Traumatic Cardiac Arrest

Question 1

Primary Survey

Answer 1

• Stabilize head and neck (if resources available)
• Assess level of consciousness using AVPU (note apnea or agonal respirations)
• Assess carotid pulse for a maximum of 10 seconds
• If no pulse, immediately start compressions
• Advise partner of known cardiac arrest and initiate COR protocol
• Open airway and ventilate using BVM
• Apply high flow of O2 at 15 lpm as soon as practical
• Insert airway adjunct as soon as practical (OPA or NPA)
• Conduct full RBS (visualize, palpate, and auscultate where appropriate)
• Treat and manage injuries as per traumatic injuries chart
• Gather critical history and attempt patient history from bystander/family

Question 2

Decision Point

Answer 2

Findings in unstable (RTC) patient include:
- Traumatic arrest
- Major trauma

Question 3

Patient History

Answer 3

SAMPLE/OPQRRRST (if available from bystander or family)

Question 4

Critical History

Answer 4

• Cause of arrest/injuries
• Estimated blood loss
• Extent of injuries
• Bystander CPR/AED initiated
• If yes, shocks/no-shocks prior to arrival
• What are transport times to the hospital

Question 5

Load and Transport

Answer 5

• If time delay is greater than 15 minutes call EPOS for likely discontinue orders
• Request additional resources (FR’s, ACP, additional PCP, etc.)
• Utilize lifting device to minimize movement of the patient (clamshell/backboard)
• Continue CPR as required during transport, minimize interruptions to CPR

Question 6

Protocol(s)

Answer 6

• Discontinue resuscitation
• Traumatic cardiac arrest protocol

Question 7

Post Arrest Care

Answer 7

• Continual assessment of ABC’s including any interventions that were introduced
• Anticipate re-arrest and preparation of resuscitation equipment
• Leave AED attached to patient until arrival at hospital
• Begin secondary survey and continue with critical history