In 5 years, 267 patients with cardiopulmonary arrest after trauma were treated at our institution. The long-term survival rate was 2.6%. Only 1.5% of the 267 patients were functional individuals. Overall, neither the mechanism of injury nor routine emergency thoracotomy influenced the salvage rate. Our results in the management of trauma victims without vital signs indicate that: 1) among blunt trauma patients, those with isolated head injury have the highest survival rate; 2) patients with blunt multisystem injuries involving the chest, abdomen, or truncal orthopedic structures are unsalvageable; 3) cardiopulmonary arrest with penetrating head or neck wounds is a lethal combination; and 4) with the exception of patients sustaining penetrating chest or heart injuries, emergency thoracotomy does not enhance the survival rate of trauma patients who were formerly declared 'dead on arrival.'