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Article Dans Une Revue Prehospital and Disaster Medicine Année : 2022

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

Résumé

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.
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Dates et versions

hal-03512029 , version 1 (05-01-2022)

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Citer

Dominique Savary, François Morin, Delphine Douillet, Adrien Drouet, Francois Xavier Ageron, et al.. Impact of Specific Emergency Measures on Survival in Out-of-Hospital Traumatic Cardiac Arrest. Prehospital and Disaster Medicine, 2022, 37 (1), pp.51-56. ⟨10.1017/S1049023X21001308⟩. ⟨hal-03512029⟩
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