Thanks to a suggestion from Melanie, this week I am discussing the management of traumatic arrest. Many things to do in these patients, but two things you definitely should not be doing are closed-chest CPR or giving ACLS medications. We discuss who gets a thoracotomy, what to do if a thoracotomy is not indicated, and when to stop.

Here is a great review article:

Hunt PA, Greaves I, Owens WA.  Emergency thoracotomy in thoracic trauma-a review. Injury. 2006 Jan;37(1):1-19.

This is one of the figures from the text. I think it is a great algorithm to determine who gets a thoracotomy:

From Hunt et al. Injury 2006;37:1

Update: This article lends further support that all patients should have tension pneumo excluded (Resus 2007;75:276)

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