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Resuscitative thoracotomy: Technique

John F Eidt, MD
Section Editors
Eileen M Bulger, MD, FACS
Allan B Wolfson, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Resuscitative thoracotomy is a procedure of last resort that is performed only under specific clinical circumstances. Resuscitative thoracotomy is nearly always performed in the emergency department and involves gaining rapid access to the heart and major thoracic vessels through an anterolateral chest incision to control exsanguinating hemorrhage or other life-threatening chest injuries. The first successful resuscitative thoracotomy was described for the resuscitation of a patient with penetrating cardiac injury and this indication remains the one associated with the highest rate of survival [1,2].

This topic will briefly review the indications for resuscitative (emergency) thoracotomy, which are discussed more fully in separate reviews, and discuss the technique of resuscitative thoracotomy. The initial resuscitation, diagnostic evaluation, and management of the trauma patient with blunt or penetrating trauma is based upon protocols from the Advanced Trauma Life Support (ATLS) program established by the American College of Surgeons Committee on Trauma. The initial evaluation and resuscitation of the patient with blunt or penetrating abdominal or thoracic trauma is discussed elsewhere.

(See "Prehospital care of the adult trauma patient".)

(See "Initial evaluation and management of blunt thoracic trauma in adults".)

(See "Initial evaluation and management of blunt abdominal trauma in adults".)

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Literature review current through: Nov 2017. | This topic last updated: May 30, 2017.
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