PREHOSPITAL TRAUMATIC CARDIAC-ARREST - THE COST OF FUTILITY

Of 12,462 trauma patients cared for by prehospital services from Octob er 1, 1989 to March 31, 1991, 138 patients underwent CPR at the scene or during transport because of the absence of blood pressure, pulse, a nd respiration. Ninety-six (70%) suffered blunt trauma, 42 (30%) suffe red penetrating trauma. Sixty (43%) were transported by air utilizing county-wide transport protocols. None of the patients survived. Aggreg ate care cost $871,186.00. In 11 cases (8%), tissue for transplantatio n was procured (only corneas). Conclusion: Trauma patients who require CPR at the scene or in transport die. Infrequent organ procurement do es not seem to justify the cost (primarily borne by hospitals), consum ption of resources, and exposure of health care providers to occupatio nal health hazards. The wisdom of transporting trauma victims sufferin g cardiopulmonary arrest at the scene or during transport must be ques tioned. Allocation of resources to these patients is not an insular me dical issue, but a broad concern for our society, and society should d ecide if the ''cost of futility'' is excessive.