title: Blunt trauma patients with prehospital pulseless electrical activity (PEA): poor ending assured.
abstract: BACKGROUND
  The paucity of information on the outcome of patients experiencing prehospital pulseless electrical activity (PEA) after blunt injury led to the present study.
  
  
  METHODS
  A retrospective review was performed of all blunt trauma victims with prehospital PEA from 1997 to 2001 in an urban county trauma system.
  
  
  RESULTS
  One hundred ten patients, 78 men and 32 women, met study criteria. Seventy-nine patients had PEA at the scene, and 31 experienced PEA en route to a trauma center. All patients were transported in advanced life support ambulances. Cardiopulmonary resuscitation was initiated when PEA was detected. Vital signs were regained en route or at the trauma center by 25 patients (23%). The incidence of pupillary reactivity at the scene was higher in patients who regained vital signs (48% vs. 16%). Only one patient, who has significant residual neurologic impairment, survived. The mean Injury Severity Score of this population was 45.1.
  
  
  CONCLUSIONS
  If these grim results are corroborated by other investigators, consideration should be given to allowing paramedics to declare blunt trauma victims with PEA dead at the scene.
authors.affiliation: Department of Surgery, Stanford University School of Medicine and Santa Clara Medical Center, San Jose, California 95128, USA.
authors.forename: Sean K
authors.initials: SK
authors.lastname: Martin
authors.forename: Clayton H
authors.initials: CH
authors.lastname: Shatney
authors.forename: John P
authors.initials: JP
authors.lastname: Sherck
authors.forename: Che-Chuen
authors.initials: CC
authors.lastname: Ho
authors.forename: S Jean
authors.initials: SJ
authors.lastname: Homan
authors.forename: Janet
authors.initials: J
authors.lastname: Neff
authors.forename: Ernest E
authors.initials: EE
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011674:Pulse; D012189:Retrospective Studies; D014474:Unconsciousness; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000628:therapy*