open skull fracture with exposed brain matter
Review the history of the event carefully. It is sometimes difficult to determine if a medical event preceded the trauma or if the severe trauma resulted in the arrest.
With signs of major trauma and absence/loss of pulse and respiration [either after your Initial Assessment and Rapid Trauma Survey or during transport], you are likely dealing with a non-survivable situation.
Contact CliniCall for likely discontinue orders.
With lower force trauma, consider medical diagnosis for the event.
This is a special situation where there may be a surgically correctable bleeding site if direct control is quickly possible.
If you are within 15 minutes anticipated time from loss of pulse/respiration to the Emergency Department then rapid transport and notification is indicated.
If time delay is greater than 15 minutes contact CliniCall for likely discontinue orders.
Though a difficult decision, in both cases if you are unable to reach CliniCall and you are greater than 15 minutes to the Emergency Department you should discontinue resuscitation.
CliniCall 1-833-829-4099 or 604 829-4099
Hypothermia and electric injury/lightning strike are special situations. Refer to the relevant Treatment Guidelines sections.