Emergency prehospital on-scene thoracotomy: a novel method

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Surgical Innovation

Background:

• Prehospital thoracotomy is a rare but potentially life-saving procedure in critical trauma cases.
• Lack of adequate equipment often prevents timely thoracotomy by emergency practitioners at trauma scenes.
• Existing surgical tools are typically unavailable in prehospital environments, limiting intervention options.

Purpose of the Study:

• To introduce a novel, minimally invasive thoracotomy technique for prehospital use.
• To demonstrate the feasibility of performing emergency thoracotomy with limited equipment.
• To provide adequate surgical exposure of the heart and great vessels in austere settings.

Main Methods:

• Presentation of a new "L" shape thoracotomy technique, also termed Thoraco-sterno-costochondrotomy.
• Description of the procedure's applicability in prehospital settings with minimal tools, such as a penknife.
• Comparison of the pragmatic approach to historical thoracotomy practices in Aztec and Mesoamerican cultures.

Main Results:

• The proposed "L" shape thoracotomy facilitates adequate exposure of thoracic contents.
• The technique is adaptable for use with basic instruments, overcoming equipment limitations.
• Historical parallels suggest the long-standing potential for such pragmatic surgical interventions.

Conclusions:

• The novel "L" shape thoracotomy offers a viable solution for emergency prehospital chest surgery.
• This technique can be performed with minimal equipment, enhancing the ability to save lives in critical situations.
• The procedure's historical context underscores the enduring need for adaptable surgical solutions.