Trauma Cardiac Arrest Medical Directive

What are the conditions for a trauma TOR?

• 16+

• altered LOC

• no palpable pulses

• no defibrillation delivered

• rhythm asystole

• no signs of life at any time since full extricated OR

• signs of life when fully extricated with the closest ED 30+ min transport time away

• rhythm PEA with the closest ED 30+ transport time away

What are the contraindications for a trauma TOR?

• less than 16

• defibrillation delivered

• signs of life at any time since fully extricated

• rhythm PEA and closest ED 30+ min transport time away

• patients with penetrating trauma to the torso or head/neck and LTH less than 30 min away

True or false: an intravenous fluid bolus may be considered where it does not delay transport and should not be prioritized over management of other reversible pathologies.

true

What does the ALS PCS consider signs of life?

• specifically any spontaneous movement

• respiratory efforts

• organized electrical activity on ECG

• reactive pupils

What should be done if the patient is in asystole?

• assess if the patient has penetrating trauma to the torso, head, or neck

• determine how far away the LTH is

  • if more than 30 away, review TOR conditions

What should be done if the patient is in PEA?

What should be done if the patient is in VF/VT?

• defibrillate once

• then transport to nearest ED