So this didnt happen to me, but a friend from work was telling me about this run they went on the other day. Mid-30s Male was struck by a vehicle going 40+ in a residential area. When they got on scene there was already a large crowd gathered and police on scene. They get to the patient and he has severe head, facial and chest trauma and deformity amongst other things. CPR had been administered prior to arrival, pulse had returned and then after another check had stopped so CPR was re-initiated. The PT is severely bleeding and with every compression blood is coming out of his mouth. Additional help is coming hot but they are about 15mins away. There arent enough trained hands on scene to move the patient so everything is being done on scene. Once the second crew arrives the PT is moved to the ALS rig and transported to the hospital. He is pronounced DOA at the hospital. I am not exactly sure what the protocol in my friends area is, but if I was on scene I would have contacted med control and seen if they wanted me to call on scene or continue. What Do you think? Should the PT have been called on scene or did my friend do the right thing?
Traumatic Arrest stop CPR?
- Thread starter sneauxpod
- Start date
- 5,018
- 1,356
- 113
Just from the details there, I wouldn't have even had to call med control to call that patient. He would not have been transported.
- 2,140
- 84
- 48
If you aren't going to load and go with this pt there is no need to ever start. Why couldnt the initial crew load and go? The only things that we can do for these pts are A. Call it or B. Get them to surgery ASAP. Acls will do nothing for this pt.
Was the pt in arrest one ems arrival or arrest in their presence? How far from a trauma center were they?
Blunt trauma arrest = injuries incompatible with life.
I would have called it there...no olmc needed.
If it was witnessed I have the option of load and go or bls code for 5 rounds and if no rosc call it. If we are less than 15 to trauma center.
Last edited by a moderator:
He was in arrest on arrival, but there was a confirmed pulse by 2 police officers a minute or two prior to arrival so im guessing either it stopped again or the officers are total idiots. so i guess technically it was witnessed.
Im pretty sure the only als they did was dropped an ET in him. besides that it was all bls. and they were about 15 from lv 1 trauma, im not sure as to why they didnt just load and go though. but im with you, I would have just called on scene.
NYMedic828
Forum Deputy Chief
- 2,094
- 3
- 36
exsanguinating blood loss is incompatible with life.
His injuries are incompatible with life.
His lack of a pulse is incompatible with life.
DOA.
His injuries are incompatible with life.
His lack of a pulse is incompatible with life.
DOA.
TransportJockey
Forum Chief
- 8,623
- 1,675
- 113
Would have called it on scene. Blunt trauma arrests are statistically a crap shoot.
NYMedic828
Forum Deputy Chief
- 2,094
- 3
- 36
all trauma arrests are arguably a crapshoot.
TransportJockey
Forum Chief
- 8,623
- 1,675
- 113
Penetrating has a slightly higher percentage of saves, but yes, it's pretty much a crapshoot all around
I don't know how fair that is, though. Police aren't paramedics. I don't know all the laws, and how to do their jobs, and I don't expect them to know how to do mine. This is more of an evolving attitude over the years from seeing good people do the best they know how to do. Hell, there are EMTs that I don't trust to do a decent assessment. When someone non-medical says the patient had a pulse after something like this, I take it with a grain of salt, and realize they probably didn't.
To be fair though, there are a small percentage that have reversible causes (tension pneumothorax, pericardial tamponade) and at least deserve a decent assessment, rather than walking up and saying "Oh, he's a trauma arrest? He's dead. See ya.", like some of my co-workers are known to do.
Im not expecting them to do my job, as far as I am concerned, if you are a police officer, you have gone through a first aid class at some point in your career, or at least have figured out over the course of your life what a pulse is, a few places you can get one, and what it feels like. that really isnt asking too much of anyone. And quite frankly, I think it should be a requirement to get a CPR card in High School. whether or not you keep it up afterwards is your choice. just my opinion though.
- 5,018
- 1,356
- 113
I seem to remember seeing an article about different types of providers and their ability- or rather inability- to distinguish between having a pulse and not. I believe it showed EMTs, paramedics, nurses, and lay people. The results, if I recall correctly, weren't that outstanding for any group. I'll see of I can find the article later, I failed to find it while on my phone.
Regardless, if you have an excited police officer with little to no medical training looking for a pulse, I could see it going either way. Either he can't find one due to looking in the wrong area, or feels his own pulse and mistakes it for the patients.
Regardless, if you have an excited police officer with little to no medical training looking for a pulse, I could see it going either way. Either he can't find one due to looking in the wrong area, or feels his own pulse and mistakes it for the patients.
I could buy if one did that, but for both to say they felt a pulse and be wrong seems to lean towards the realm of unlikelihood I think at least. I would actually like to read that article if you can find it though, because personally, the only pulse ive ever really had a hard time with is pedal pulses only because I never really got a chance to do them during school or working.
- 5,018
- 1,356
- 113
Power of suggestion? I find it very likely if neither know what they're doing. Not fighting with you, more just playing devils advocate.
I'm at a mass cas exercise today, but I'll certainly look for it when I get home
Power of suggestion? I find it very likely if neither know what they're doing. Not fighting with you, more just playing devils advocate.
I'm at a mass cas exercise today, but I'll certainly look for it when I get home
Oh no didnt take it like that at all lol. I play DA all the time so I can kind of sense when someone else does it haha.
Sounds pretty interesting, let us know how that goes.
Anjel
Forum Angel
- 4,548
- 302
- 83
Nothing to do with protocol or anything. But the medics I work with would of taken that to the ER or pronouncement.
We don't work in a great area, and mist people don't think twice about pulling a gun, so when we have a huge crowd like that, we will transport, just to save the drama of leaving a dead person on the street.
We don't work in a great area, and mist people don't think twice about pulling a gun, so when we have a huge crowd like that, we will transport, just to save the drama of leaving a dead person on the street.
Bullets
Forum Knucklehead
- 1,600
- 222
- 63
DOA, dont waste the time doing any work.
Any chance one cop felt for a pulse while the other was doing compressions? Blunt trauma with a the visible deformities you describe are all reasons to not even start
Any chance one cop felt for a pulse while the other was doing compressions? Blunt trauma with a the visible deformities you describe are all reasons to not even start
Mad Russian
Forum Ride Along
- 7
- 0
- 0
Overall survival rate in traumatic arrest is 3% these people generally stay dead, I would have presumed him on scene.
That is somewhat of a misleading number.
When you break it down into penetrating arrest, the local variance is between 6-8% usually.
The blunt arrest is <1%
to call it an overall 3% I think is an oversimplification of a more complex statistic that does not reflect reality.