Hello, some further clarity/confirmations on the trauma cardiac arrest algorithm is still needed for a rather large group of paramedic students. Note, some of the "greater/less than" symbols in your previous replies show up as papyrus-esque and cannot be deciphered. Please reply with words only in case that issue repeats itself. 
-A patient with penetrating trauma to head/neck/torso in asystole (and no signs of life): if nearest LTH is greater than 30 min away, but nearest regular ED is 15 min away, we still patch for trauma TOR, right? Or do we transport to that nearest regular ED? 
-A patient with penetrating trauma to head/neck/torso in PEA: if nearest LTH is greater than 30 min away, but nearest regular ED is 15 min away, do we patch for trauma TOR (due to over 30 min transport time to LTH) or do we transport to that nearest regular ED that's 15 min away? 
-A patient with a blunt trauma and asystole (and no signs of life) automatically gets a patch for TOR, right? 
-A patient with blunt trauma in PEA would only get a patch for TOR if there was no hospital (regular ED or LTH) that was less than 30 minutes away? Ie. Only patch for TOR if either ED or LTH were both over 30 minutes away. 
 
Thanks! 

We are sorry that the symbols did not translate for you. 

1. A patient with penetrating trauma to the head/neck/torso with no signs of life, with LTH greater than 30 min away Patch for Trauma TOR (note that a trauma TOR may or may not be granted) 
2. A patient with penetrating trauma to the head/neck/torso in PEA, with LTH greater than 30 min, Transport to closest ED. Rationale: PEA is organized electrical activity on ECG and considered a sign of life in the Clinical Considerations for the Trauma Medial Cardiac Arrest. 
3. A patient with blunt trauma and asystole (and no other signs of life) will need to meet all other aspects of the Trauma TOR (be fully extricated, age criteria, no defib delivered) in order to meet the Trauma TOR criteria 
4. A patient with blunt trauma and PEA would qualify for TOR only if the other aspects of the Trauma TOR were met and the closest ED (including LTH) is 30 or more minutes away. 

We hope this clarifies the issue. 

Cardiac/Circulation,Symptomatic Bradycardia,Tachydysrhythmia

Pacemaker, Symptomatic bradycardia, Tachybrady syndrome, Tachydysrhythmia, Ventricular Tachycardia, VT, VTach

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