Emergency thoracotomy in the field: Experience of SAMUR Madrid
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摘要
SAMUR-Protección Civil is a two-tier Emergency Medical Service of Madrid, with Advance Life Support teams led by Emergency Physicians, Emergency Nurses and Paramedics. Over the last 3 years, medical teams from SAMUR have performed ET in six cases, after a short period of cardiac arrest, restoring cardiac output in two cases, and one patient with a normal neurological outcome. The following SAMUR protocol describes these emergency situations and details the case of the patient who was treated and discharged from hospital without any repercussions.

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Injurya>
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Injury,&#xa0;Volume 37, Issue 1,&#xa0;January 2006, Pages 1-19
P.A. Hunt, I. Greaves, W.A. Owens

Abstract
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ass="h3">Summary

Thoracic trauma is one of the leading causes of death in all age groups and accounts for 25–50%of all traumatic injuries. While the majority of patients with thoracic trauma can be managed conservatively, a small but significant number requires emergency thoracotomy as part of their initial resuscitation. The procedure has been advocated for evacuation of pericardial tamponade, direct control of intrathoracic haemorrhage, control of massive air-embolism, open cardiac massage and cross-clamping of the descending aorta.

Emergency thoracotomy can be defined as thoracotomy “occurring either immediately at the site of injury, or in the emergency department or operating room as an integral part of the initial resuscitation process”. Following emergency thoracotomy, the overall survival rates for penetrating thoracic trauma are around 9–12%but have been reported to be as high as 38%. The survival rate for blunt trauma is approximately 1–2%. The decision to perform emergency thoracotomy involves careful evaluation of the scientific, ethical, social and economic issues.

This article aims to provide a review of the current literature and to outline the pathophysiological features, technical manoeuvres and selective indications for emergency thoracotomy as a component of the initial resuscitation of trauma victims with thoracic injury.


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Journal of Emergency Medicinea>
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Journal of Emergency Medicine,&#xa0;Volume 6, Issue 1,&#xa0;January-February 1988, Page 75
Paul J. Donovan

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Emergency thoracotomy in the field: Experience of SAMUR Madrid

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