Chen YC, et al. - Researchers investigated the factors influencing the outcomes in traumatic cardiac arrest (TCA) patients without prehospital return of spontaneous circulation (ROSC). On conducting a retrospective cohort study using a multi-institutional, 5-year database, they noted an ROSC rate of 16% and a 30-day survival rate of 2% in 463 TCA patients without prehospital ROSC. Favorable ROSC were noted in association with an injury severity score < 16, trauma center admission, a shorter length of Emergency Department (ED) resuscitation, and total resuscitation length < 20 minutes. They identified a necessity for simple and accurate transport criteria for EMS to transport TCA patients to the trauma centers. They recommend settling a well-trained trauma team and organized algorithms for identification and management of reversible causes in order to achieve early and sustained ROSC.