« Back to All

Emergency Department, Resuscitative Thoracotomy

359 pageviews

FAST ultrasound examination as a predictor of outcomes after resuscitative thoracotomy: a prospective evaluation.
Inaba K, Chouliaras K, Zakaluzny S, Swadron S, Mailhot T, Seif D, Teixeira P, Sivrikoz E, Ives C, Barmparas G, Koronakis N, Demetriades D.
Ann Surg. 2015 Sep;262(3):512-8; discussion 516-8.

Rationale for inclusion: FAST ultrasound can help discriminate potential survivors of ED thoracotomy; Cardiac motion on FAST was 100% sensitive and 74% specific for survivors and organ donors.

Citations - 17 (as of July 2017)

An evidence-based approach to patient selection for emergency department thoracotomy: A practice management guideline from the Eastern Association for the Surgery of Trauma.
Seamon MJ, Haut ER, Van Arendonk K, Barbosa RR, Chiu WC, Dente CJ, Fox N, Jawa RS, Khwaja K, Lee JK, Magnotti LJ, Mayglothling JA, McDonald AA, Rowell S, To KB, Falck-Ytter Y, Rhee P.
J Trauma Acute Care Surg. 2015 Jul;79(1):159-73

Rationale for inclusion: EAST practice management guideline synthesizing 72 studies of ED thoracotomy. Not primary data but important synthesis of important information.

Citations - 39 (as of July 2017)

Defining the limits of resuscitative emergency department thoracotomy: a contemporary Western Trauma Association perspective.
Moore EE, Knudson MM, Burlew CC, Inaba K, Dicker RA, Biffl WL, Malhotra AK, Schreiber MA, Browder TD, Coimbra R, Gonzalez EA, Meredith JW, Livingston DH, Kaups KL; WTA Study Group.
J Trauma. 2011 Feb;70(2):334-9.

Rationale for inclusion: Resuscitative thoracotomy in the ED can be considered futile care when (a) prehospital CPR exceeds 10 minutes after blunt trauma without a response, (b) prehospital CPR exceeds 15 minutes after penetrating trauma without a response, and (c) asystole is the presenting rhythm and there is no pericardial tamponade.

Citations - 98 (as of July 2017)

Prehospital procedures before emergency department thoracotomy: "scoop and run" saves lives.
Seamon MJ, Fisher CA, Gaughan J, Lloyd M, Bradley KM, Santora TA, Pathak AS, Goldberg AJ.
J Trauma. 2007 Jul;63(1):113-20.

Rationale for inclusion: Prehospital procedures in penetrating trauma victims had a negative effect on survival, suggesting that "scoop and run" is superior.

Citations - 122 (as of July 2017)

Is emergency department resuscitative thoracotomy futile care for the critically injured patient requiring prehospital cardiopulmonary resuscitation?
Powell DW, Moore EE, Cothren CC, Ciesla DJ, Burch JM, Moore JB, Johnson JL.
J Am Coll Surg. 2004 Aug;199(2):211-5.

Rationale for inclusion: Review of 959 patients who underwent ED thoracotomy; suggests that EDT in patients with blunt trauma and CPR >5 min, and penetrating trauma with CPR >15 min is futile. Survival is possible for asystolic patients with tamponade.

Citations - 151 (as of July 2017)

Survival after emergency department thoracotomy: review of published data from the past 25 years.
Rhee PM, Acosta J, Bridgeman A, Wang D, Jordan M, Rich N.
J Am Coll Surg. 2000 Mar;190(3):288-98.

Rationale for inclusion: The best survival results are seen in patients who undergo emergency thoracotomy for thoracic stab injuries and who arrive with signs of life in the emergency department. All three factors-mechanism of injury, location of major injury and signs of life- should be taken into account when deciding whether to perform EDT. 

Citations - 278 (as of July 2017)

Emergency thoracotomy: survival correlates with physiologic status.
Lorenz HP, Steinmetz B, Lieberman J, Schecoter WP, Macho JR.
J Trauma. 1992 Jun;32(6):780-5; discussion 785-8.

Rationale for inclusion: Survival from emergency thoracotomy correlates with physiologic status in the field and upon arrival with no survival in patients who have no signs of life on prehospital assessment.

Citations - 115 (as of July 2017)

The role of thoracic aortic occlusion for massive hemoperitoneum.
Ledgerwood AM, Kazmers M, Lucas CE.
J Trauma. 1976 Aug;16(08):610-5.

Rationale for inclusion:  Historical article, describing aortic occlusion in the chest for hemoperitoneum.

Citations - 135 (as of July 2017)

« Back to All

Eastern Association for the Surgery of Trauma

633 N. Saint Clair Street, Suite 2400 Chicago, IL 60611-3295 (312) 202-5508 phone (312) 202-5064 fax managementoffice@east.org
Stay connected to EAST
Support EAST
  • AmazonSmiel