medline
II Neutral (Yellow) Mortality Patient PH-Paramedic Liu A, Nguyen J, Ehrlich H, Bisbee C, Santiesteban L, Santos R, et al. Emergency Resuscitative Thoracotomy for Civilian Thoracic Trauma in the Field and Emergency Department Settings: A Systematic Review and Meta-Analysis. J Surg Res 2022; 273:44–55. Medline
III Supportive (Green) Survival Patient PH-Paramedic & MD Nevins EJ., Moori PL., Smith-Williams J., Bird NTE., Taylor JV., Misra N. Should pre-hospital resuscitative thoracotomy be reserved only for penetrating chest trauma? European journal of trauma and emergency surgery 2018; 44(6) 811-8. Medline
III Supportive (Green) Survival Patient PH-MD & CCT Rogerson T, Efstratiades T, Von Oppell U, Davies G, Curtin R. Survival after pre-hospital emergency clamshell thoracotomy for blunt cardiac rupture. Injury 2020 Jan;51(1):122-123. Medline
III Neutral (Yellow) ROSC Patient PH-MD & CCT Van VM, Van WO, Kooij FO., Peters JH., Van LE, Verhofstad MHJ. Out of hospital thoracotomy for cardiac arrest after penetrating thoracic trauma. Injury 2017; 48(9) 1865-9. Medline


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