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J Trauma. 2001 Apr;50(4):670-3.

Prehospital resuscitative thoracotomy for cardiac arrest after penetrating trauma: rationale and case series.

Author information

1
Academic Unit of Accident and Emergency, St. Bartholomew's and the Royal London School of Medicine, Queen Mary and Westfield College, University of London, London, United Kingdom. t.j.coats@mds.qmw.ac.uk

Abstract

OBJECTIVE:

The purpose of this study is to present the rationale for an algorithm that describes the place of resuscitative thoracotomy in the prehospital management of a patient with penetrating chest injury, and to review a 6-year experience using this algorithm.

METHODS:

This study was a retrospective review of all cases where a prehospital thoracotomy was performed by the medical teams of the London Helicopter Emergency Medical Service.

RESULTS:

Thirty-nine prehospital thoracotomies were performed. Four (10%) patients survived, one with long-term disability. Factors associated with survival were stab wound, single cardiac wound, cardiac tamponade, and loss of pulse in the presence of an experienced prehospital doctor.

CONCLUSION:

Current evidence suggests that patients who suffer a cardiac arrest more than 10 minutes away from emergency room thoracotomy are very unlikely to survive. Prehospital thoracotomy is associated with a small number of survivors. This intervention should be considered if there is an appropriately experienced, trained, and equipped doctor present, who is acting within a trauma system with ongoing training and quality assurance.

PMID:
11303162
[Indexed for MEDLINE]
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