Abstract 205: Termination of Resuscitation Rules for Traumatic Cardiopulmonary Arrest: Old Dogma, New Validation

• DOI: 10.1161/circ.128.suppl_22.a205
• Publication Date: 2024-04-23T10:56:54Z
• Authors: Yu-Sheng Huang; Wen-Chu Chiang; Patrick Chow-In Ko; Sot Shih-Hung Liu; Chien-Hao Lin; Kah-Meng Chong; Ming-Tai Cheng; Hui-Chih Wang; Chih-Wei Yang; Shey-Ying Chen; Bin-Chou Lee; Matthew Huei-Ming Ma

Introduction: Pre-hospital terminations of resuscitation (TOR) rules for traumatic cardiopulmonary arrest (TCPA) have been proposed by the National Association Emergency Medical Physicians (NAEMSP) and American College Surgeons Committee on Trauma (ACSCOT) a decade. However, validation studies from United Kingdom Australia produced conflicting results. This study aimed to evaluate performance TOR TCPA in an Asian metropolitan area. Methods: We analyzed data Utstein registry system adult patients with Taipei test first guiding criteria TCPA: blunt trauma patient found asystole upon arrival emergency medical service (EMS) at scene. Predictive outcome was in-hospital death. Test statistics including sensitivity, specificity, positive predictive value (PPV), negative values (NPV), decreased transport rate (DTR) were calculated. Results: From Jan 1, 2008 Dec 31, 2009, there 328 TCPA. The mechanism 155 (47.3%), penetrating 106 (32.3%) uncertain (32.3%), mechanisms 67 (20.4%). presenting rhythm 54/155 (34.8%) trauma, 57/107(53.3%) 28/67 (41.8%) mechanism. Overall survival (to hospital discharge) 11/328 (3.4%). For those only 4 survived discharge (2.6%). (i.e. asystole) sensitivity analysis categorizing as presented Table. Conclusion: Application rule thumb NAEMSP ACSCOT can accurately identify non-survivors (100% PPV 100% specificity) decrease unnecessary EMS transports (16.5%~25.0%) Metropolitan