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Impact of Specific Emergency Measures on Survival in Out-of-Hospital Traumatic Cardiac Arrest

Published online by Cambridge University Press:  17 December 2021

Dominique Savary Open the ORCID record for Dominique Savary [Opens in a new window] ,
François Morin ,
Delphine Douillet ,
Adrien Drouet ,
François Xavier Ageron ,
Romain Charvet ,
Bruno Carneiro ,
Pierre Metton ,
Marc Fadel  and
Alexis Descatha
Dominique Savary*
Affiliation:
Emergency Department, Angers University Hospital, Angers, France UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement, et Travail) - UMR_S1085, Angers, France
François Morin
Affiliation:
Emergency Department, Angers University Hospital, Angers, France
Delphine Douillet
Affiliation:
Emergency Department, Angers University Hospital, Angers, France
Adrien Drouet
Affiliation:
SAMU 74, Emergency Department, General Hospital, Annecy, France
François Xavier Ageron
Affiliation:
Emergency Department, CHUV, 1011Lausanne, Switzerland
Romain Charvet
Affiliation:
Emergency Department, Angers University Hospital, Angers, France
Bruno Carneiro
Affiliation:
Emergency Department, Angers University Hospital, Angers, France
Pierre Metton
Affiliation:
Northern French Alp Emergency Network, General Hospital, Annecy, France
Marc Fadel
Affiliation:
UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement, et Travail) - UMR_S1085, Angers, France
Alexis Descatha
Affiliation:
UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement, et Travail) - UMR_S1085, Angers, France CHU Angers, Poisoning Control Center, Data Center, Angers, France
*
Correspondence: Pr. Dominique SAVARY Chef du Département de Médecine d’Urgence Centre Hospitalier Universitaire 4 rue Larrey 49100 ANGERS – France E-mail: dsavary74@gmail.com
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Abstract

Introduction:

The management of out-of-hospital traumatic cardiac arrest (TCA) for professional rescuers entails Advanced Life Support (ALS) with specific actions to treat the potential reversible causes of the arrest: hypovolemia, hypoxemia, tension pneumothorax (TPx), and tamponade. The aim of this study was to assess the impact of specific rescue measures on short-term outcomes in the context of resuscitating patients with a TCA.

Methods:

This retrospective study concerns all TCA patients treated in two emergency medical units, which are part of the Northern French Alps Emergency Network (RENAU), from January 2004 through December 2017. Utstein variables and specific rescue measures in TCA were compiled: fluid expansion, pelvic stabilization, tourniquet application, bilateral thoracostomy, and thoracotomy procedures. The primary endpoint was survival rate at Day 30 with good neurological status (Cerebral Performance Category [CPC] score CPC 1 and CPC 2).

Results:

In total, 287 resuscitation attempts in TCA were included and 279 specific interventions were identified: 262 fluid expansions, 41 pelvic stabilizations, five tourniquets, and 175 bilateral thoracostomies (including 44 with TPx).

Conclusion:

Among the standard resuscitation measures to treat the reversible causes of cardiac arrest, this study found that bilateral thoracostomy and tourniquet application on a limb hemorrhage improve survival in TCA. A larger sample for pelvic stabilization is needed.

Keywords

Advanced Life Supportcardiac arresttrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 37 , Issue 1 , February 2022 , pp. 51 - 56
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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