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Resuscitative thoracotomy
A resuscitative thoracotomy (sometimes referred to as an emergency department thoracotomy or, colloquially, as "cracking the chest") is a thoracotomy typically done in order to resuscitate a person who has been severely injured after sustaining a severe trauma involving the thoracic cavity. For most persons with thoracic trauma the procedure is not necessary; only 15% of those with thoracic injury require the procedure.〔Moore 2012, p.462〕
==Indications==
A resuscitative thoracotomy is indicated when severe injuries within the thoracic cavity prevent the physiologic functions needed to sustain life (such as hemorrhage). The injury may also affect a specific organ such as the heart which can develop an air embolism or a cardiac tamponade (which prevents the heart from beating properly). Other indications for the use of this procedure would be the appearance of blood from a thoracostomy tube placed that returns more than 1500 mL of blood, or ≥200 mL of blood per hour.
For resuscitative thoracotomy to be indicated, signs of life must also be present including cardiac electrical activity and a systolic blood pressure >70 mm Hg.〔 In blunt trauma, if signs of life, such as eye dilatation, are found en route to the hospital by first responders, but not found when the patient arrives, then further resuscitative interventions are contraindicated; however; when first responders find signs of life and cardiopulmonary resuscitation time is under 15 minutes, the procedure is indicated.〔Peitzman 2002, p. 227〕
The use of a focused assessment with sonography for trauma may be performed to determine the need of the procedure by finding free floating fluid in the thoracic cavity.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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