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Traumatic cardiac arrest — DIPIMC MCQ

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HardPre-Hospital TraumaTraumatic cardiac arrestDIPIMCDipIMC

A pedestrian struck by a car is in cardiac arrest when your team arrives four minutes after the collision. There is an obvious flail segment, distended neck veins and a rigid abdomen. A colleague is delivering chest compressions and asks what the priority is. Which approach is most appropriate for this traumatic cardiac arrest?

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Correct answer: C — Address reversible causes with bilateral thoracostomies, haemorrhage control and volume

In traumatic cardiac arrest, survival depends on rapidly correcting reversible causes (the HOTT priorities: hypovolaemia, oxygenation, tension pneumothorax, tamponade) rather than the standard medical algorithm. Chest compressions are relatively ineffective in an empty circulation, and adrenaline has little role while the underlying cause is untreated. Defibrillation is rarely relevant because arrest is usually hypovolaemic with a non-shockable rhythm. Pearl: simultaneous bilateral thoracostomies, external haemorrhage control and rapid volume replacement take precedence.

Reference: Resuscitation Council UK Guidelines 2025 (Special Circumstances); JRCALC Clinical Guidelines