A comprehensive narrative review of traumatic cardiac arrest

Abstract

Background: Traumatic cardiac arrest (TCA) has historically been viewed as largely untreatable, with low survival rates and limited intervention strategies. Advances in understanding the pathophysiology of TCA, improvements in diagnostic and therapeutic technologies, and refinements in treatment protocols have shifted this perspective. This review focuses on the implications of these advancements for paramedics involved in emergency management and treatment strategies for TCA. Aim: To provide a comprehensive review of current insights into TCA management, with a particular emphasis on the roles of pharmacists and paramedics in improving patient outcomes through advanced emergency care. Methods: This narrative review synthesizes recent literature on TCA management, including epidemiology, etiology, treatment strategies, and outcomes. It highlights the contributions of pharmacists in medication management and paramedics in emergency response, using case studies and evidence-based practices. Results: Advances in diagnostic tools like point-of-care ultrasound (POCUS) and treatment protocols have improved outcomes for specific patient subgroups. The review identifies key challenges in TCA management, including distinguishing between true and pseudo-PEA and addressing reversible causes of arrest. Outcomes vary significantly, with survival rates and neurological recovery improving for certain subgroups. Conclusion: The review underscores the evolving role of pharmacists and paramedics in TCA management.