QUESTION AT THE BOTTOM
I am from Hong Kong and for injured patients who are treated by paramedics and need transport to hospital for treatment they have a trauma diversion guide. This is for patients with major trauma, designed to go direct to a trauma centre, instead of the nearest hospital.
The trauma diversion guide is as follows: If the patient is in cardiac arrest OR cannot maintain airway or breathing they are to go to the CLOSEST hospital regardless if it is a trauma centre or not.
If patient is not in cardiac arrest and can maintain airway or breathing, physiological and anatomical criteria will be applied to decide if they need to go to a trauma centre. If they fit ANY of the criteria below, they will be transported to a trauma centre.
- GCS < 14
- systolic BP < 90
- Respiratory rate < 10 or > 29 per minute
- Flail chest
- 2 or more long bone fractures
- amputation proximal to wrist or ankle
- penetrating trauma to head, neck or torso
- limb paralysis
- pelvic fracture
- combined trauma/burn (equal to or greater than 2nd degree or equal to or greater than 20%)
My question is, if the patient is in cardiac arrest why does the Hong Kong trauma diversion guide state that they need to go to the closest hospital? Wouldn't it be better for them to travel to a hospital in which a resuscitative thoracotomy can be performed?