RT Book, Section
A1 Ghanta, Ravi K.
A1 Wall Jr, Matthew J.
A1 Mattox, Kenneth L.
A2 Feliciano, David V.
A2 Mattox, Kenneth L.
A2 Moore, Ernest E.
SR Print(0)
ID 1175133552
T1 Trauma Thoracotomy: Principles and Techniques
T2 Trauma, 9e
YR 2020
FD 2020
PB McGraw Hill
PP New York, NY
SN 9781260143348
LK accesssurgery.mhmedical.com/content.aspx?aid=1175133552
RD 2024/04/19
AB KEY  POINTSDespite  frequent  emphasis  on  devastating  injuries,  the  most  common  thoracic  injury  is  a  chest  wall  contusion  or  rib  fracture.History,  physical  examination,  and  chest  x-ray  remain  fundamental  to  the  diagnosis  of  thoracic  injury.  Additional  imaging,  including  extended  focused  ultrasonography  assessment  for  trauma,  computed  tomography  (CT)  scanning,  and  CT  angiography  are  frequently  used.A  thoracostomy  tube  output  of  1500  mL  of  blood  on  insertion  or  200  mL  of  blood  per  hour  usually  warrants  an  urgent  thoracotomy.A  left  anterolateral  thoracotomy  through  the  third  or  fourth  interspace  allows  exposure  for  opening  the  pericardium,  open  cardiac  massage,  clamping  of  the  descending  thoracic  aorta,  and  treatment  of  a  large  percentage  of  cardiac  and  left  lung  injuries.A  retained  hemothorax  should  be  evacuated  by  video-assisted  thoracoscopy  or  thoracotomy  as  soon  as  diagnosed.New  technologies,  such  as  retrograde  endovascular  balloon  occlusion  of  the  aorta  and  extracorporeal  cardiopulmonary  resuscitation,  have  the  potential  to  further  change  the  philosophy  of  prehospital  management  for  thoracic  injuries.