title: Cardiopulmonary resuscitation after traumatic cardiac arrest is not always futile.
abstract: BACKGROUND
  The use of guidelines regarding the termination or withholding of cardiopulmonary resuscitation (CPR) in traumatic cardiac arrest patients remains controversial. This study aimed to describe the outcomes for victims of penetrating and blunt trauma who received prehospital CPR.
  
  
  METHODS
  We conducted a retrospective review of a statewide major trauma registry using data from 2001 to 2004. Subjects suffered penetrating or blunt trauma, received CPR in the field by paramedics and were transported to hospital. Demographics, vital signs, injury severity, prehospital time, length of stay and mortality data were collected and analysed.
  
  
  RESULTS
  Eighty-nine patients met inclusion criteria. Eighty percent of these were blunt trauma victims, with a mortality rate of 97%, while penetrating trauma patients had a mortality rate of 89%. The overall mortality rate was 95%. Sixty-six percent of patients had a length of stay of less than 1 day. Four patients survived to discharge, of which two were penetrating and two were blunt injuries. Hypoxia and electrical injury were probable associated causes of two cardiac arrests seen in survivors of blunt injury.
  
  
  CONCLUSIONS
  While only a small number of penetrating and blunt trauma patients receiving CPR survived to discharge, this therapy is not always futile. Prehospital emergency personnel need to be aware of possible hypoxic and electrical causes for cardiac arrest appearing in combination with traumatic injuries.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.
authors.forename: Cameron D
authors.initials: CD
authors.lastname: Willis
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cameron
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Bernard
authors.forename: Mark
authors.initials: M
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D004638:Emergency Treatment; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014739:Victoria / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality*; D014950:Wounds, Penetrating / Q000150:complications / Q000401:mortality*