⚠️⚠️❤ This is something you won't see very often! A #procedure called resuscitative #thoracotomy with direct cardiac #massage, performed on a patient after a chest injury to try to control the bleeding and keep him alive. . .
A resuscitative thoracotomy (sometimes called an #emergency department thoracotomy) is a thoracotomy performed to resuscitate a patient with severe trauma who has suffered severe thoracic or abdominal trauma and who has gone into cardiac arrest because of this. .
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The procedure allows immediate direct access to the chest cavity, allowing rescuers to control bleeding, relieve cardiac tamponade, repair or control serious injuries to the heart, lungs or thoracic vasculature and perform massage or direct cardiac defibrillation. .
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For most patients with chest trauma, the procedure is not necessary, only 15% of those with severe chest injury need the procedure. .
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Left anterolateral thoracotomy is the common method of opening the chest, as it provides quick access, can be easily extended into the right hemithorax and provides access to most important anatomical structures during resuscitation, including the aorta. .
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First, an incision is made along the fourth or fifth intercostal space, the intercostal muscles and the parietal pleura are divided, and then the ribs are retracted to provide visualization. .
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When the incision covers the right and left hemithorax, it is called a "cup" thoracotomy. .
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Claw thoracotomy is used when there is a pulmonary or vascular lesion on the right side, or when greater access or visualization is desired.
DR VIJAY KUMAWAT
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