Aidan Brown
Journal of Paramedic Practice, Vol. 10, Iss. 5, 04 May 2018, pp 194 - 198

Traumatic cardiac arrest (TCA) is a rare event in the pre-hospital setting and has
a varied aetiology. Paramedic management has changed significantly over the
past 5 years. Chest compressions have been de-emphasised in guidelines, and
the 'HOT' principles have been adopted. This principle stands for hypovolaemia;
oxygenation; tension pneumothorax/tamponade. The recommendation is that
these should be addressed prior to performing chest compressions. There may
however be patient groups in TCA who benefit from chest compressions. A
management plan including 'no chest compressions' for TCA is not supported
in the evidence, and they should be commenced as soon as appropriate
reversible causes have been addressed. In addition, chest compressions may
take precedence over the administration of fluid if both cannot be performed
simultaneously. Ambulance services may improve management of TCA by the
introduction of an aide-memoire to support clinicians.

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