Traumatic Cardiac Arrest
A traumatic cardiac arrest (TCA) is traumatic not just for patients but also for staff and all those involved - Karl Kavanagh and Nuala Quinn
When healthcare practitioners hear the word “arrest” they automatically move into the “chest compressions” mindset. However medical cardiac arrest and traumatic cardiac arrest are two completely different entities with ensuing separate management.
I follow the PERUKI guideline...The bundle needs to be prioritised over chest compressions and defibrillation...
- External haemorrhage control
- Adequate oxygenation and ventilation
- Bilateral thoracostomies
- Rapid volume replacement with blood and blood products (crystalloid only if blood not available)
- Apply pelvic binder in blunt trauma
Traumatic cardiac arrest (TCA) is an infrequent event in paediatrics, and a cause of significant stress in the busy trauma resuscitation room. Outcomes are similar in both paediatric and adult arrests, with poor survival rates in both. There are now international guidelines on the management of traumatic cardiac arrest. A traumatic cardiac arrest (TCA) is traumatic not just for patients but also for staff and all those involved.
A large prospective study out of Los Angeles in 2015 found that no patient with a traumatic cardiac arrest and absence of both cardiac motion and pericardial effusion on POCUS survived ED thoracotomy.
Traumatic cardiac arrest is known to have a poor outcome, and some authors have stated that attempted resuscitation from traumatic cardiac arrest is futile. However, advances in damage control resuscitation and understanding of the differences in pathophysiology of traumatic cardiac arrest compared to medical cardiac arrest have led to unexpected survivors.
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