Date Published

January 12, 2015

Updated For

ALS PCS Version ALS PCS Version 5.2


Question: My question falls under the category of Trauma Cardiac Arrests. Are we expected to check the pulse of a PEA patient, secondary to trauma, every two minutes? I believe we do as this follows heart and stroke and also verifies a PEA is in fact pulseless.

The BLS states to reassess pulse every 2 minutes under medical section 2-18, but trauma section 3-6, referring to trauma VSA, states to follow ALS patient care standards and protocols.

Our protocol does not state or outline the desired pulse assessment treatment during transport after the one analysis is performed. Thank you in advance.


 Excellent question.  In managing a Trauma VSA patient, you are correct, paramedics should follow the Trauma Cardiac Arrest Medical Directive.  If a TOR is not ordered by the BHP or not indicated by the Medical Directive, paramedics should transport to the most appropriate receiving hospital. Paramedics should only stop CPR during transport in this situation if signs of life are noted.  Checking the pulse every 2min or pulling over performing additional rhythm analyses en-route are not indicated.



Advanced Life Support (ALS), Pulseless Electrical Activity (PEA), Vital Signs Absent (VSA)

Additional Resources

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