Chen et al evaluated trauma patients who experienced prehospital cardiac arrest and who did not have spontaneous return of spontaneous circulation (ROSC).
The authors are from Chang Gung Memorial Hospital in Taiwan.
Patient selection: trauma patient with cardiac arrest and without prehospital return of spontaneous circulation
Rate of ROSC in traumatic cardiac arrest: 20-31%
Survival to 30 days: 14%
Factors associated with ultimate return of spontaneous circulation:
(1) ISS >= 16 (odds ratio 0.06, so lower ISS favorable)
(2) admission to a trauma center (odds ratio 2.7)
(3) length of ED resuscitation in minutes (odds ratio 0.98, so shorter time favorable)
(4) total resuscitation time > 20 minutes (odds ratio 0.21, so shorter time favorable)
Resuscitation attempts could be beneficial if:
(1) performed promptly
(2) early aggressive management is directed toward reversible causes of the cardiac arrest
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