Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study
Objectives: The management of traumatic cardiac arrest (TCA) focuses on the immediate treatment of reversible causes, including bilateral thoracostomy. In our prehospital emergency service, bilateral thoracostomy has been recommended since 2012 for the management of TCA. We sought to analyse the pre...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
|
| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425000074 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589981467541504 |
|---|---|
| author | Nicolas Beysard Tara Agudo Peter Serfozo Tobias Zingg Perrine Truong Roland Albrecht Vincent Darioli Mathieu Pasquier |
| author_facet | Nicolas Beysard Tara Agudo Peter Serfozo Tobias Zingg Perrine Truong Roland Albrecht Vincent Darioli Mathieu Pasquier |
| author_sort | Nicolas Beysard |
| collection | DOAJ |
| description | Objectives: The management of traumatic cardiac arrest (TCA) focuses on the immediate treatment of reversible causes, including bilateral thoracostomy. In our prehospital emergency service, bilateral thoracostomy has been recommended since 2012 for the management of TCA. We sought to analyse the prehospital management and clinical course of patients with TCA, focusing on changes over time in the use of thoracostomy. Methods: In this single-centre retrospective observational study, we included patients with TCA managed by physicians of the prehospital service of Lausanne University Hospital from 2012 to 2024. The primary outcome was the annual rate of bilateral thoracostomy. Secondary outcomes included the rate of additional on-site measures, such as pelvic binder placement and airway management, and follow-up at 48 h. Results: Among 3206 cardiac arrests during the study period, 473 (15%) were TCAs. Among the 247 patients with resuscitation attempts, thoracostomy was judged as indicated in 223 (90%) and performed in 148 (66%). Twenty-seven (18%) patients who had a thoracostomy were alive on arrival at hospital, with 9 (6.1%) still alive at 48 h. The mean annual proportion of patients in whom a thoracostomy was performed was 68% (range 0–100%) and increased significantly over the years (p < 0.001). Conclusions: The annual rate of thoracostomy in TCA patients increased significantly in the period 2012 to 2024. Larger studies are required to determine the impact of thoracostomy on survival. |
| format | Article |
| id | doaj-art-6c9f72b4abe84cdb978b7cfd0c36701f |
| institution | Kabale University |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-6c9f72b4abe84cdb978b7cfd0c36701f2025-01-24T04:45:45ZengElsevierResuscitation Plus2666-52042025-03-0122100870Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective studyNicolas Beysard0Tara Agudo1Peter Serfozo2Tobias Zingg3Perrine Truong4Roland Albrecht5Vincent Darioli6Mathieu Pasquier7Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland; Corresponding author at: Department of Emergency Medicine, Lausanne University Hospital and University of Lausanne, rue du Bugnon 46, 1011 Lausanne, Switzerland.Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, SwitzerlandDepartment of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandFaculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland; Department of Visceral Surgery, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandSwiss Air-Rescue (Rega), Zurich, SwitzerlandDepartment of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Emergency Medicine, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Rue du Bugnon 21, 1011 Lausanne, SwitzerlandObjectives: The management of traumatic cardiac arrest (TCA) focuses on the immediate treatment of reversible causes, including bilateral thoracostomy. In our prehospital emergency service, bilateral thoracostomy has been recommended since 2012 for the management of TCA. We sought to analyse the prehospital management and clinical course of patients with TCA, focusing on changes over time in the use of thoracostomy. Methods: In this single-centre retrospective observational study, we included patients with TCA managed by physicians of the prehospital service of Lausanne University Hospital from 2012 to 2024. The primary outcome was the annual rate of bilateral thoracostomy. Secondary outcomes included the rate of additional on-site measures, such as pelvic binder placement and airway management, and follow-up at 48 h. Results: Among 3206 cardiac arrests during the study period, 473 (15%) were TCAs. Among the 247 patients with resuscitation attempts, thoracostomy was judged as indicated in 223 (90%) and performed in 148 (66%). Twenty-seven (18%) patients who had a thoracostomy were alive on arrival at hospital, with 9 (6.1%) still alive at 48 h. The mean annual proportion of patients in whom a thoracostomy was performed was 68% (range 0–100%) and increased significantly over the years (p < 0.001). Conclusions: The annual rate of thoracostomy in TCA patients increased significantly in the period 2012 to 2024. Larger studies are required to determine the impact of thoracostomy on survival.http://www.sciencedirect.com/science/article/pii/S2666520425000074Traumatic cardiac arrestThoracostomyPrehospitalAdherenceGuidelines |
| spellingShingle | Nicolas Beysard Tara Agudo Peter Serfozo Tobias Zingg Perrine Truong Roland Albrecht Vincent Darioli Mathieu Pasquier Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study Resuscitation Plus Traumatic cardiac arrest Thoracostomy Prehospital Adherence Guidelines |
| title | Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study |
| title_full | Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study |
| title_fullStr | Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study |
| title_full_unstemmed | Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study |
| title_short | Adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest: A retrospective study |
| title_sort | adherence to prehospital thoracostomy practice guidelines for traumatic cardiac arrest a retrospective study |
| topic | Traumatic cardiac arrest Thoracostomy Prehospital Adherence Guidelines |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425000074 |
| work_keys_str_mv | AT nicolasbeysard adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT taraagudo adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT peterserfozo adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT tobiaszingg adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT perrinetruong adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT rolandalbrecht adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT vincentdarioli adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy AT mathieupasquier adherencetoprehospitalthoracostomypracticeguidelinesfortraumaticcardiacarrestaretrospectivestudy |