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Emergency thoracotomy

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Indications

  • witnessed trauma arrest in hospital
  • penetrating precordial trauma
  • normal QRS duration
  • potentially salvageable patient

Contraindications

  • Associated head injury
  • Multi-system injury
  • Team not trained or equipment not available

Complications

  • recurrent bleeding
    • chest wall
    • internal mammary artery
  • anoxic brain injury in 3-50%  of survivors
    • absent pupillary response poorly predictive
  • damage to:
    • phrenic nerve
    • coronary artery
 

©Charles Gomersall, October, 2009 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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