Field triage of the pulseless trauma patient

F. Battistell, W. Nugenent, J. Owings, J. Anderson

Research output: Contribution to journalArticlepeer-review


This study looked at trauma patients who had CPR performed at the scene, or en route to the ED or in the ED over a five-year period (1991-1996). There were equal numbers of blunt versus penetrating trauma victims. The data describe the number of patients pronounced dead on arrival and the survival rates of patients with ED thoracotomies and patients with continued resuscitation in the operating room. The survival rate of pulseless trauma patients in all cases was equally dismal. There were 212 patients with asystole at the scene of injury; 195 were pronounced dead upon arrival to the ED. The other 17 were taken to the OR and then pronounced after failed resuscitation. ED thoracotomies were performed on 195 of the patients. There were 134 patients with an initial heart rate of less than 40 beats per minute. None of the 134 patients survived; 76 had thoracotomies in the ED and 24 resuscitation attempts were made in the OR. Five patients survived long enough to be admitted to the ICU, but all 5 died within 48 hours. Despite our best efforts and advances in trauma medicine, trauma patients requiring CPR have a very poor prognosis. This study suggests current therapies to revive pulseless trauma patients are unsuccessful, and therefore these patients should be pronounced dead at the scene of injury. Protocols should be in place to allow prehospital personnel, in conjunction with a medical command physician, to pronounce pulseless trauma patients dead.

Original languageEnglish (US)
JournalJournal of Trauma Nursing
Issue number1
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Emergency
  • Critical Care
  • Advanced and Specialized Nursing


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