Traumatic cardiac arrest ( TCA ) is a condition in which the heart has ceased to beat due to blunt or penetrating trauma , such as a stab wound to the thoracic area. It is a medical emergency which will always result in death without prompt advanced medical care. Even with prompt medical intervention, survival without neurological complications is rare. In recent years, protocols have been proposed to improve survival rate in patients with traumatic cardiac arrest, though the variable causes of this condition as well as many coexisting injuries can make these protocols difficult to standardize. Traumatic cardiac arrest is a complex form of cardiac arrest often derailing from advanced cardiac life support in the sense that the emergency team must first establish the cause of the traumatic arrest and reverse these effects, for example hypovolemia and haemorrhagic shock due to a penetrating injury.
23-605: [REDACTED] Look up tca in Wiktionary, the free dictionary. TCA may refer to: Chemistry and biochemistry [ edit ] Toxin complex a , an insecticidal toxin complex produced by Photorhabdus luminescens bacteria Tricarboxylic acid cycle , an alternate name for the citric acid cycle pathway in cellular metabolism Trichloroacetic acid , chemical used to precipitate protein in serum 2,4,6-Trichloroanisole , cause of cork taint in wine Tricyclic antidepressant ,
46-425: A class of medications TCA, a codon for the amino acid serine Culture and media [ edit ] Taiwanese Cultural Association Tekeyan Armenian Cultural Association , a network of Armenian cultural organisations Television Critics Association The Canadian Amateur , radio amateur magazine Tribune Content Agency , a syndication company owned by Tribune Publishing Triple Crown of Acting
69-553: A defunct Brazilian airline Politics [ edit ] Taiwan Constitution Association , a political party in Taiwan EU–UK Trade and Cooperation Agreement , between the UK and the EU (2020) The Competition Authority (Ireland) (2002–2014) Other uses [ edit ] Terminal control area , a volume of controlled airspace Topology change acknowledgement , a message in
92-431: A myth or that conditions including low temperatures, low lighting, abundance of blood, time on battlefield, presence of specific vegetation, presence of rain and humidity, and the time to organize medical evacuation would prevent the phenomenon from recurring in current conditions. P. luminescens ' genome has been sequenced . It contains a MACPF protein, however, this molecule appears non-lytic. It also contains
115-402: A proteic toxin through the expression of a single gene called makes caterpillars floppy (mcf). It also secretes enzymes which break down the body of the infected insect and bioconvert it into nutrients which can be used by both nematode and bacteria. In this way, both organisms gain enough nutrients to replicate (or reproduce in the case of the nematode) several times. The bacteria enter
138-502: A standardized manner due to differences in pre-hospital care and the wide variety of causes of traumatic cardiac arrest compared to medical cardiac arrest. Evolving algorithms are directed at quickly identifying incidences of cardiac arrest with a traumatic source and rapidly intervening to address reversible causes. Historically, traumatic cardiac arrest was thought to lead invariably to death. More recently, evolutions of advanced trauma life support guidelines and improved understanding of
161-601: Is bioluminescent ; however, the reason for this is not yet properly understood. It has been reported that infection by this bacterium of the wounds of soldiers in the American Civil War at the Battle of Shiloh caused the wounds to glow, and that this aided the survival of the soldiers due to the production of antibiotics by P. luminescens . This led to the phenomenon's nickname "Angel's Glow." There are no contemporary accounts of this phenomenon, meaning that it may be
184-456: Is a Gammaproteobacterium of the family Morganellaceae , and is a lethal pathogen of insects . It lives in the gut of an entomopathogenic nematode of the family Heterorhabditidae . When the nematode infects an insect, P. luminescens is released into the blood stream and rapidly kills the insect host (within 48 hours) by producing toxins, such as the high molecular weight insecticidal protein complex Tca. P. luminescens also produces
207-975: Is a term used in the American entertainment industry to describe actors who have won a competitive Academy Award, Emmy Award, and Tony Award in the acting categories Twentieth Century Animation , the animation division of 20th Century Studios Economics and finance [ edit ] Transaction cost analysis Total cost of acquisition True cost accounting Education [ edit ] The Classical Academy (Colorado) , Colorado Springs, US Trinity Christian Academy (Deltona, Florida) , US Trinity Christian Academy (Jackson, Tennessee) , US Organizations [ edit ] Taipei Computer Association The Consulting Association Total Community Action Trans-Canada Air Lines , predecessor to Air Canada Train Collectors Association Transportes Carga Aérea ,
230-433: The gcvB RNA gene which encodes a small non-coding RNA involved in the regulation of a number of amino acid transport systems as well as amino acid biosynthetic genes. A deletion of the hfq gene causes loss of secondary metabolite production. It is a source for bioluminescence imaging . Traumatic cardiac arrest Traumatic cardiac arrest can occur in patients following any severe blunt or penetrating injury to
253-520: The 802.1D Spanning Tree Protocol (STP) Transportation Corridor Agencies , a toll road authority in Orange County, California Traumatic cardiac arrest , due to trauma Tennant Creek Airport , IATA airport code "TCA" Turks and Caicos Islands , country code Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title TCA . If an internal link led you here, you may wish to change
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#1732844318743276-604: The cardiac function of pumping blood throughout the body, however cases where the heart is either unable to fill with blood or the total blood volume is depleted, this intervention may be ineffective. Additionally, as many of the interventions targeted at specific causes of arrest are centered around procedures performed around the patient's chest, head, and neck, compressions may interfere with definitive management. Current guidelines tailored to treatment of specific causes of traumatic cardiac arrest have improved outcomes for patients, however these guidelines may be difficult to apply in
299-588: The chambers of the heart are unable to fill with blood. Inability to maintain oxygenation in trauma patients may be a result of airway compromise due to mechanical injury or obstruction or due to loss of the respiratory drive from cervical spine or peripheral nerve injury . These conditions result in the hypoxia that may lead to cardiac arrest. Patients will present following a traumatic event most often with pulseless electrical activity (PEA). Patients will exhibit low blood pressure with pulses that cannot be palpated. Patients will progress into asystole if
322-433: The chest . Following the traumatic event, the heart ceases to pump blood through the body. Unlike medical cardiac arrest, there are several potentially reversible causes that may result in cardiac arrest in the setting of trauma. Clinicians will rapidly assess for these causes, and interventions will be directed to the specific cause. In both blunt and penetrating trauma, massive internal or external bleeding may decrease
345-407: The chest results in bleeding into the thoracic cavity. Similar to tension pneumothorax, increasing pressure prevents the return of blood from circulation to the heart. In the setting of trauma, cardiac tamponade results from an acute pericardial effusion , the accumulation of blood within the sac that surrounds the heart. As this sac is filled with fluid, the pressure on the heart is increased, and
368-436: The heart itself. As clinicians begin to intervene, they will simultaneously seek reversible causes of the arrest. Management begins by establishing multiple points of IV access and evaluating the patient's airway and breathing. Other interventions may include thoracostomy and thoracotomy , as well as treatment of the underlying cause of arrest. Basic life support is commonly initiated by bystanders and first responders, but
391-463: The link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=TCA&oldid=1224413231 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Toxin complex a Xenorhabdus luminescens Photorhabdus luminescens (previously called Xenorhabdus luminescens )
414-454: The nematode progeny as they develop. 3,5-Dihydroxy-4-isopropyl-trans-stilbene is produced by P. luminescens bacterial symbiont of the nematode Heterorhabditis megidis . Experiments with Galleria mellonella infected larvae supports the hypothesis that the compound has antibiotic properties that help minimize competition from other microorganisms and prevents the putrefaction of the nematode-infected insect cadaver. P. luminescens
437-497: The patient to receive blood transfusion if necessary. Other work-up involved in diagnosis of a trauma patient may include e-FAST , RUSH exam , CBC , pelvic X-ray, and CT of the head, neck, chest, abdomen, and pelvis. Treatment of traumatic cardiac arrest is guided by advanced trauma life support guidelines . Standard advanced cardiac life support guidelines are inappropriate for use in traumatic cardiac arrest, as they are directed primarily at treating pathology originating within
460-580: The role of basic life support in traumatic cardiac arrest is unclear. Basic life support is targeted to maintain oxygenation and circulation throughout the body, which can be lifesaving in cases of medical cardiac arrest, but does not address the frequent large volume blood loss encounters in many cases of traumatic cardiac arrest. Chest compressions are considered the most important initial intervention in cases of medical cardiac arrest, however studies evaluating their efficacy have excluded patients with traumatic cardiac arrest. Chest compressions work to replace
483-486: The underlying causes of traumatic cardiac arrest have improved outcomes for patients. Recent studies suggest that the survival rate for traumatic cardiac arrest is similar to that of all-cause cardiac arrest. There is wide variability in the estimated survival rate based on factors that include initiation of pre-hospital care and nature of injury. Many patients who survive traumatic cardiac arrest may develop long-term neurological damage resulting from lack of circulation to
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#1732844318743506-579: The underlying condition is not reversed. Other non-specific signs and symptoms associated with impending traumatic cardiac arrest may include sweating, altered mental status , rapid or slow breathing , and signs of trauma (bruising, laceration , fractures, etc.). Diagnosis of traumatic cardiac arrest is initially made with electrocardiogram with EMS or in the emergency department. Clinicians will also order diagnostic testing that may include chest x-ray , bedside ultrasound and echocardiogram , and blood gas levels. A type and cross will be ordered to match
529-406: The volume of blood is available to be pumped by the heart to the body. This is considered preload dependent arrest. Tension pneumothorax is caused when air is able to enter the space between the lung and the chest wall , but is not able to escape. The increasing pressure within the chest cavity prevents blood from returning from the body to fill the heart. Hemothorax occurs when injury to
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