Category: Trauma Cardiac Arrest

Trauma TOR and ROSC

Question #: 430


1. With a trauma VSA , ROSC is not a contraindication so does that mean you can TOR someone if they ROSC and rearrest during the call and meet all indications for a TOR at that point?


Please note that in the Trauma Cardiac Arrest Medical Directive does not indicate ROSC as a contraindication to TOR. Rather, it specifies “no palpable pulses AND no defibrillation delivered AND monitored HR = 0 OR monitored HR > 0 with the closest ED ≥ 30 min transport time away” in the indications and “monitored HR > 0 and closest ED 30 min transport time away” in the contraindications.
The terminology “no palpable pulses” implies that for you to consider TOR within the Trauma Cardiac Arrest Medical Directive, the patient must be in cardiac arrest, regardless if you had a ROSC during the call.
Please note that chances of ROSC during a Trauma Cardiac Arrest are slim. Although slim, if you do get a ROSC, you can consider the duration of ROSC as an important point to discuss with the Base Hospital Physician while establishing the best management plan tailored for your patient during the patch.

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