Successful roadside resuscitative thoracotomy

Case report and literature review

M. J. Wall, P. E. Pepe, K. L. Mattox

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Patients with injuries severe enough to require cardiopulmonary resuscitation (CPR) have a dismal prognosis. Time to surgical intervention is a major determinant of outcome in moribund trauma patients who have a potential for survival. With the exception of endotracheal intubation during evacuation to surgical intervention, no other usual prehospital procedures have been validated to affect outcome in such cases of extremis. This is a report of a case in which resuscitative surgical techniques were extended successfully to the prehospital environment. The patient was a 30-year-old man in extremis after a stab wound to the left chest. Estimating a transport time of 15 minutes, a physician riding with the emergency medical service (EMS) crews elected to perform a resuscitative thoracotomy. Following digital aortic compression, the patient regained both blood pressure and consciousness by the time of arrival at the trauma center. A left lower lobectomy was then performed in the operating room. The patient recovered fully and was discharged home in 21 days, neurologically intact. Four years later, the patient was alive, healthy, and working. This report demonstrates the feasibility of prehospital thoracotomy and raises provocative issues regarding future intense surgical involvement in prehospital care.

Original languageEnglish (US)
Pages (from-to)131-134
Number of pages4
JournalJournal of Trauma
Volume36
Issue number1
StatePublished - 1994

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Thoracotomy
Stab Wounds
Intratracheal Intubation
Trauma Centers
Cardiopulmonary Resuscitation
Wounds and Injuries
Emergency Medical Services
Operating Rooms
Consciousness
Thorax
Blood Pressure
Physicians
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Successful roadside resuscitative thoracotomy : Case report and literature review. / Wall, M. J.; Pepe, P. E.; Mattox, K. L.

In: Journal of Trauma, Vol. 36, No. 1, 1994, p. 131-134.

Research output: Contribution to journalArticle

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