Podcast 823: Immediate Resuscitative Thoracotomy

Podcast 823: Immediate Resuscitative Thoracotomy

Contributor: Jared Scott, MD

Educational Pearls:

  • Immediate resuscitative thoracotomy can be performed in the ED to gain rapid access to the thoracic cavity in cases of traumatic cardiac arrest
  • Western Trauma Association Society Criteria for ED thoracotomy
    • Blunt trauma + <10 min of prehospital CPR
    • Penetrating trauma to torso + <15 min prehospital CPR
    • Penetrating trauma to the neck/extremity + <5 min prehospital CPR
    • Signs of life with refractory shock can consider resuscitative thoracotomy
  • Outcomes in immediate resuscitative thoracotomy are poor but are improving
  • A recent study evaluated over 2,000 patients meeting inclusion criteria for immediate resuscitative thoracotomy
    • Overall survival rate of 20%
      • 26% survival rate in penetrating trauma
      • 7% survival rate in blunt trauma
    • Predictors for poor outcomes
      • Patient age > 60 years
      • Blunt trauma mechanism of injury
      • A prehospital or ED HR <60 bpm
      • Absent signs of life at time of ED arrival
  • When criteria are met, immediate resuscitative thoracotomy should rapidly be performed in the ED

References

Burlew CC, Moore EE, Moore FA, et al. Western Trauma Association critical decisions in trauma: resuscitative thoracotomy. J Trauma Acute Care Surg. 2012;73(6):1359-1363.

Panossian VS, Nederpelt CJ, El Hechi MW, et al. Emergency Resuscitative Thoracotomy: A Nationwide Analysis of Outcomes and Predictors of Futility. J Surg Res. 2020;255:486-494.

Summarized by Mark O'Brien, MS4 | Edited by John Spartz, MS4 & Erik Verzemnieks, MD

In an effort to promote diversity, equity, and inclusion in Emergency Medicine, The Emergency Medical Minute is proud to present our 2nd annual Diversity and Inclusion Award. We support increasing the representation of underrepresented groups in medicine and extend this award to individuals applying to emergency medicine residencies during the 2022-2023 cycle. For information on award eligibility and the application process, visit https://emergencymedicalminute.com/edi-award/

Donate to EMM today!

Jaksot(1144)

Episode 987: Cough Suppressants

Episode 987: Cough Suppressants

Contributor: Meghan Hurley, MD Educational Pearls:  OTC Medications Dextromethorphan (DM) Most common OTC cough suppressant Minimal efficacy: Little evidence that it shortens the duration or severit...

15 Joulu 20257min

Episode 986: Lateral Canthotomy in Emergency Settings

Episode 986: Lateral Canthotomy in Emergency Settings

Contributor: Taylor Lynch, MD Educational Pearls: What is orbital compartment syndrome, and how is it assessed in the emergency room? Orbital compartment syndrome (OCS) is an emergent ophthalmic cond...

8 Joulu 20254min

Episode 985: Amiodarone vs. Lidocaine

Episode 985: Amiodarone vs. Lidocaine

Contributor: Aaron Lessen, MD Educational Pearls: How do amiodarone and lidocaine work on the heart? Amiodarone Blocks potassium channels (Class III effect). Also blocks sodium and calcium channels....

8 Joulu 20252min

Episode 984: Fish Hooks

Episode 984: Fish Hooks

Contributor: Megan Hurley, MD Educational Pearls: Assess first: confirm the hook isn't near vital structures. Automatic subspecialty consult for eye involvement or proximity to carotid artery, radial...

24 Marras 20254min

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Episode 983: Head-of-Bed Position in Large Vessel Occlusion Strokes

Contributor: Aaron Lessen MD Educational Pearls:  Recent prospective randomized clinical trial assessed optimal head-of-bed positioning in patients with LVO 0º vs. 30º elevation Objective was to det...

18 Marras 20252min

Episode 982: Epistaxis Management

Episode 982: Epistaxis Management

Contributor: Meghan Hurley, MD Educational Pearls: 1. Initial Assessment Start with a physical examination: Determine if the bleed is anterior or posterior. Perform a primary survey: assess ai...

10 Marras 20256min

Episode 981: Electrical Burns

Episode 981: Electrical Burns

Contributor: Travis Barlock, MD Educational Pearls: Quick Statistics on Electrical Burns: Electrical burns compose roughly 2 to 9% of all burns that come into emergency departments. The majority of p...

3 Marras 20253min

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Tox Talks 2025 Recap 1, Digoxin and Beta Blockers

Contributors: Preeya Prakash MD, Adam Greenhaw PharmD, Travis Barlock MD, and Jeffrey Olson MS4 In this episode, cardiologist Preeya Prakash and medical student Jeffrey Olson listen in as two cases ar...

29 Loka 202557min

Suosittua kategoriassa Tiede

rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
tiedekulma-podcast
rss-lihavuudesta-podcast
docemilia
utelias-mieli
mielipaivakirja
radio-antro
sotataidon-ytimessa
filocast-filosofian-perusteet
rss-laakaripodi
rss-mental-race
rss-opeklubi
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi