Trauma Patients Receiving CPR: Predictors of Survival
- 1 May 2005
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal Of Trauma-Injury Infection and Critical Care
- Vol. 58 (5), 951-958
- https://doi.org/10.1097/01.ta.0000162174.06448.5a
Abstract
To determine whether prehospital clinical assessments are associated with the survival of traumatic cardiopulmonary arrest (TCPA) patients and to test recently issued clinical guidelines for prehospital cessation of resuscitative efforts published by the National Association of Emergency Physicians and the American College of Surgeons Committee on Trauma. A retrospective cohort study was done of all TCPA patients who had transported to a Level I trauma center by a municipal EMS provider between January 1, 1994 and April 1, 2001. Data regarding mechanism of injury, clinical assessments and care provided by EMS and the emergency department (ED), hospital care, survival, and neurologic outcome was collected. 184 patients met exclusion criteria, with 14 (7.6%) surviving to discharge. Pupillary response to light, presence of a prehospital pulse or respiratory effort, a sinus electrocardiogram, and a Glascow Coma Scale greater than three were all significantly associated with survival but were not exclusive. 28.6% of patients admitted to the trauma center from the ED survived. There were frequent discrepancies between prehospital and ED clinical assessments. Several survivors met criteria for non-treatment according to the proposed clinical guidelines. ± Prehospital clinical assessments are not reliable for the triage of TCPA patients. Patients should be transported to the ED for further evaluation and care. The guidelines should not adopted until more thorough studies are conducted.Keywords
This publication has 12 references indexed in Scilit:
- Additional evidence in support of withholding or terminating cardiopulmonary resuscitation for trauma patients in the field1Journal of the American College of Surgeons, 2004
- Physiologic Predictors of Survival in Post-Traumatic ArrestThe American Surgeon, 2003
- Blunt Trauma Patients with Prehospital Pulseless Electrical Activity (PEA): Poor Ending AssuredJournal Of Trauma-Injury Infection and Critical Care, 2002
- Prehospital Pulseless, Unconscious Penetrating Trauma VictimsJournal Of Trauma-Injury Infection and Critical Care, 1998
- Defining "Dead on Arrival"Journal Of Trauma-Injury Infection and Critical Care, 1996
- Epidemiology of Trauma DeathsJournal Of Trauma-Injury Infection and Critical Care, 1995
- PREHOSPITAL TRAUMATIC CARDIAC ARRESTJournal Of Trauma-Injury Infection and Critical Care, 1993
- Emergency Center Thoracotomy: Impact of Prehospital ResuscitationJournal Of Trauma-Injury Infection and Critical Care, 1992
- Prehospital cardiopulmonary resuscitation of the critically injured patientThe American Journal of Surgery, 1984
- Outcomes of Trauma Patients with No Vital Signs on Hospital AdmissionJournal Of Trauma-Injury Infection and Critical Care, 1983