Resus - Traumatic

Question 1

What are the four (4) reversible causes of traumatic arrest?

Answer 1

• Hypovolaemia
• Airway obstruction & inadequate ventilation
• Tension pneumothorax
• Cardiac tamponade

Question 2

What are the five (5) key areas of traumatic arrest interventions?

Answer 2

• Control of catastrophic external haemorrhage
• Haemorrhage control & fluid resus
• Control airway & maximise oxygenation
• Bilateral chest decompression
• Cardiac tamponade

Question 3

What two procedures can be done to control catastrophic haemorrhage?

Answer 3

• Direct pressure

* Arterial tourniquets

Question 4

What are the fluid resuscitation guidelines in a traumatic arrest?

Answer 4

Two-step manner.
• First step:
- aggressive 20ml/kg normal saline (blood
preferred) to restore circulating blood volume
• Second step:
- further 5-10ml/kg if hypovolaemia is ongoing
cause of persistent arrest; in conjunction with
bandaging, pressure dressing, binders, splints

Question 5

In order of likely aetiology of cardiac arrest list the measures that should be taken

Answer 5

Control external catastrophic haemorrhage
- Consider:
• Arterial tourniquet
• Arterial compression

Control airway & maximise oxygenation
- Consider:
• LMA/ETT

Bilateral chest decompression

Fluid resus/haemorrhage 
 • IV/IO
 • 20ml/kg PRBC or Sodium chloride 0.9%
 • Further 5-10ml/kg boluses if indicated 
 • Pelvic binder 
 • # immobilisation & splinting 

• BLS/ALS can occur @ the same time if there are sufficient resources & it does not interfere with the Rx priorities

Question 6

If ROSC is not achieved after the priority interventions what is the process?

Answer 6

Continue resus for 20mins after reversible causes have been addressed.
Consider ROLE