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World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2006

Open Access 01-12-2006 | Review

Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes

Authors: C Clay Cothren, Ernest E Moore

Published in: World Journal of Emergency Surgery | Issue 1/2006

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Abstract

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.
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Metadata
Title
Emergency department thoracotomy for the critically injured patient: Objectives, indications, and outcomes
Authors
C Clay Cothren
Ernest E Moore
Publication date
01-12-2006
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2006
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/1749-7922-1-4

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