Emergency medical dispatch recognition, clinical intervention and outcome of patients in traumatic cardiac arrest from major trauma: an observational study
Prentice, Craig Jeyanathan, Jeyasankar De Coverly, Richard Williams, Julia Lyon, Richard M.
Prentice, Craig
Jeyanathan, Jeyasankar
De Coverly, Richard
Williams, Julia
Lyon, Richard M.
Citations
Altmetric:
Journal Title
Book Title
Publication Volume
Publication Issue
Publication Begin Page
Publication End Page
Publication Number of Pages
Abstract
https://bmjopen.bmj.com/content/bmjopen/8/9/e022464.full.pdf
Objectives The aim of this study is to describe the
demographics of reported traumatic cardiac arrest (TCA)
victims, prehospital resuscitation and survival to hospital
rate.
Setting Helicopter Emergency Medical Service (HEMS)
in south-east England, covering a resident population of
4.5million and a transient population of up to 8million
people.
Participants Patients reported on the initial 999 call to be
in suspected traumatic cardiac arrest between 1 July 2016
and 31 December 2016 within the trust’s geographical
region were identified. The inclusion criteria were all cases
of reported TCA on receipt of the initial emergency call.
Patients were subsequently excluded if a medical cause of
cardiac arrest was suspected.
Outcome measures Patient records were analysed for
actual presence of cardiac arrest, prehospital resuscitation
procedures undertaken and for survival to hospital rates.
Results 112 patients were reported to be in TCA on
receipt of the 999/112 call. 51 (46%) were found not to
be in TCA on arrival of emergency medical services. Of
the ‘not in TCA cohort’, 34 (67%) received at least one
advanced prehospital medical intervention (defined as
emergency anaesthesia, thoracostomy, blood product
transfusion or resuscitative thoracotomy). Of the 61
patients in actual TCA, 10 (16%) achieved return-ofspontaneous circulation. In 45 (88%) patients, the HEMS
team escorted the patient to hospital.
Conclusion A significant proportion of patients reported
to be in TCA on receipt of the emergency call are not in
actual cardiac arrest but are critically unwell requiring
advanced prehospital medical intervention. Early activation
of an enhanced care team to a reported TCA call allows
appropriate advanced resuscitation. Further research is
warranted to determine which interventions contribute to
improved TCA survival.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6129099/pdf/bmjopen-2018-022464.pdf
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/bmjopen-2018-022464