Air medical transport for the trauma patient requiring cardiopulmonary resuscitation: A 10-year experience

Introduction: Air medical response and transport for the injured patient in cardiopulmonary arrest remain controversial. This study is a large, single-program experience. Methods: A retrospective chart review and descriptive study of all injured patients requiring cardiopulmonary resuscitation (CPR) immediately before or during air medical transport. The crew functioned under advanced cardiac life support/advanced trauma life support protocols. Setting: The patients, when transported, went to a variety of facilities, with the majority of patients transported to a level-I trauma center. The service area was primarily rural. Results: During 1985 to 1994, inclusive, there were 12,518 completed missions. A total of 320 injured patients required CPR (284 with blunt injury and 36 with penetrating injury), six of the 320 patients (1.9%) survived. Survivors and nonsurvivors did not differ significantly in age, mechanism of injury, time from initiation of CPR to arrival in the emergency department (ED), year of injury or initial cardiac rhythm. All survivors did, however, present to the ED in normal sinus rhythm with a palpable blood pressure. Conclusion: Air medical transport for the injured patient without signs of life following prehospital intervention appears futile.