Prehospital CPR for Traumatic Arrest: Can Prehospital Variables Help Identify Futile Transport?

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Critical Care

Background:

• Resuscitative efforts (RE) for trauma patients require substantial prehospital (PH) and hospital resources.
• A significant portion of transported patients with cardiac arrest following trauma are declared dead on arrival (DOA) or undergo immediate termination of resuscitative efforts (ITRE).

Purpose of the Study:

• To identify prehospital variables associated with DOA/ITRE in trauma patients.
• To evaluate the potential for improved triage to conserve healthcare resources.

Main Methods:

• Analysis of 405 trauma patients who received prehospital CPR (PHCPR) between 2014-2023 at a Level 1 trauma center.
• Inclusion of clinical variables: demographics, mechanism of injury (MOI), prehospital resuscitative efforts (PHRE), and hospital RE.
• Primary outcome: DOA/ITRE.

Main Results:

• 25.2% of patients experienced DOA/ITRE.
• DOA/ITRE patients were older, more likely to have blunt MOI, and received fewer PH interventions.
• Patients with penetrating injuries had shorter ED times compared to blunt injuries.

Conclusions:

• Over 25% of transported trauma arrest patients undergo DOA/ITRE.
• Blunt MOI, older age, and fewer PH interventions are associated with DOA/ITRE.
• Enhanced prehospital triage may optimize resource allocation for trauma patients.