Outcomes of cardiopulmonary resuscitation in trauma patients in the Emergency Department

Abstract

OBJECTIVE: We aimed to determine our performance and factors effecting outcomes in cardiopulmonary resuscitation (CPR) for the patients with trauma in the Emergency Department (ED). PATIENTS AND METHODS: In a period of 5 years, file data of 136 consequtive adult trauma patients who have required CPR in our ED were collected, retrospectively. Patients were divided into subgroups according to years, mechanism of trauma, hour of the trauma, location of cardiac arrest, the period of the CPR, the rhythm during the onset of arrest, atropine use and ED specialist accompaniment. Patients were also divided into two subgroups as those who died in the ED and those who survived. RESULTS: The leading cause of trauma was motor vehicle accidents. The period between arrest and CPR was 0-5 minutes in 92 patients. Of these 92 patients 12 have survived and as the time prolonges, number of survivors tended to decrease. The most common rhythm determined shortly before cardiac arrest was asystole. When all patients with trauma requiring CPR were considered, overall rate of survival was found to be 9.5%. When an ED specialist accompanied, survival rate increased. According to the rates of survival, atropine was found to be useless. CONCLUSIONS: Our results revealed that, when performed in the leadership of an ED specialist, more successful outcomes may be obtained in CPR in trauma patients. We also determined that use of atropine does not contribute to survival rate. As CPR prolonges, the success rate falls.