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  • Meeting abstract
  • Open Access

Prehospital emergency thoracotomy: is there any indication? Report of five cases and an algorithm

  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care20037 (Suppl 3) :P114

https://doi.org/10.1186/cc2310

  • Published:

Keywords

  • Emergency Medicine
  • Emergency Room
  • Life Support
  • Great Chance
  • Cardiac Injury

Objectives

To report five cases of emergency thoracotomy in a prehospital setting and its indication with an algorithm.

Materials and methods

A case report of five emergency thoracotomies for penetrating thoracic trauma, in a prehospital environment, in an advanced life support unit with a physician.

Results

All patients were male with a median age of 24 years and presented by a left penetrating thoracic trauma: two were gunshots, two were vehicle debris and one was stabbed. All of them had a hemothorax, two of them with cardiac injury (only one tamponated). Internal cardiac massage was performed in all patients, with return of a spontaneous circulation (ROSC) in two of them. One patient died at the scene, one in the emergency room, two in the operation room and the other 6 hours after surgery. Three patients had signs of life before the procedure and two of them had ROSC.

Conclusion

Emergency thoracotomy has a dismal result in a prehospital environment. Patients with signs of life before the procedure have the greatest chance of ROSC. An algorithm for rational use of emergency thoracotomy is proposed.

Authors’ Affiliations

(1)
Emergency Medical Services, Belo Horizonte City, Minas Gerais, Brazil

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