Resuscitative Thoracostomy

Question 1

What is a resuscitative thoracotomy?

Answer 1

• Incision into pleural space of chest to gain access to thoracic organs (most commonly heart) for purpose of resuscitation

Question 2

Rationale for resuscitative thoracotomty

Answer 2

• intrathoracic hemorrhage control
• release of pericardial tamponade
• open cardiac compression
• air embolis treatment
• cross-clamping of descending thoracic aorta

Question 3

contraindications for resuscitative thoracotomy

Answer 3

• Blunt/penetrating injury with no signs of life observed within 15 minutes of injury
• Severe head injury or unsurvivable severe multisystem injury
• Non-traumatic cardiac arrest

Question 4

What signs of life are considered in contraindications for resuscitative thoracotomy

Answer 4

• ECG electrical activity (+/- pulse)
• Corneal, pupillary or gag reflexes
• GCS >3