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Traumatic Arrest

Date Last Search Run: May 17, 2023
Table last updated: Apr 22, 2023
Data last added: Apr 22, 2023

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
II Neutral (Yellow) Survival to discharge Process PH-Paramedic & MD Nishimura T, Suga M, Nakao A, Ishihara S, Naito H. Prehospital advanced airway management of emergency medical service-witnessed traumatic out-of-hospital cardiac arrest patients: analysis of nationwide trauma registry. Acute Med Surg 2022; 9(1):e786. 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
X Not Yet Graded (White) - Williamson F, Lawton CF, Wullschleger M. Outcomes in traumatic cardiac arrest patients who underwent advanced life support. Emerg Med Australas 2022. Medline

Blood transfusion
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) ROSC Process PH-MD & CCT 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
II Neutral (Yellow) Survival to discharge Patient PH-Paramedic Williamson F, Lawton CF, Wullschleger M. Outcomes in traumatic cardiac arrest patients who underwent advanced life support. Emerg Med Australas 2022. 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
II Neutral (Yellow) Survival to discharge Patient PH-Paramedic Williamson F, Lawton CF, Wullschleger M. Outcomes in traumatic cardiac arrest patients who underwent advanced life support. Emerg Med Australas 2022. 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
X Not Yet Graded (White) - -Kuo IM, Chen YF, Chien CY, Hong YW, Kang SC, et al. A novel scoring system using easily assessible predictors of return of spontaneous circulation and mortality in traumatic out-of-hospital cardiac arrest patients: A retrospective cohort study. Int J Surg 2022; 106731. 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) Prehospital factors associated with increased risk of death in trauma patients. Patient PH-Paramedic 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
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

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 Supportive (Green) Mortality Patient ED-Paramedic & MD Fierro NM, Dhillon NK, Yong FA, Muniz T, Siletz AE, Barmparas G, Ley EJ. No Resuscitative Thoracotomy? When to Stop Chest Compressions After Prehospital Traumatic Cardiac Arrest. Am Surg 2022; 31348221101500. Medline
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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