A Unique Hybrid Simulation Used to Train General Surgery Residents in the Cognitive and Procedural Aspects of Emergency Department Thoracotomy

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 488A
Author(s):  
William Watson ◽  
Michael Macko ◽  
Brian Zeno ◽  
Angie Wade ◽  
Jennifer Moreland ◽  
...  
Keyword(s):  
Emergency Department ◽  
General Surgery ◽  
Hybrid Simulation ◽  
Emergency Department Thoracotomy

scholarly journals Multidisciplinary Approach for the Management of Complex Hepatic Injuries AAST-OIS Grades IV—V: A Prospective Study

2007 ◽  
Vol 96 (3) ◽  
pp. 214-220 ◽  
Author(s):  
J. A. Asensio ◽  
P. Petrone ◽  
L. Garcí-Núñez ◽  
B. Kimbrell ◽  
E. Kuncir
Keyword(s):  
Emergency Department ◽  
Logistic Regression ◽  
Blood Loss ◽  
Blood Cells ◽  
Multidisciplinary Approach ◽  
Stepwise Logistic Regression ◽  
Packed Red Blood Cells ◽  
Emergency Department Thoracotomy ◽  
Estimated Blood Loss ◽  
Hepatic Injuries

Background: Complex hepatic injuries grades IV—V are highly lethal. The objective of this study is to assess the multidisciplinary approach for their management and to evaluate if survival could be improved with this approach. Study Design: Prospective 54-month study of all patients sustaining hepatic injuries grades IV—V managed operatively at a Level I Trauma Center. Main outcome measure: survival. Statistical analysis: univariate and stepwise logistic regression. Results: Seventy-five patients sustained penetrating (47/63%) and blunt (28/37%) injuries. Seven (9%) patients underwent emergency department thoracotomy with a mortality of 100%. Out of the 75 patients, 52 (69%) sustained grade IV, and 23 (31%) grade V. The estimated blood loss was 3,539±-3,040 ml. The overall survival was 69%, adjusted survival excluding patients requiring emergency department thoracotomy was 76%. Survival stratified to injury grade: grade IV 42/52–81%, grade V 10/23–43%. Mortality grade IV versus V injuries (p <0.002; RR 2.94; 95% CI 1.52–5.70). Risk factors for mortality: packed red blood cells transfused in operating room (p=0.024), estimated blood loss (p<0.001), dysryhthmia (p<0.0001), acidosis (p=0.051), hypothermia (p=0.04). The benefit of angiography and angioembolization indicated: 12% mortality (2/17) among those that received it versus a 36% mortality (21/58) among those that did not (p=0.074; RR 0.32; 95% CI 0.08–1.25). Stepwise logistic regression identified as significant independent predictors of outcome: estimated blood loss (p=0.0017; RR 1.24; 95% CI 1.08–1.41) and number of packed red blood cells transfused in the operating room (p=0.0358; RR 1.16; 95% CI 1.01–1.34). Conclusions: The multidisciplinary approach to the management of these severe grades of injuries appears to improve survival in these highly lethal injuries. A prospective multi-institutional study is needed to validate this approach.

Emergency department thoracotomy

1982 ◽  
Vol 11 (8) ◽  
pp. 413-416 ◽  
Author(s):  
Timothy C. Flynn ◽  
Richard E. Ward ◽  
Priscilla W. Miller
Keyword(s):  
Emergency Department ◽  
Emergency Department Thoracotomy

Technique of Cross-Clamping of Descending Thoracic Aorta During Emergency Department Thoracotomy

2021 ◽  
pp. 000313482110234
Author(s):  
Elias Degiannis ◽  
Konstantinos Degiannis ◽  
Dietrich Doll
Keyword(s):  
Emergency Department ◽  
Thoracic Aorta ◽  
Medical Staff ◽  
Descending Thoracic Aorta ◽  
Emergency Department Thoracotomy

Cross-clamping of the descending thoracic aorta is one of the operative maneuvers, that can be necessitated in an Emergency Department Thoracotomy and it is important for the Emergency Department medical staff to theoretically familiarize itself with its technique before need arises.

Survival after emergency department thoracotomy in the pediatric trauma population: a review of published data

2018 ◽  
Vol 34 (8) ◽  
pp. 857-860 ◽  
Author(s):  
Eliza E. Moskowitz ◽  
Clay Cothren Burlew ◽  
Ann M. Kulungowski ◽  
Denis D. Bensard
Keyword(s):  
Emergency Department ◽  
Pediatric Trauma ◽  
Published Data ◽  
Emergency Department Thoracotomy ◽  
Trauma Population

EMERGENCY DEPARTMENT THORACOTOMY

2008 ◽  
pp. 114-124
Author(s):  
Juan A. Asensio ◽  
Patrizio Petrone ◽  
Luis Manuel Garcí-a-Núñez ◽  
Dan L. Deckelbaum ◽  
Dominic Duran ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Thoracotomy

scholarly journals Emergency Department Thoracotomy: Development of a Reliable, Validated Checklist for Procedural Training

2019 ◽  
Vol 4 (2) ◽  
pp. 139-146 ◽  
Author(s):  
Hashim Q. Zaidi ◽  
Sarah S. Dhake ◽  
Danielle T. Miller ◽  
Priyanka Sista ◽  
Matthew J. Pirotte ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Department Thoracotomy ◽  
Procedural Training
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