Updates in Traumatic Cardiac Arrest

Emerg Med Clin North Am. 2020 Nov;38(4):891-901. doi: 10.1016/j.emc.2020.06.009. Epub 2020 Sep 9.

Abstract

Evaluating and treating traumatic cardiac arrest remains a challenge to the emergency medicine provider. Guidelines have established criteria for patients who can benefit from treatment and resuscitation versus those who will likely not survive. Patient factors that predict survival are penetrating injury, signs of life with emergency medical services or on arrival to the Emergency Department, short length of prehospital cardiopulmonary resuscitation, cardiac motion on ultrasound, pediatric patients, and those with reversible causes including pericardial tamponade and tension pneumothorax. Newer technologies such as resuscitative endovascular balloon occlusion of the aorta, selective aortic arch perfusion, and extracorporeal membrane oxygenation may improve outcomes, but remain primarily investigational.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Pediatric trauma; Resuscitative endovascular balloon occlusion of the aorta; Thoracotomy; Traumatic cardiac arrest.

Publication types

  • Review

MeSH terms

  • Abdomen / diagnostic imaging
  • Aorta
  • Balloon Occlusion
  • Emergency Service, Hospital
  • Extracorporeal Membrane Oxygenation
  • Heart / diagnostic imaging
  • Heart Arrest / etiology
  • Heart Arrest / therapy*
  • Humans
  • Practice Guidelines as Topic
  • Resuscitation
  • Resuscitation Orders
  • Thoracotomy
  • Ultrasonography
  • Wounds and Injuries / complications*