List Archives

Thu Dec 21 08:46:12 GMT 2006

I was talking about a patient arresting in the ED. But we can talk about the 
option of prehospital or en route arrest as well

>From: "Ronald Gross" <Rgross at harthosp.org>
>Reply-To: "Trauma &amp; Critical Care mailing list" 
><trauma-list at trauma.org>
>To: <trauma-list at trauma.org>
>Subject: Re: head injury- termi ation of resuscitative efforts
>Date: Tue, 19 Dec 2006 14:38:28 -0500
>
>As I recall, the patient had a cardiac arrest s/p TBI.  The patient
>arrived without an airway and in PEA.  If you want to do CPR (assuming
>that someone was doing so en route without ET intubation) then continue.
>  Bag in the guise of "preoxygenation", place leads and do an epigastric
>FAST view.  If there is no cardiac activity, stop, and proceed where I
>left off on my last e-mail......take care of the family, etc.
>
> >>> <rwolfer at aol.com> 12/19/2006 1:20 PM >>>
>I would do a code. Nothing heroic.  I agree about organ donation.  I
>have actually gotten a couple of donations  because of this. The family
>always seems to "feel better" that everything was done and donation
>occurred.  They state " atleast something good will come of it"
>
>Rebecca Wolfer, MD, FACS, FCCP
>Associate Professor, Marshall University School of Medicine
>Dept of Surgery
>Director Thoracic Surgery
>Director, Surgical Critical Care Cabell Huntington Hospital
>Director, Trauma Cabell Huntington Hospital
>
>
>-----Original Message-----
>From: Rgross at harthosp.org
>To: trauma-list at trauma.org
>Sent: Tue, 19 Dec 2006 12:18 PM
>Subject: Re: head injury- termi ation of resuscitative efforts
>
>
>I treat the family.  The patient is dead, and will stay dead,
>regardless
>of what you do.  Now is the time to help the family honor the
>patient's
>wishes, if known, and to call the organ donation service in your
>region.
>  Lastly, thoracotomy IS indicated - to procure the heart and lungs for
>transplantation. (so there - I did come forward and admit it!)
>
>Take care,
>Ron
> >>> "oded private" <tangentcarrot at hotmail.com> 12/19/2006 11:47 AM >>>
>Hello list
>
>I'd like to hear your opinion about deciding to terminate treatment
>for
>
>isolated TBI resulting in cardiac arrest.
>
>What if the pateint is still in PEA? Will you attempt to defibrilate
>VF, if
>it happened for some reason?
>
>If you do treat him- what will you do?  ET intubation and ventilation
>alone?
>CPR? Does anybody here practice thoractomy in the scenario and is
>ready
>to
>"come forward" and admit to it?
>
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head injury- termi ation of resuscitative efforts