traumatic arrest algorithms

[Bjorn, Pret]

Micah and Stephen,

You're convincingly proving Oded's point. 

There is no predictable (much less proven) benefit in squishing the
heart as a treatment for trauma.  Period.  Organ procurement is entirely
irrelevant, and bystander morale is only relevant to the extent that the
circumstances are influenced more by pathos than physiology.

Sadly, the best place to answer this question, once and for all, is
probably on the battlefield.  One wonders if anyone in military medicine
would consider randomizing chest compressions to odd and even days so we
can put an end to myths such as this.



Endless sympathy, respect, and admiration to our veterans, who deserve
so much better than flags on their graves and a parade once a year.

Pret Bjorn, RN
Bangor, ME USA


-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Stephen hines
Sent: Sunday, November 12, 2006 6:55 AM
To: 'Trauma & Critical Care mailing list'
Subject: RE: traumatic arrest algorithms

What about organ harvesting?

Should this be a consideration in cardiac arrest where we know the
outcome
for the patient is unchangeable? 

Stephen.

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org]
On Behalf Of Micah Shaw
Sent: 11 November 2006 22:42
To: Trauma & Critical Care mailing list
Subject: Re: traumatic arrest algorithms

All

First, props for "oded private", your post "transfer to neurosurgical
center" sparked a lot of interesting debate.

As a "paraprofessional" in one of the most traumatic theaters, military
medicine, I can't speak for civilians, but I can speak for myself and my
colleagues.  I, and those that I work with, understand that prehospital
CPR
in traumatic arrest is worthless in the best case, and as you have
mentioned, possibly harmful in the sense of saving the patient.  

The only case that I can see CPR in traumatic arrest as accepted is for
morale purposes.  In a combat situation, Marines, Soldiers, and Sailors
need
to know that their medical coverage is doing all that they can.  The
"grunts" (with few exceptions) don't understand what a thoracotomy is,
let
alone how CPR can hinder.  In a situation where your men and women need
to
know you are doing all you can for them, and bullets, not chest
compressions
delay definitive treatment, a minute or two (keeping your own safety in
mind) of CPR can tell the Marines "doc is doing all he can for you,
fight
on".



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