Martin Sean K, Shatney Clayton H, Sherck John P, Ho Che-Chuen, Homan S Jean, Neff Janet, Moore Ernest E
Department of Surgery, Stanford University School of Medicine and Santa Clara Medical Center, San Jose, California 95128, USA.
J Trauma. 2002 Nov;53(5):876-80; discussion 880-1. doi: 10.1097/00005373-200211000-00011.
The paucity of information on the outcome of patients experiencing prehospital pulseless electrical activity (PEA) after blunt injury led to the present study.
A retrospective review was performed of all blunt trauma victims with prehospital PEA from 1997 to 2001 in an urban county trauma system.
One hundred ten patients, 78 men and 32 women, met study criteria. Seventy-nine patients had PEA at the scene, and 31 experienced PEA en route to a trauma center. All patients were transported in advanced life support ambulances. Cardiopulmonary resuscitation was initiated when PEA was detected. Vital signs were regained en route or at the trauma center by 25 patients (23%). The incidence of pupillary reactivity at the scene was higher in patients who regained vital signs (48% vs. 16%). Only one patient, who has significant residual neurologic impairment, survived. The mean Injury Severity Score of this population was 45.1.
If these grim results are corroborated by other investigators, consideration should be given to allowing paramedics to declare blunt trauma victims with PEA dead at the scene.
钝性损伤后出现院外无脉电活动（PEA）患者的预后信息匮乏，由此开展了本研究。
对1997年至2001年在一个城市县创伤系统中所有有院外PEA的钝性创伤受害者进行回顾性研究。
110例患者符合研究标准，其中男性78例，女性32例。79例患者在现场出现PEA，31例在转运至创伤中心途中出现PEA。所有患者均由高级生命支持救护车转运。检测到PEA时即开始心肺复苏。25例患者（23%）在转运途中或创伤中心恢复了生命体征。恢复生命体征的患者现场瞳孔反应发生率更高（48%对16%）。仅1例患者存活，但有明显的神经功能残留障碍。该人群的平均损伤严重度评分为45.1。
如果其他研究者证实了这些严峻的结果，应考虑允许护理人员在现场宣布有PEA的钝性创伤受害者死亡。
