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Prehospital care for traumatic cardiac arrest in the US: A cross-sectional analysis and call for a national guideline.
- Source :
-
Resuscitation [Resuscitation] 2022 Oct; Vol. 179, pp. 97-104. Date of Electronic Publication: 2022 Aug 12. - Publication Year :
- 2022
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Abstract
- Aim: We describe emergency medical services (EMS) protocols and prehospital practice patterns related to traumatic cardiac arrest (TCA) management in the U.S.<br />Methods: We examined EMS management of TCA by 1) assessing variability in recommended treatments in state EMS protocols for TCA and 2) analyzing EMS care using a nationwide sample of EMS activations. We included EMS activations involving TCA in adult (≥18 years) patients where resuscitation was attempted by EMS. Descriptive statistics for recommended and actual treatments were calculated and compared between blunt and penetrating trauma using χ <superscript>2</superscript> and independent 2-group Mann-Whitney U tests.<br />Results: There were 35 state EMS protocols publicly available for review, of which 16 (45.7%) had a specific TCA protocol and 17 (48.5%) had a specific termination of resuscitation protocol for TCA. Recommended treatments varied. We then analyzed 9,565 EMS activations involving TCA (79.1% blunt, 20.9% penetrating). Most activations (93%) were managed by advanced life support. Return of spontaneous circulation was achieved in 25.5% of activations, and resuscitation was terminated by EMS in 26.4% of activations. Median prehospital scene time was 16.4 minutes; scene time was shorter for penetrating mechanisms than blunt (12.0 vs 17.0 min, p < 0.001). Endotracheal intubation was performed in 32.0% of activations, vascular access obtained in 66.6%, crystalloid fluids administered in 28.8%, and adrenaline administered in 60.1%.<br />Conclusion: Actual and recommended approaches to EMS treatment of TCA vary nationally. These variations in protocols and treatments highlight the need for a standardized approach to prehospital management of TCA in the U.S.<br /> (Copyright © 2022 Elsevier B.V. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1873-1570
- Volume :
- 179
- Database :
- MEDLINE
- Journal :
- Resuscitation
- Publication Type :
- Academic Journal
- Accession number :
- 35970396
- Full Text :
- https://doi.org/10.1016/j.resuscitation.2022.08.005