Blunt Trauma Patients with Prehospital Pulseless Electrical Activity (PEA): Poor Ending Assured

Abstract

If these grim results are corroborated by other investigators, consideration should be given to allowing paramedics to declare blunt trauma victims with PEA dead at the scene.

Does the prognosis of cardiac arrest differ in trauma patients?*

“…This is in agreement with Martin et al (5), who suggested that initial rhythm (pulseless electrical activity) in trauma is probably not a robust predictor of patient outcome. Therefore, we think that trauma patients in cardiac arrest need active resuscitation in the field until they regain cardiac activity instead of quick transportation to a trauma center, especially if the transport will last for Ͼ15 mins (6).…”

“…Despite advances in medical care, survival rates of 0% to 2% have been consistently reported for blunt trauma patients who arrive at a trauma center with no signs of life (2)(3)(4)(5)(6). Unfortunately, many of these survivors experience severe permanent neurologic disability (5,7).…”

“…Despite advances in medical care, survival rates of 0% to 2% have been consistently reported for blunt trauma patients who arrive at a trauma center with no signs of life (2)(3)(4)(5)(6). Unfortunately, many of these survivors experience severe permanent neurologic disability (5,7). Consequently, according to the guidelines from the National Association of EMS Physicians/American College of Surgery Committee on Trauma and the protocols for advanced trauma life support, it is actually suggested to not resuscitate blunt trauma patients with out-of-hospital cardiac arrest (OHCA) or penetrating trauma patients found pulseless, apneic, and with no sign of life, and to make a death pronouncement at the injury scene (6).…”

Blunt cardiac rupture: A successful experience of echo-guided pericardiocentesis with large bore central vein catheter drainage in the management of traumatic cardiac tamponade and early thoracotomy for cardiorrhaphy

“…11 Martin et al reported 110 BCR patients with prehospital PEA, concluding that the chance of survival diminishes if a patient develops prehospital cardiac arrest or PEA. 9 Clinical manifestations depend on the presence or absence of tear in the pericardium. Intact pericardium after BCR can result in cardiac tamponade whilst tear in pericardium often presents with haemothorax and haemorrhagic shock in a small percentage of patients (10%).…”

Multiple trauma, resuscitation, and 15 minutes of esophageal intubation: survival without neurologic deficit

“…SpO 2 climbed to 80% and the patient regained spontaneous Unrecognized esophageal intubation is frequent [1], and traumatic PEA resuscitation is often futile [2], so there are 3 messages we want to address:…”