>Year 2001, Issue 4
Padilla GMA, Meneses CA, Magaña SI
Thoracotomy at the emergency room in patients with thoraco-abdominal trauma
Cir Gen 2001; 23 (4)
PDF: 4. Kb.
Objective: To review indications, contraindications, and results of thoracotomy as an extreme measure at the emergency room in patients with thoraco-abdominal trauma in critical conditions.
Setting: Third level health care hospital.
Data collection: We reviewed the literature on the subject, choosing 30 references.
Justification: Due to the increase in trauma among the civilian population in our country, we considered it necessary to implement a systemized approach to the care of critical patients that might benefit from the procedure.
Results: Clear evidences exist regarding the application of the procedure in severely injured patients, concluding that the type of trauma, the existence of vital signs and the time of cardio-pulmonary resuscitation (CPR) are the most important factors for the prognosis. It is fundamental to establish the selection criteria to offer the procedure to patients with the following signs: severe penetrating thoraco-abdominal trauma in state of severe shock, flank trauma with sudden hemodynamic failure while in the emergency room, flank trauma with resuscitation in progress with vital signs at arrival and CPR below 5 minutes in non-catheterized patients and less than 20 min in catheterized patients. Prognosis is bad for all patients not fulfilling these criteria.
Conclusion: Although thoracotomy as a standard procedure in the emergency rooms remains a controversial issue, it is indispensable to know its advantages and disadvantages to be able to provide the benefits of its use to those patients in need of it and save lives otherwise lost due to the lack of adequate trauma care.
||Emergency thoracotomy, thoraco-abdominal trauma.
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>Year 2001, Issue 4