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Resuscitative Thoracotomy in Emergency Department

  • Mariana F. Jucá Moscardi
  • Luis Fernando Spagnuolo Brunello
  • Flavio Saavedra Tomasich
  • Gerrard Daniel Pust
Chapter

Abstract

The main objectives of emergency department thoracotomy (EDT) are to avoid the cardiovascular collapse from mechanical sources or extreme hypovolemia, in patients in extremis. The indication is to perform in patients presenting pulseless with signs of life, pulseless electrical activity (PEA), sudden cardiac arrest (SCA), or imminence of SCA (profound refractory shock). It must be remembered to avoid in patients with isolated cranial injuries. The best timing of closed-chest CPR plausible to start the thoracotomy is 15 minutes for penetrating traumas and 10 minutes for blunt traumas.

Keywords

Emergency department thoracotomy (EDT) Resuscitative thoracotomy Trauma Pulseless Shock 

References

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    Seamon MJ, Haut ER, Van Arendonk K, Barbosa RR, Chiu WC, Dente CJ, et al. An evidence-based approach to patient selection for emergency department thoracotomy: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2015;79(1):159–73.CrossRefGoogle Scholar
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    American College of Surgeons. Advanced Trauma Life Support® (ATLS®): the tenth edition. Chicago, IL: American College of Surgeons (ACS), Committee on Trauma (COT); 2018. 377 p.Google Scholar
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    Mattox K, Moore EE, Feliciano D V. Trauma. 8th ed. New York: McGraw-Hill; 2017.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Mariana F. Jucá Moscardi
    • 1
  • Luis Fernando Spagnuolo Brunello
    • 2
  • Flavio Saavedra Tomasich
    • 3
  • Gerrard Daniel Pust
    • 4
  1. 1.University of Miami, Ryder Trauma CenterMiamiUSA
  2. 2.Iwan Collaço Trauma Research GroupHospital do Trabalhador Trauma Center, Federal University of ParanaCuritibaBrazil
  3. 3.Department of Surgery, Iwan Collaço Trauma Research GroupHospital do Trabalhador Trauma Center, Federal University of ParanaCuritibaBrazil
  4. 4.Division of Trauma and Surgical Critical Care, The DeWitt Daughtry Family Department of SurgeryRyder Trauma Center/Jackson Memorial Hospital, Miller School of Medicine, University of MiamiMiamiUSA

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