I guess the major difference is with Trauma you need a trauma center but any hospital can work a non traumatic code?
There are a couple of factors that come into play.
Trauma centers are generally in urban areas, where volume wise, there is more trauma with a very short transport time.
Another factor that comes into play is the surgery/ICU avaliability. Most trauma does not require surgery, but high acuity requires a $hitload of resources and experience quickly.
Perhaps the most major aspect is that medical arrests usually originate from one system. So if you can bring that system back to a compensatory level of function, you are likely to get a save. (like reversing v-fib in acute MI)
In trauma, every system in the body is affected with multiple organs and systems suddenly decompensating.
Most outside of critical medicine/surgery, are never taught that death from shock occurs in 2 phases. 1. failure of o2 delivery 2.inflammatory response.
Even most emergency rooms only deal with oxygen delivery. So just like the MI example, one pathology involved is much easier to deal with.
Restoring delivery of oxygen may require immediate surgery, many ERs are not equipped for it nor providers prepared to do it.
While many EMs will argue that they can open a chest and certainly I do not dispute that, how many actually do?
How many are prepared/willing to open another part of the body like the abdomen, shoulder, skull, or neck to correct vascular trauma?
How many will create a temporary graft or shunt?
Even when you get this O2 delivery fixed, the subsequent inflammatory response is very difficult to manage and the patient will likely die in the ICU. In a very scripted and predictable way. After a few observations, you can actually see the pattern.
Critical trauma is a game where the board it already set against you. It is like starting a chess game where you don't get many of your good pieces and are already in check. Trauma arrests are even worse.
