Brief history on the origins of prehospital thoracotomies

Define thoracotomy (Differentiate from thoracostomy)

Discuss indications and contraindications

Visualize the procedure

Discuss safety

Discuss ethics

Highlight London HEMS protocols

Discussion of feasibility and implementation

Objectives

-Ostomy: Exit; Drainage

-Otomy: Access

Absolute

Pericardial Tamponade

Exsanguinating

Intrathoracic

Hemorrhage

Pulseless with SOL after

penetrating thoracic

injury (<10 minutes)

Open cardiac massage

Relative

Pulseless with no SOL

after penetrating thoracic

injury

Pulseless with SOL after

blunt thoracic injury

Safety

Ethics

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Outcomes? Retrieved from EMS World: https://www.emsworld.com/article/12284767/prehospital-resuscitative-

thoracotomy-the-next-step-in-improving-trauma-outcomes

Konig, T., Perkins, Z., & Davies, G. (2012). Training Non-Surgeons to Perform Resuscitative Thoracotomy. Trauma,

Resuscitation & Emergency Medicine.

Lockey, D., & Brohi, K. (2015). Pre-Hospital Thoracotomy and the Evolution of Pre-Hospital Critical Care for Victims of

Trauma. Injury.

Mike McEvoy, e. a. (2018). Critical Care Transport. Burlington, MA: Jones & Bartlett Learning.

Moy, P. (2018, February 28). Dr. (S. Tomko, Interviewer)

Norman E. G. (2017). Out of Hospital Thoracotomy for Cardiac Arrest After Penetrating Thoracic Trauma. Injury.

Woltmann, . McSwain, J. e. (2016). Prehospital Trauma Life Support. Burlington, MA: Jones & Barlett Learning.

Ottestad, W. (2016, Novemeber 14). Prehospital Thoracotomy for Traumatic Arrest. Retrieved 2018, from

tidsskriftet.no/en/2016/12/commentary-and-debate/prehospital-thoracotomy-traumatic-cardiac-arrest.

Vledder, MN. (2018, March 2). Dr. (S. Tomko, Interviewer)

Wright, K. (2002). Cardiac Tamponade: A Case for Kitchen Floor Thoracotomy. Emergency Medicine Journal.

stephen.tomko@air-evac.com