TY - CHAP M1 - Book, Section TI - Emergency Department Thoracotomy A1 - Burlew, Clay Cothren A1 - Moore, Ernest E. A2 - Moore, Ernest E. A2 - Feliciano, David V. A2 - Mattox, Kenneth L. PY - 2017 T2 - Trauma, 8e AB - The number of patients arriving at hospitals in extremis, rather than expiring in the prehospital setting, has increased due to the maturation of regionalized trauma systems (see Chapter 4). Salvage of individuals with imminent cardiac arrest or those already undergoing cardiopulmonary resuscitation (CPR) often requires immediate thoracotomy as an integral component of their initial resuscitation in the emergency department (ED). The optimal application of emergency department thoracotomy (EDT) requires a thorough understanding of its physiologic objectives, technical maneuvers, and the cardiovascular and metabolic consequences. Although, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been advocated as a resuscitation maneuver that should replace EDT, there is no objective data to substantiate this proposal and we believe its clear role at this moment is for unstable pelvic fractures with advanced hemorrhagic shock (see Chapter 35). This chapter reviews the features of EDT and highlights the specific clinical indications, all of which are essential for the appropriate use of this potentially life-saving yet costly procedure. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/10 UR - accesssurgery.mhmedical.com/content.aspx?aid=1141186524 ER -