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Traumatic cardiac arrest

schiller181 at comcast.net schiller181 at comcast.net
Tue May 26 15:00:29 BST 2015

Yes and yes. 
Medical cardiac arrest - ROSC is paramount, if we don't establish prior to transport then it's pretty much game over so we stay and fight at point of contact upwards of 20-30 minutes depending on presenting rhythm. We have fairly robust field termination language which calls for aggressive ACLS attempts at ROSC with options for field termination if subsequently unsuccessful. 

Traumatic cardiac arrest (no signs of life)- 3 categories 
1. Blunt trauma - pronounce on scene 
2. Penetrating trauma outside of the cardiac window and not immediately reversible with chest decompression or airway- pronounce on scene 
3. Penetrating trauma to the cardiac window and < 8 minutes to a scalpel - immediate transport with any interventions done en route. 

These policies stem from the research done on survivability of trauma patients, which the group can probably cite chapter and verse better then I. 
These are, of course, policy guidelines and exceptions are made if diagnostics or field conditions warrant them. Feel free to contact me off line and I can get you our SOPs and the evidence from which it is established. 


Susan Schiller, NRP 
Deputy Superintendent, Field Operations 
Boston Emergency Medical Services 
785 Albany Street 
Boston, MA 02118-2525 
schiller at bostonems.org 

----- Original Message -----

From: "Paul Bailey" <paul.bailey at gmail.com> 
To: "Trauma-List [TRAUMA.ORG]" <trauma-list at trauma.org> 
Sent: Tuesday, May 26, 2015 9:07:13 AM 
Subject: Traumatic cardiac arrest 

Greetings to the list - long time lurker, rare contributor. 

I have a question for those of you involved in the pre-hospital / EMS 
sphere - with regards to cardiac arrest. 

Does your system treat traumatic cardiac arrest differently to "medical" 
cardiac arrest, and if so are you willing to share your thoughts. 

Particularly interested in evidence base, if any. 

Also interested to see if anyone is working in a system that administers 
blood pre-hospital and what logistics problems that might throw up. 


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