Victorian State Trauma System

Major Trauma Guidelines & Education – Victorian State Trauma System

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Preventable early death in trauma is commonly due to haemorrhage, tension pneumothorax or airway obstruction. Priority should be given to managing these emergencies.

Endpoint to Resuscitation

Restoration of circulating volume sufficient to sustain spontaneous circulation may take several minutes depending on the equipment and access.
Termination of resuscitation efforts should be considered if there is:

  • No ROSC for 10 minutes after reversible causes have been addressed.
  • In PEA arrest, no detectable ultrasonographic cardiac activity.

If attempts at obtaining ROSC are unsuccessful the team leader should discuss stopping CPR with the team. The decision to stop should rely upon clinical judgement and careful assessment of the likelihood of achieving ROSC. ARV can assist with advice on making the decision to cease treatment.