Blunt Trauma:
- consider the institutional resources
When is ED Thoracotomy futile?
Blunt trauma:
- CPR > 5 min and no signs of life
- Asystole (without cardiac tamponade)
Penetrating trauma:
- CPR >15 min and no signs of life
- Asystole (without cardiac tramponade)
Once you've done it have an exit plan:
- what are your indications to stop your ED thoracotomy resuscitation?
- was a tamponade present?
- is the heart filling?
- don't let your ED physicians/anesthesiologists get to carried away with transfusion/epinepherine; SBP 90 is enough
- Base deficit >20 is a very, very strong predictor of mortality
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