Indications for thoracotomy in traumatic cardiac arrest
Blunt trauma
Patient arrives at ED with pulse, BP & and spontaneous resps and then witnessed cardiac arrest
Penetrating cardiac trauma
Witnessed cardiac arrest in ED or
Patient arrives in ED after <5 minutes of out-of-hospital CPR and with positive secondary signs of life (e.g., pupillary reflexes, spontaneous movement, organized ECG activity)
Penetrating thoracic (non cardiac) trauma
Witnessed cardiac arrest in ED or
<15 minutes of out-of-hospital CPR and with positive secondary signs of life (e.g., pupillary reflexes, spontaneous movement, organized ECG activity)
Exsanguinating abdominal vascular trauma
Witnessed cardiac arrest in ED
or
Arrives with positive secondary signs of life (e.g. pupillary reflexes, spontaneous movement, organized ECG activity)
plus
Resources available for definitive repair of abdominal-vascular injuries
