Trauma Cardiac Arrest Flashcards
What is a trauma cardiac arrest?
A cardiac arrest that occurs due to severe blunt or penetrating trauma.
What is blunt trauma?
Injury caused by forceful impact without penetrating the skin. Common in motor vehicle collisions, falls from height, and physical assault.
What is penetrating trauma?
Injury caused by an object penetrating the body. Common in stab wounds, gunshot wounds, and impalements.
What critical thinking should be applied for trauma arrests?
Identify whether the trauma is blunt or penetrating, and determine if the injuries are survivable or non-survivable.
What defines survivable injuries?
Injuries with potential for ROSC (Return of Spontaneous Circulation) with appropriate care.
What defines non-survivable injuries?
Gross signs of death or injuries incompatible with life.
What are the CPR guidelines for impalement in the chest?
Reposition hands around the object to avoid dislodging it. If ineffective, remove the object to facilitate compressions.
What are the presumptive death criteria for paramedics?
A paramedic may presume death when there are obvious signs of death such as decapitation, transection, visible decomposition, grossly charred body, rigor mortis, or open head/torso wounds.
What is the protocol for defibrillation pad placement?
Apply defibrillation pads following standard AED/defibrillator protocols, with modifications as needed for traumatic injuries or impaled objects.
What are the criteria for initiating a Trauma TOR?
Patient is ≥ 16 years old, no defibrillation delivered, and no palpable pulses.
What additional criteria apply for Asystole in Trauma TOR?
No signs of life since extrication or signs of life but extrication time or resuscitation ≥ 30 minutes.
What additional criteria apply for PEA in Trauma TOR?
Emergency response ≥ 30 minutes with no ROSC.
What are the steps for initiating a Trauma TOR?
Identify yourself and certification level, state the reason for the call, and state findings and criteria.
What should be included in the findings and criteria for a Trauma TOR call?
Patient’s age, duration of CPR before arrival, no shocks delivered, current rhythm on the monitor, and confirmation of no ROSC.
What are important reminders for trauma-specific considerations?
Determine the cause of VSA, address traumatic injuries, and apply the ‘1 and Out’ principle for rhythm analysis.
What are the key points for documentation in trauma cases?
Document patient demographics, timeline of events, interventions performed, TOR communication, and outcome of resuscitation.
What special considerations should paramedics keep in mind for blunt trauma?
Internal injuries and hemorrhaging may be significant despite minimal external signs.
What special considerations should paramedics keep in mind for penetrating trauma?
Monitor for tamponade or pneumothorax that may impede CPR effectiveness.
What reversible causes should be considered before terminating resuscitation?
Consider the 4 H’s (Hypoxia, Hypovolemia, Hypothermia, Hydrogen ion) and 4 T’s (Tension pneumothorax, Tamponade, Toxins, Thrombosis).
What is the summary of key points regarding trauma cardiac arrest?
Indications: Cardiac arrest secondary to severe trauma. Contraindications: Gross signs of death or non-survivable injuries. TOR Requirements: ≥ 16 years, no defibrillation, and no pulses. CPR Guidelines: Adapt for impaled objects and reassess effectiveness. Documentation: Ensure thorough documentation of findings, interventions, and communication during the event.
What should be done for a 22-year-old male with a gunshot wound to the chest who is VSA and has an impaled object preventing effective CPR?
Remove the object to facilitate effective CPR.
What action should be taken for a 45-year-old male in PEA after 32 minutes of CPR with no shocks delivered?
Initiate a Trauma TOR if no ROSC is achieved after 30 minutes.
What is the appropriate response for a 33-year-old male who shows complete decapitation?
Presume death and withhold resuscitation.
What should be done for a 27-year-old female with a stab wound to the chest who is VSA and has persistent PEA after 28 minutes of CPR?
Continue CPR for 2 more minutes and consider a Trauma TOR after 30 minutes.
