Traumatic Cardiac Arrest: Moving Beyond <1% Survival With Coordinated Prehospital Intervention

Traumatic cardiac arrest (TCA) has historically carried survival rates below 1%, reinforcing a belief that resuscitation is often futile. Emerging field data, however, challenges this narrative. This session examines coordinated prehospital strategies — hemorrhage control, whole blood resuscitation, high-performance CPR, and externally applied aortic compression — that have demonstrated return of spontaneous circulation (ROSC) and meaningful survival in both combat and civilian settings. Using insights from a Ukrainian case series in which six TCA patients received rapid, integrated intervention and achieved 100% ROSC, this session outlines reproducible, mechanism-driven practices that EMS teams can adopt. Comparative data on technologies such as the AAJT-S will be referenced to illustrate physiologic rationale and operational considerations (not endorsement). The presentation focuses on translating battlefield lessons into actionable EMS protocols applicable across diverse environments — from rural services to high-threat, urban, and tactical teams.