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blunt traumatic arrest pharmacotherapy

MARK FORREST atacc.doc at btinternet.com
Fri Dec 11 22:56:45 GMT 2009

Hi Ron
I have been following this with great interest as we have recently been having a real dilemma with a new training manual for UK firefighters and firearms officers. 90% of their work will be trauma related, however they may still attend some cardiac arrests. We have tried to produce a manual and treatment algorithm that brings together trauma and cardiac care into one simple process but whilst this has been fairly straight forward to sell to our trauma care providers and medical Faculty, the UK paramedics that have reviewed the manual just cannot get ALS out of there head and will not accept pulse checks, supportive ventilation for resp rates less than 8 and worst of all, they expect all 'unresponsive' patients or with abnormal breathing to get immediate chest compressions, as thats what BLS says!

We want to ignore this and to reach our guys to assess the casualty further in terms of conscious level, pulses,  CRT etc but the 'cardiac ALS' guys just wont have it and say that this introduces delays and does not fit ERC guidelines.

They also insist that ALS includes trauma!!! God knows why we all do ATLS, ATACC etc if that is the case!!!

How do we resolve this for these guys.....do we just accept CPR in every unresponsive victim??


Dr Mark Forrest
Consultant in Anaesthetics & Critical Care

From: "Gross, Ronald" <Ronald.Gross at baystatehealth.org>
To: Trauma-List [TRAUMA.ORG] <trauma-list at trauma.org>
Sent: Friday, 11 December, 2009 11:30:33
Subject: RE: blunt traumatic arrest pharmacotherapy

Not me.  Over 8 minutes of CPR with a tube in place and I "treat" with Subxiphoid FAST view and a call to the ME.


-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of caesar ursic
Sent: Friday, December 11, 2009 12:08 AM
To: Trauma-List [TRAUMA.ORG]
Subject: blunt traumatic arrest pharmacotherapy

Who among you treats victims of blunt traumatic cardiac arrest with "ACLS
protocol" drugs?  I'm referring to the blunt trauma patient brought in to ER
with closed chest compressions in progress and no palpable pulses with
wide-complex bradycardia.  Who gives boluses of epinephrine/atropine/sodium
bicarbonate to these patients?  What is the role for these drugs in the
treatment of obvious blunt traumatic arrest?

CM Ursic, MD
g. surg.
trauma-list : TRAUMA.ORG
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