A retrospective analysis of a multicenter prospective registry included 462 adults with traumatic out-of-hospital cardiac arrest, excluding patients with a palpable pulse at EMS arrival. Patients were grouped by pupillary light reflex, spontaneous respiration, and cardiac electrical activity at the scene. Overall, 22 patients (4.8%) survived beyond the emergency department, while 318 (68.8%) had no signs of life at the scene. Survival beyond the emergency department was highest with cardiac activity plus spontaneous respiration (4/16; 25%), followed by cardiac activity alone (10/117; 8.5%).
Scene cardiac electrical activity, particularly with spontaneous respiration, was associated descriptively with greater survival beyond the emergency department. These findings do not establish long-term prognosis or a basis for resuscitation decisions.
Study limitation: Small descriptive subgroups and an endpoint limited to survival beyond the emergency department constrain prognostic interpretation.
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