title: Traumatic cardiac arrest in the emergency department - Overview upon primary causes.
abstract: BACKGROUND
  Trauma is the leading cause of death for patients aged less than 40 years. Trauma patients with cardiac arrest have low survival rates, the resuscitation being often considered futile and consumptive of medical and human resources.
  
  
  OBJECTIVE
  The aim of this study is to describe the main characteristics in cases of patients critically traumatized, who were admitted in our emergency department.
  
  
  RESULTS
  The study is based on a retrospective analysis of cases of major trauma admitted in an Emergency Department between 2004 and 2008. There were 201 cases of critically traumatized patients, who received cardiopulmonary resuscitation. The patients were aged between 16 and 79, mostly men (67.16%), with a range of ISS between 30 and 75. Regarding the type of mechanism that produced the injury we noted a predominance of blunt trauma (87,2% of cases) and hypovolemia as a direct cause that led to the cardiac arrest. The first monitored rhythm was non-shockable for over 90% of the cases. In our group, 4 patients were discharged alive (2% of all cardiac arrest cases). The mechanism of cardiac arrest for those 4 cases were hypoxia through massive facial trauma in one case and tension pneumothorax through severe thoracic trauma in three cases.
  
  
  CONCLUSIONS
  Given the low survival figures, all the efforts that could be achieved by an emergency team in the face of severe trauma had to be oriented towards the maintaining of the vital functions or, when needed, towards restoring life in order to enrich the operation theatre for the definitive care.
authors.affiliation: "Carol Davila" Clinical Nephrology Hospital, Bucharest.
authors.forename: V
authors.initials: V
authors.lastname: Georgescu
authors.affiliation: "Sf. Pantelimon" Emergency Hospital, Bucharest.
authors.forename: O
authors.initials: O
authors.lastname: Tudorache
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, "Carol Davila" Clinical Nephrology Hospital, Bucharest.
authors.forename: V
authors.initials: V
authors.lastname: Strambu
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000473:pathology; D055815:Young Adult
keywords: Cardiac arrest; ISS; blunt trauma; thoracic trauma