Podcast 823: Immediate Resuscitative Thoracotomy

<p><strong>Contributor: Jared Scott, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Immediate resuscitative thoracotomy can be performed in the ED to gain rapid access to the thoracic cavity in cases of traumatic cardiac arrest</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Western Trauma Association Society Criteria for ED thoracotomy</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Blunt trauma + <10 min of prehospital CPR</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Penetrating trauma to torso + <15 min prehospital CPR</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Penetrating trauma to the neck/extremity + <5 min prehospital CPR</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Signs of life with refractory shock can consider resuscitative thoracotomy</span></li> </ul> </li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Outcomes in immediate resuscitative thoracotomy are poor but are improving</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">A recent study evaluated over 2,000 patients meeting inclusion criteria for immediate resuscitative thoracotomy</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;"> </span><span style= "font-weight: 400;">Overall survival rate of 20%</span></li> <li style="list-style: none; display: inline"> <ul> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;">26% survival rate in penetrating trauma</span></li> <li style="font-weight: 400;" aria-level="3"><span style= "font-weight: 400;"> </span><span style="font-weight: 400;">7% survival rate in