Title: ED Thoracotomy

Posted: 8/9/2011 by Mike Winters, MBA, MD

When may an ED thoracotomy be futile?

Performing an ED thoracotomy is incredibly stressful and a resource-intense procedure.
While we've all learned that stab wounds to a ventricle have the highest survival rate, what about indicators that an ED thoracotomy may be futile?
A recent study of 18 trauma centers across the US found that ED thoracotomy was unlikely to yield productive survival in the following:
- Blunt trauma patients that require > 10 min of prehospital CPR without response
- Penetrating trauma patients that require > 15 min of prehospital CPR without response
- Patients presenting in asystole without evidence of pericardial tamponade on bedside ultrasound.

References

Moore EE, Knudson M, Burlew CC, Inaba K, et al. Defining the limits of resuscitative emergency department thoracotomy: a contemporary Western Trauma Association perspective. J Trauma 2011;70:334-9.