Paramedic PapersHome Cardiac arrest Signs of life in traumatic OHCA
Cardiac arrest
Signs of life in traumatic OHCA
Signs of Life and Clinical Outcomes in Patients With Traumatic Out-of-Hospital Cardiac Arrest: A Nationwide Multicenter Observational Study
The Journal of Emergency Medicine · 2026-09-23 · Added 16 October 2026
Retrospective analysis of 462 adults with traumatic OHCA from a Japanese prospective registry found 4.8% survived beyond the ED, with the best survival where scene cardiac activity and spontaneous respiration coexisted (25%).
- Study type
- Registry
- Design
- Retrospective analysis of a prospective multicentre OHCA registry
- Participants
- 462 adults with traumatic OHCA, no pulse at EMS arrival
- Main finding
- 4.8% survived beyond the ED; 25% where cardiac activity and spontaneous respiration were both present at scene, 8.5% with cardiac activity alone, and none among the 318 patients (68.8%) with no signs of life
- Caveat
- Retrospective descriptive analysis with survival beyond the ED only — no discharge or neurological outcomes
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Scene prognostication in traumatic arrest is core paramedic decision-making everywhere, but this is a descriptive Japanese registry with survival beyond the ED as the endpoint rather than discharge or neurological outcome.
Learning goal
Strengthen my judgement on when signs of life at scene justify ongoing resuscitation in traumatic cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 16 October 2026
- Podcast: Paramedic Papers Daily, 16 October 2026
Related papers on Cardiac arrest
-
Every minute counts: early bystander CPR
A time-to-event analysis of the All-Japan Utstein registry found overall bystander CPR rates stayed stable through the pandemic, but initiation within 10 minutes slipped — and earlier starts sharply improved neurological outcomes (aOR 3.27 for 0–3 min vs >10 min).
-
Commotio cordis outcomes hinge on fast AED
A nationwide Japanese school-sports database reconstructed 30 sports-related OHCAs from external causes and found commotio cordis cases did dramatically better when AEDs were applied fast — 80% favourable neurological outcome — while other external causes fared poorly.
-
ROSC nomogram from a physician-led EMS
Chinese retrospective study of 9,386 non-traumatic OHCA cases built a ROSC prediction nomogram (AUC 0.775) from factors including shockable rhythm, intubation and — unique to physician-staffed systems — the attending physician's sex and seniority.
-
Dispatcher CPR and survival in shockable OHCA
Nationwide Hungarian cohort of 3,674 shockable OHCAs found dispatcher-assisted CPR ongoing at ambulance arrival was associated with far better outcomes than crew-initiated CPR — 30-day survival 54.6% vs 7.1% and one-year survival 45.8% vs 6.2%.