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Prehospital Factors Associated with Refractory Traumatic Arrest
Jeong Hun Lee1, Yong Won Kim1, Tae Youn Kim1
1Department of Emergency Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea.
Emergency Medicine International
|December 30, 2021
Summary
Prehospital factors like asystole, no return of spontaneous circulation (ROSC), and high falls predict death in traumatic arrest patients. These findings aid in deciding when to terminate resuscitation efforts.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Prehospital Care
Background:
- Traumatic arrest presents significant challenges in prehospital care.
- Identifying factors predicting poor outcomes is crucial for resource allocation and treatment decisions.
Purpose of the Study:
- To identify prehospital clinical factors associated with mortality in patients experiencing traumatic arrest.
- To inform decisions regarding the termination of resuscitation in the emergency room.
Main Methods:
- A multicenter retrospective study was conducted in South Korea from January 2016 to December 2018.
- Adult trauma arrest patients arriving via ambulance, excluding those deceased on arrival, were analyzed.
- Prehospital data and emergency room outcomes were collected and compared between survival and death groups.
Main Results:
- Asystole was significantly associated with emergency room death (OR 4.033).
- Prehospital return of spontaneous circulation (ROSC) was inversely related to emergency room death (OR 0.100).
- For fall-related injuries, a fall height greater than 10 meters strongly predicted emergency room death.
Conclusions:
- Asystole, absence of prehospital ROSC, and significant fall height are key predictors of mortality in traumatic arrest.
- These clinical factors should be considered comprehensively when making decisions about resuscitation termination.
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