Traumatic cardiac arrest

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Traumatic cardiac arrest
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Unconsciousness, apnea, pulselessness
Complications	Death, hypoxic brain injury
Onset	Trauma
Duration	Variable
Types	N/A
Causes	Blunt trauma, penetrating trauma, blast injury
Risks	Severe hemorrhage, tension pneumothorax, cardiac tamponade
Diagnosis	Clinical assessment, ultrasound, ECG
Differential diagnosis	Medical cardiac arrest, pulmonary embolism, myocardial infarction
Prevention	N/A
Treatment	Advanced trauma life support, surgical intervention, resuscitation
Medication	N/A
Prognosis	Poor, depends on cause and response to treatment
Frequency	Unknown, varies by region and trauma incidence
Deaths	N/A

Pulseless electrical activity EKG

EKG showing asystole

Echocardiogram showing four chambers of the heart

Traumatic cardiac arrest is a condition where the heart stops beating due to a severe physical injury. This type of cardiac arrest is distinct from medical cardiac arrest, which is caused by medical conditions such as a heart attack. Traumatic cardiac arrest can result from various types of trauma, including blunt force, penetrating injuries, or a combination of both.

Causes

Traumatic cardiac arrest can be caused by:

• Blunt trauma: This includes injuries from car accidents, falls, or assaults that cause significant impact to the body.
• Penetrating trauma: Injuries such as stab wounds or gunshot wounds that penetrate the body and damage internal organs.
• Hypovolemia: Severe blood loss leading to insufficient blood volume to maintain circulation.
• Tension pneumothorax: Air trapped in the pleural space causing lung collapse and impaired venous return to the heart.
• Cardiac tamponade: Accumulation of fluid in the pericardial sac, compressing the heart and preventing it from filling properly.

Diagnosis

Diagnosis of traumatic cardiac arrest involves:

• Physical examination: Assessing for signs of life, such as movement, breathing, or pulse.
• Electrocardiogram (ECG):

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An ECG showing pulseless electrical activity

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An ECG showing asystole

• Echocardiography:

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An echocardiogram showing the four chambers of the heart

Treatment

The treatment of traumatic cardiac arrest focuses on addressing the underlying cause of the arrest. Key interventions include:

• Advanced trauma life support (ATLS) protocols.
• Chest compressions and cardiopulmonary resuscitation (CPR).
• Fluid resuscitation to restore blood volume.
• Decompression of tension pneumothorax using a needle or chest tube.
• Pericardiocentesis to relieve cardiac tamponade.
• Surgical intervention for repair of internal injuries.

Prognosis

The prognosis for traumatic cardiac arrest is generally poor, with survival rates significantly lower than those for medical cardiac arrest. However, rapid and appropriate intervention can improve outcomes in some cases.

See also

• Cardiac arrest
• Trauma surgery
• Emergency medicine