{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T23:12:25Z","timestamp":1784848345275,"version":"3.55.0"},"reference-count":27,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J R Army Med Corps"],"accepted":{"date-parts":[[2017,8,22]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The UK military was continuously engaged in armed conflict in Iraq and Afghanistan between 2003 and 2014, resulting in 629 UK fatalities. Traumatic cardiac arrest (TCA) is a precursor to traumatic death, but data on military outcomes are limited. In order to better inform military treatment protocols, the aim of this study was to define the epidemiology of TCA in the military population with a particular focus on survival rates and injury patterns.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective database analysis of the UK Joint Theatre Trauma Registry was undertaken. Patients who were transported to a UK deployed hospital between 2003 and 2014 and suffered TCA were included. Those patients injured by asphyxiation, electrocution, burns without other significant trauma and drowning were excluded. Data included mechanism of injury, Injury Severity Score (ISS), Abbreviated Injury Scale (AIS) for each body region and survival to deployed (Role 3) field hospital discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>424 TCA patients were identified during the study period; median age was 23 years, with a median ISS of 45. The most common mechanism of injury was explosive (55.7%), followed by gunshot wound (38.9%), road traffic collision (3.5%), crush (1.7%) and fall (0.2%). 45 patients (10.6% (95% CI 8.0% to 13.9%)) survived to deployed (Role 3) hospital discharge. The most prevalent body region with a severe to maximum AIS injury was the head, followed by the lower limbs, thorax and abdomen. Haemorrhage secondary to abdominal and lower limb injury was associated with survival; traumatic brain injury was associated with death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study has shown that short-term survival from TCA in a military population is 10.6%. With appropriate and aggressive early management, although unlikely, survival is still potentially possible in military patients who suffer traumatic cardiac arrest.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jramc-2017-000818","type":"journal-article","created":{"date-parts":[[2017,10,7]],"date-time":"2017-10-07T20:10:12Z","timestamp":1507407012000},"page":"150-154","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["The outcome of patients in traumatic cardiac arrest presenting to deployed military medical treatment facilities: data from the UK Joint Theatre Trauma Registry"],"prefix":"10.1136","volume":"164","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5187-1952","authenticated-orcid":false,"given":"Ed B G","family":"Barnard","sequence":"first","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK"},{"name":"Department of Seconded Medical Officers, Institute of Naval Medicine, Gosport, Hampshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P A F","family":"Hunt","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK"},{"name":"Emergency Department, James Cook University Hospital, Middlesbrough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P E H","family":"Lewis","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK"},{"name":"Emergency Department, Frimley Park Hospital, Frimley, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Smith","sequence":"additional","affiliation":[{"name":"Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research & Academia), Birmingham, UK"},{"name":"Emergency Department, Derriford Hospital, Plymouth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,6]]},"reference":[{"key":"2025081312594620000_164.3.150.1","unstructured":"Iraq coalition casualty count. http:\/\/www.icasualties.org (accessed May 2017)."},{"key":"2025081312594620000_164.3.150.2","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2013-000215"},{"key":"2025081312594620000_164.3.150.3","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-2015-000490"},{"key":"2025081312594620000_164.3.150.4","unstructured":"The Care Quality Commission. Defence medical services: a review of compliance with the essential standards of quality and safety. http:\/\/www.cqc.org.uk\/sites\/default\/files\/documents\/20120621_dms_report_full_final.pdf (accessed May 2017)."},{"key":"2025081312594620000_164.3.150.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/TA.0000000000000580","article-title":"Improved survival in UK combat casualties from Iraq and Afghanistan: 2003-2012","volume":"78","author":"Penn-Barwell","year":"2015","journal-title":"J Trauma Acute Care Surg"},{"key":"2025081312594620000_164.3.150.6","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2010.0232"},{"key":"2025081312594620000_164.3.150.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2011.04.018"},{"key":"2025081312594620000_164.3.150.8","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.resuscitation.2016.11.001","article-title":"Epidemiology and aetiology of traumatic cardiac arrest in England and Wales-a retrospective database analysis","volume":"110","author":"Barnard","year":"2017","journal-title":"Resuscitation"},{"key":"2025081312594620000_164.3.150.9","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-198303000-00006"},{"key":"2025081312594620000_164.3.150.10","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.7.742"},{"key":"2025081312594620000_164.3.150.11","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199309000-00022"},{"key":"2025081312594620000_164.3.150.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2006.03.015"},{"key":"2025081312594620000_164.3.150.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2007.04.018"},{"key":"2025081312594620000_164.3.150.14","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31827d5d3c"},{"key":"2025081312594620000_164.3.150.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2012.12.003"},{"key":"2025081312594620000_164.3.150.16","doi-asserted-by":"publisher","DOI":"10.1177\/0141076814560837"},{"key":"2025081312594620000_164.3.150.17","unstructured":"Resuscitation Council UK. Consensus paper on out-of-hospital cardiac arrest in England. https:\/\/www.resus.org.uk\/EasySiteWeb\/GatewayLink.aspx?alId=845 (accessed May 2017)."},{"key":"2025081312594620000_164.3.150.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.08.015"},{"key":"2025081312594620000_164.3.150.19","doi-asserted-by":"crossref","first-page":"e1002349","DOI":"10.1371\/journal.pmed.1002349","article-title":"A comparison of selective aortic arch perfusion and resuscitative endovascular balloon occlusion of the aorta for the management of hemorrhage-induced traumatic cardiac arrest: a translational model in large swine","volume":"14","author":"Barnard","year":"2017","journal-title":"PLoS Med"},{"key":"2025081312594620000_164.3.150.20","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182569ebc"},{"key":"2025081312594620000_164.3.150.21","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0000000000000136"},{"key":"2025081312594620000_164.3.150.22","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.jss.2017.01.020","article-title":"Hemodynamic effects of the abdominal aortic and junctional tourniquet in a hemorrhagic swine model","volume":"212","author":"Rall","year":"2017","journal-title":"J Surg Res"},{"key":"2025081312594620000_164.3.150.23","doi-asserted-by":"crossref","first-page":"39","DOI":"10.55460\/X2LL-7JPS","article-title":"Conceptualized use of self-expanding foam to rescue special operators from abdominal exsanguination: percutaneous damage control for the forward deployed","volume":"15","author":"Rago","year":"2015","journal-title":"J Spec Oper Med"},{"key":"2025081312594620000_164.3.150.24","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(99)00233-1"},{"key":"2025081312594620000_164.3.150.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2015.07.017"},{"key":"2025081312594620000_164.3.150.26","doi-asserted-by":"publisher","DOI":"10.1186\/cc12504"},{"key":"2025081312594620000_164.3.150.27","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1016\/j.resuscitation.2017.01.004","article-title":"Reply to letter: mortality in traumatic cardiac arrest","volume":"113","author":"Barnard","year":"2017","journal-title":"Resuscitation"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2017-000818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T19:59:54Z","timestamp":1755115194000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2017-000818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,6]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2018,7,18]]},"published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1136\/jramc-2017-000818"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2017-000818","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,6]]}}}