Emergency physician credentialing for resuscitative thoracotomy for trauma

Emergency Medicine Australasia : EMA
Mark FitzgeraldAmit Maini

Abstract

A low case incidence and variable skill level prompted the development of a credentialing programme and specific surgical training in resuscitative thoracotomy for emergency physicians at The Alfred, a Level 1 Adult Victorian Major Trauma Service. A review of the incidence of traumatic pericardial tamponade and the objectives of resuscitative thoracotomy were undertaken. A training programme involving pre-reading of a 17 page teaching manual, a 40 min didactic lecture and a 2 h surgical skills station using anaesthetized pigs were developed. The specific indication for resuscitative thoracotomy for this programme is ultrasound demonstrated cardiac tamponade secondary to blunt or penetrating truncal trauma in a haemodynamically unstable patient with a systolic blood pressure of less than 70 mmHg despite pleural decompression and intravenous volume replacement. Cardiac electrical activity must be present. The primary aims of resuscitative thoracotomy taught are release of cardiac tamponade, control of haemorrhage and access for internal cardiac massage. Emergency physicians working in high-volume Trauma Centres are expected to diagnose cardiac tamponade and on occasion decompress the pericardium. Specific training in the procedur...Continue Reading

References

Apr 26, 2000·The Journal of Trauma·J G TyburskiC Steffes
Jan 18, 2006·Injury·P A HuntW A Owens
Jun 12, 2008·The Journal of Trauma·John B KortbeekRobert Winter
Nov 18, 2009·The Journal of Trauma·Andreas Saxlund PahleJohan Pillgram-Larsen
Jul 2, 2010·Emergency Medicine Australasia : EMA·Costa RepanosWilliam Coman

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Citations

Oct 25, 2014·World Journal of Surgery·Lindsay M FairfaxIan D Civil
May 14, 2016·Emergency Medicine Australasia : EMA·Ian Mc FergusonCliff Reid
Sep 25, 2020·The Western Journal of Emergency Medicine·Danielle T MillerDavid H Salzman
Nov 19, 2020·Emergency Medicine Australasia : EMA·Christopher GroombridgeMark Fitzgerald
May 31, 2021·Clinical Neurology and Neurosurgery·Paul J Fitzgerald

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