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Related Experiment Videos

Emergency thoracotomy: survival correlates with physiologic status.

H P Lorenz1, B Steinmetz, J Lieberman

  • 1Department of Surgery, University of California, San Francisco.

The Journal of Trauma
|June 1, 1992
PubMed
Summary

Emergency thoracotomy is a life-saving procedure for trauma patients. It should not be performed if there are no signs of life pre-hospital, but is indicated for penetrating trauma. Blunt trauma cardiac arrest is a relative contraindication.

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Area of Science:

  • Trauma Surgery
  • Emergency Medicine
  • Cardiovascular Surgery

Background:

  • Emergency thoracotomy is a critical intervention for cardiac arrest in severe trauma.
  • Refining indications is essential for optimizing patient outcomes.

Purpose of the Study:

  • To analyze survival rates and refine indications for emergency thoracotomy in moribund trauma patients.
  • To identify patient characteristics associated with successful outcomes.

Main Methods:

  • Retrospective review of 463 moribund trauma patients undergoing emergency thoracotomy between 1980 and 1990.
  • Analysis of survival rates based on trauma type (blunt vs. penetrating), injury severity, and location of procedure (ED vs. OR).

Main Results:

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  • Overall survival rate was 13%. Penetrating trauma had a higher survival rate (22%) compared to blunt trauma (2%).
  • Patients undergoing thoracotomy in the operating room (OR) had a significantly higher survival rate (54%) than those in the emergency department (ED) (2%).
  • No survival was observed in patients with absent signs of life on pre-hospital assessment. Patients in shock with penetrating trauma had improved survival rates (64% profound, 56% mild).

    • Conclusions:

    • Emergency thoracotomy should not be performed if no signs of life are present on initial pre-hospital assessment.
    • Emergency thoracotomy is indicated for most patients with penetrating trauma.
    • Blunt traumatic cardiac arrest is a relative contraindication for emergency thoracotomy.