Pulseless Arrest After Rapid Sequence Intubation of the Massively Hemorrhaged Warfighter: A Case Series

Description

Pulseless Arrest After Rapid Sequence Intubation of the Massively Hemorrhaged Warfighter: A Case Series
Schwarzkoph BW, Emerling AD, Iteen A, Deaton TG, Auten JD, Bianchi WD 22(1). 104
Publication Type: Case Reports (Case Reports)

Abstract:
Management of hemorrhagic shock and airway stabilization are two pillars of trauma resuscitation which have a dependent, yet incompletely understood relationship. Patients presenting with traumatic hemorrhage may manifest shock physiology prior to intubation, conferring a higher risk of postintubation hypotension, pulseless arrest, and mortality. This case series describes of a group of seven US military members with combat-related trauma who experienced pulseless arrest after rapid sequence intubation in a role 2 or role 3 setting. All except one of the patients had hemodynamics suggesting hemorrhagic shock prior to intubation. This case series highlights the need for further research to define which trauma patients are at risk of postintubation pulseless arrest. It also focuses on the knowledge gap related to the role that delayed airway management and judicious blood product resuscitation may play in preventable death after injury.

Keywords: pulseless arrest; traumatic arrest; rapid sequence intubation; transfusion; TCCC
PMID: 35278324

DOI: 10.55460/ANSR-FR0P