Confusion surrounding the treatment of traumatic cardiac arrest.

Abstract

To delineate the most reasonable approach to patients with traumatic cardiac arrest we studied the experience at our level 1 trauma center. Patients with life-threatening trauma admitted during a 41-month period were screened to identify 245 patients who suffered cardiac arrest. Mechanisms of injury, location of arrest, length of arrest, transport methods, treatment rendered, neurologic state, outcomes, and cost of treatment were determined. Six (2.4 percent) patients survived. Mechanism of injury, location of arrest, and age did not correlate with survival. Arrest time longer than ten minutes and loss of neurologic function were associated with mortality. Cost of care was not excessive. Patients with traumatic cardiac arrest with intact neurologic function should receive treatment. Resuscitation should not be attempted in patients who also have severe brain injury or prolonged time of cardiac arrest.