SAQ 355 – Trauma – blunt traumatic cardiac arrest

Trauma – blunt traumatic cardiac arrest.

a. Immediate priorities

• Intubation and mechanical ventilation.
• Bilateral finger thoracostomies.
• Apply a pelvic binder.
• Reduce long-bone fractures.
• Activate massive transfusion and give blood products.

b. CPR role

• The role is controversial and evidence is limited.
• It may have a role if arrest is medical rather than traumatic.
• If key reversible traumatic causes have not been addressed, CPR is unlikely to help and may inhibit interventions.
• After key interventions are completed, CPR may have a possible role.

c. ED thoracotomy

• Survival after blunt traumatic arrest is very poor, usually less than 2%.
• A possible indication is blunt trauma with arrest under 10 minutes plus pericardial effusion and cardiac activity on PoCUS.