Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes
<p>Abstract</p> <p>In the past three decades there has been a significant clinical shift in the performance of emergency department thoracotomy (EDT), from a nearly obligatory procedure before declaring any trauma patient to select patients undergoing EDT. The value of EDT in resus...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2006-03-01
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| Series: | World Journal of Emergency Surgery |
| Online Access: | http://www.wjes.org/content/1/1/4 |
| _version_ | 1818066292477788160 |
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| author | Moore Ernest E Cothren C Clay |
| author_facet | Moore Ernest E Cothren C Clay |
| author_sort | Moore Ernest E |
| collection | DOAJ |
| description | <p>Abstract</p> <p>In the past three decades there has been a significant clinical shift in the performance of emergency department thoracotomy (EDT), from a nearly obligatory procedure before declaring any trauma patient to select patients undergoing EDT. The value of EDT in resuscitation of the patient in profound shock but not yet dead is unquestionable. Its indiscriminate use, however, renders it a low-yield and high-cost procedure. Overall analysis of the available literature indicates that the success of EDT approximates 35% in the patient arriving in shock with a penetrating cardiac wound, and 15% for all penetrating wounds. Conversely, patient outcome is relatively poor when EDT is done for blunt trauma; 2% survival in patients in shock and less than 1% survival with no vital signs. Patients undergoing CPR upon arrival to the emergency department should be stratified based upon injury and transport time to determine the utility of EDT. The optimal application of EDT requires a thorough understanding of its physiologic objectives, technical maneuvers, and the cardiovascular and metabolic consequences.</p> |
| first_indexed | 2024-12-10T15:05:28Z |
| format | Article |
| id | doaj.art-818597c4347f456f85d5bba144c25541 |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-12-10T15:05:28Z |
| publishDate | 2006-03-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-818597c4347f456f85d5bba144c255412022-12-22T01:44:03ZengBMCWorld Journal of Emergency Surgery1749-79222006-03-0111410.1186/1749-7922-1-4Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomesMoore Ernest ECothren C Clay<p>Abstract</p> <p>In the past three decades there has been a significant clinical shift in the performance of emergency department thoracotomy (EDT), from a nearly obligatory procedure before declaring any trauma patient to select patients undergoing EDT. The value of EDT in resuscitation of the patient in profound shock but not yet dead is unquestionable. Its indiscriminate use, however, renders it a low-yield and high-cost procedure. Overall analysis of the available literature indicates that the success of EDT approximates 35% in the patient arriving in shock with a penetrating cardiac wound, and 15% for all penetrating wounds. Conversely, patient outcome is relatively poor when EDT is done for blunt trauma; 2% survival in patients in shock and less than 1% survival with no vital signs. Patients undergoing CPR upon arrival to the emergency department should be stratified based upon injury and transport time to determine the utility of EDT. The optimal application of EDT requires a thorough understanding of its physiologic objectives, technical maneuvers, and the cardiovascular and metabolic consequences.</p>http://www.wjes.org/content/1/1/4 |
| spellingShingle | Moore Ernest E Cothren C Clay Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes World Journal of Emergency Surgery |
| title | Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes |
| title_full | Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes |
| title_fullStr | Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes |
| title_full_unstemmed | Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes |
| title_short | Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes |
| title_sort | emergency department thoracotomy for the critically injured patient objectives indications and outcomes |
| url | http://www.wjes.org/content/1/1/4 |
| work_keys_str_mv | AT mooreerneste emergencydepartmentthoracotomyforthecriticallyinjuredpatientobjectivesindicationsandoutcomes AT cothrencclay emergencydepartmentthoracotomyforthecriticallyinjuredpatientobjectivesindicationsandoutcomes |