Resuscitative Thoracotomy in the Emergency Department: a Case Report

Dur, Ali; Cander, Başar; Gül, Mehmet; Gültekin, Mustafa; Koyuncu, Ferudun; Kocabıyık, Mehmet
March 2013
Journal of Academic Emergency Medicine / Akademik Acil Tip Olgu ;2013, Vol. 12 Issue 1, p46
Academic Journal
Case Study
Resuscitative Thoracotomy (RsT) is a lifesaving procedure when performed according tor the correct indications and rapid applications in patients sustaining trauma to the thoracoabdominal region, particularly penetrating injuries. In the past three decades, there has been a significant clinical shift in the performance of RsT throughout the world, particularly developed countries. A 20-year-old man with a blunt chest injury presented as an emergency with chest pain and dyspnea, as a result of a massive hemopneumothorax causing lung laceration. He sustained cardiac arrest in the emergency department due to hemorrhagic shock and bilateral hemopneumothorax, despite no apparent thoracic surface injury. He was intubated and RsT was performed immediately. An immediate manual compression of the pulmonary hilum was done as damage control, surgical repairm to lung laceration was performed and the bleeding was completely stopped. After open-chest cardiopulmonary rescucitation the patient regained cardiac contraction and pulse. Resuscitation was achieved with RT and internal cardiac massage in the patient who had sustained blunt chest injury. The outcome of the patient to whom RsT is performed is frequently related to multiple factors like age, trauma types and application time. RsT is a rarely performed procedure in an emergency department in Turkey. For this reason, the present case reports discusses the efficiency of RsT and its indications.


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