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Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Emergency department thoracotomy in Jamaica: a case controlled study.
S O Cawich1, D I G Mitchell, E W Williams
1The Department of Basic Medical Sciences (Section of Anatomy), The University of the West Indies, Mona, Kingston 7, Jamaica, West Indies. socawich@hotmail.com
International Journal of Surgery (London, England)
|May 22, 2007
Summary
Emergency Department Thoracotomy (EDT) outcomes in Jamaica showed low survival rates, influenced by injury type and pre-hospital care. Tailored selection criteria are needed for developing nations to improve patient selection and outcomes.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Public Health
Background:
- Advances in pre-hospital care increase severely injured patients in Emergency Rooms.
- Emergency Department Thoracotomy (EDT) is a life-saving procedure for select trauma patients.
- Lack of regional data hinders EDT selection in Developing Caribbean Nations.
Purpose of the Study:
- To evaluate Emergency Department Thoracotomy (EDT) outcomes at the University Hospital of the West Indies.
- To identify factors predicting survival from EDT in a Caribbean setting.
- To inform the development of localized EDT selection criteria.
Main Methods:
- Retrospective study of 13 Emergency Department Thoracotomy (EDT) procedures.
- Data collected over 11 years (January 1995 - January 2006).
- Analysis of patient demographics, injury types, pre-hospital care, and survival outcomes.
Main Results:
- Low survival rate: 15% early survivors, one patient discharged.
- Predictors of mortality included gunshot injuries, extra-thoracic injuries, and inadequate pre-hospital resuscitation.
- Prolonged transport time and absence of vital signs on arrival were also significant mortality predictors.
Conclusions:
- Significant healthcare limitations impact EDT outcomes in this setting.
- Focused Emergency Room preparation and tailored management protocols are crucial.
- Strict, locally adapted selection criteria are necessary to avoid futile procedures.
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