Resuscitative thoracotomy
Resuscitative thoracotomy | |
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Other names | Emergency department thoracotomy |
eMedicine | 82584 |
A resuscitative thoracotomy (sometimes referred to as an emergency department thoracotomy (EDT), trauma thoracotomy or, colloquially, as "cracking the chest") is a
Indications
A resuscitative thoracotomy is indicated when severe injuries within the thoracic cavity (such as
For resuscitative thoracotomy to be indicated, signs of life must also be present, including
The use of a focused assessment with sonography for trauma may be performed to determine the need of the procedure by finding free floating fluid in the thoracic cavity.[9]
Technique
A left anterolateral thoracotomy is the common method of opening the chest, as it provides rapid access, can be easily extended into the right hemithorax, and provides access to most of the important anatomical structures during resuscitation including the
Recovery
Usually those who undergo resuscitative thoracotomy do not recover—only 10% of those receiving it after sustaining a blunt injury, and 15–30% of those with penetrating trauma survive.[10][11][2]: 240 Patients with thoracic stab wounds and patients who arrive at the emergency department with signs of life are associatated with the highest rates of survival. Patients with polytrauma and patients who present without signs of life are associated with the lowest rates of survival.[12]
History
The procedure was first utilized during the late 1800s by Schiff in conjunction with open cardiac massage. Shortly after it was also used by Block to treat heart
References
- ^ November 27, 2012. Resuscitative Thoracotomy. San Diego: The Division of Trauma/Surgical Critical Care/Burns is part of the Department of Surgery, UC San Diego Health System.
- ^ ISBN 978-0-07-166351-9.
- ^ Eidt JF, Foreman ML. Bulger EM, Wolfson AB, Collins KA (eds.). "Resuscitative thoracotomy: Technique". www.uptodate.com. Retrieved 2023-07-16.
- PMID 33456957.
- PMID 30906584.
- ^ S2CID 240245430.
- PMID 16759407.
- ISBN 0-7817-2641-7.
- PMID 22560130.
- ^ PMID 16410079.
- ISBN 9781880696316.
- PMID 10703853.
- ^ Brohi K (6 June 2001). "Emergency Department Thoracotomy". Trauma.org. Retrieved January 1, 2013.