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Traumatic cardiac arrest is usually not primary cardiac event. Use Rapid Trauma Survey to identify cause of arrest. Intubate or surgical airway. Transport immediately. Monitor cardiac rhythm. Defibrillate v-fib.
Traumatic cardiac arrest is usually not primary cardiac event. Use Rapid Trauma Survey to identify cause of arrest. Intubate or surgical airway. Transport immediately. Monitor cardiac rhythm. Defibrillate v-fib.
Traumatic cardiac arrest is usually not primary cardiac event. Use Rapid Trauma Survey to identify cause of arrest. Intubate or surgical airway. Transport immediately. Monitor cardiac rhythm. Defibrillate v-fib.
Chapter XXI THE TRAUMA CARDIOPULMONARY ARREST trauma arrest 21-2 Overview Causes of cardiac arrest in trauma patients Management of cardiac arrest in trauma patients Compare and contrast management of traumatic arrest with Advanced Cardiac Life Support guidelines trauma arrest 21-3 Traumatic Cardiac Arrest Very high mortality Victims in asystole after massive blunt trauma can be pronounced dead in the field. Most trauma arrest victims Young and healthy Little underlying cardiac disease Traumatic cardiac arrest is usually not primary cardiac event. trauma arrest 21-4 Treatment Plan Management must be directed towards identifying and treating the cause of the arrest. trauma arrest 21-5 Treatment Plan Is the scene safe? Airway management with cervical spine control within <90 seconds Examination and treatment en route to the hospital Early notification of the receiving hospital Activation of the trauma team trauma arrest 21-6 BTLS Primary Survey Use the Initial Assessment to identify arrest. Establish airway. Place patient on backboard and transport immediately. Use Rapid Trauma Survey to identify correctable causes of arrest. trauma arrest 21-7 Causes of Traumatic Cardiac Arrest Airway Breathing Circulation trauma arrest 21-8 Airway Problems Obstruction by Foreign body Tongue Blood and vomitus Fractures Face, jaw, or larynx Patients arrest from hypoxia. trauma arrest 21-9 Breathing Problems Sucking chest wound Flail chest High spinal cord injury CNS depression Head injury Drugs/alcohol Tension pneumothorax All compromise ventilation. trauma arrest 21-10 Breathing Problems Smoke inhalation Carbon monoxide Aspiration Near drowning All impair exchange of oxygen. trauma arrest 21-11 Circulatory Problems Hemorrhagic shock Tension pneumothorax Pericardial tamponade Myocardial contusion Myocardial infarction Arrhythmia from electric shock or lightning strike trauma arrest 21-12 Management Use Rapid Trauma Survey to identify cause of arrest. Secure airway with cervical spine stabilization. Intubation or surgical airway. 100% oxygen. Transport immediately. Support ventilation. Monitor cardiac rhythm. Defibrillate V-Fib. Follow ACLS guidelines when other causes ruled out. trauma arrest 21-13 Management Assess neck veins and chest. Rule out tension pneumothorax. Needle decompression if present. Establish IV access. Rapid infusion of 2 liters of NS or RL if patient is hypovolemic. Control any bleeding. Rapid transport to a trauma center. trauma arrest 21-14 Important Points Trauma arrest patient qualifies for rapid extrication. During transport three rescuers needed to treat: #1 Ventilate. #2 Perform CPR. #3 Identify and treat the cause of the arrest. trauma arrest 21-15 Special Situations Trauma arrest in the pregnant patient or child is treated the same as other patients. Electric shock patients: Do not become a victim! Usually are in V-Fib. Respond to conventional ACLS. Remember to protect the cervical spine.
trauma arrest 21-16 Do not delay transport of the trauma arrest patient. All treatment after establishing the airway should be done during transport to the hospital. Do not rely on ACLS alone. Identify correctable causes. trauma arrest 21-17 Summary Have a Plan of Action. Remember the ABCs. Transport early. Identify treatable causes. Hypoxia Late hemorrhagic shock Cardiac tamponade Tension pneumothorax Open chest wound Notify receiving facility early. trauma arrest 21-18
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