Category Archives: Trauma Cardiac Arrest

Question: with regards to the Trauma Cardiac Arrest Medical Directive, do you support the placement of a pelvic binder on the patient assuming severe blunt trauma? I understand that under the Blunt/Penetrating Injury Standard in the BLS it is stated: "if the patient has a pelvic fracture, attempt to stabilize the clinically unstable pelvis with a circumferential sheet wrap or a commercial device". Furthering this thought, the Intravenous and Fluid Therapy Medical Directive found within the ALS PCS now states: "An intravenous fluid bolus may be considered for a patient who does not meet trauma TOR criteria, where it does not delay transport and should not be prioritized over management of other reversible causes." Thinking about this all together has me wondering that if a patient who is VSA secondary to severe trauma is eligible to receive an IV bolus to presumably treat hypovolemic shock, would the use of a pelvic binder be supported in the same way? If so, when would be the recommendation to apply a pelvic binder when treating under the Trauma Cardiac Arrest Medical Directive? Thank you.

Since COVID supraglottic airways are highly recommended to be placed in a VSA patient prior to CPR. Is this for medical VSAs or does this apply to traumatic as well?

Hi, I have a question in relation to the FTT standard. If I had a patient who was VSA on arrival due to a multi-system trauma (no penetrating injuries, only blunt), but does not qualify for trauma TOR because the closest ED is 10 minutes away but LTH is 20 minutes away... am I transporting to the ED or the LTH? I understand for penetrating injuries we are going to LTH if it's < 30 minutes, regardless of vital signs... but for other situations like the one I am stating, what is the appropriate action?

Is a suspected pelvic fracture a contraindication to IO in the tibia?

Question: If an 18 year old male hockey player was tackled and hit his face off the ice, has otorrhagea and and is VSA. First analysis shows asystole. Should he be treated under the trauma cardiac arrest directive or medical?

Question: My question falls under the category of Trauma Cardiac Arrests. Are we expected to check the pulse of a PEA patient, secondary to trauma, every two minutes? I believe we do as this follows heart and stroke and also verifies a PEA is in fact pulseless.

The BLS states to reassess pulse every 2 minutes under medical section 2-18, but trauma section 3-6, referring to trauma VSA, states to follow ALS patient care standards and protocols.

Our protocol does not state or outline the desired pulse assessment treatment during transport after the one analysis is performed. Thank you in advance.

Question: My question is regarding Traumatic TOR caused by penetrating injury. I have been informed that penetrating trauma TOR is only allowed if it involves the head or torso. Is this correct or is it anywhere on the body? Thanks.

Question: There is some debate in regards to chest compression's, monitor applied, analyze and then airway. What happens when the compression count is at thirty and the pads are still not applied? Does the paramedic at the chest check the oral cavity, get the airway, insert it, open the BVM bag, prepare the BVM and attempt 2 breaths or continue compression's until the other medic applies the pads and the analysis is complete?

Question: VSA trauma patients - chest compressions and defib is the priority for this patient. C-spine maintained manually. In this scenario, is it mandatory to apply a collar prior to a shock being delivered as the manual c-spine must be removed to deliver the shock?

CPAP- indication b/p 100 or above systolic. Contraindication is hypotension. If CPAP is applied while normotensive, can we leave the device on until they become hypotensive or we must remove when b/p drops below 100? Thanks.

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