EMERGENCY THORACIC SURGERY

EMERGENCY THORACIC SURGERY

Emergency thoracic surgery is an essential part of the arma - mentarium of any surgeon dealing with major trauma. A - timely surgical intervention for the correct indications can be the key step in saving an injured patient’s life. It is important to make a distinction between: - /uni25CF immediate thoracotomy in the emergency department for the control of haemorrhage, cardiac tamponade or inter - nal cardiac massage; /uni25CF emergency sternotomy for anterior mediastinal structures and the heart; /uni25CF planned thoracotomy for definitive correction of the prob - lem – this usually takes place in the more controlled envi - ronment of the operating theatre. - The clinical decision as to whether a patient requires sur - - gery in the emergency department or they can be transferred to the operating theatre can be complex. It is far better to per - form a thoracotomy in the operating theatre, either through t an anterolateral approach or a median ster notomy , with good light and assistance and the potential for autotransfusion or bypass, than it is to attempt heroic emergency surgery in the resuscita tion area. However, if the patient is in extremis with a falling systolic blood pressure, there is no choice but to pro - ceed immediately with a left anterolateral thoracotomy . In cer - tain circumstances, when care is futile, it may not need to be performed at all. A resuscitation room thoracotomy following blunt trauma has limited indications and is rarely successful. EMERGENCY THORACIC SURGERY

Emergency thoracic surgery is an essential part of the arma - mentarium of any surgeon dealing with major trauma. A - timely surgical intervention for the correct indications can be the key step in saving an injured patient’s life. It is important to make a distinction between: - /uni25CF immediate thoracotomy in the emergency department for the control of haemorrhage, cardiac tamponade or inter - nal cardiac massage; /uni25CF emergency sternotomy for anterior mediastinal structures and the heart; /uni25CF planned thoracotomy for definitive correction of the prob - lem – this usually takes place in the more controlled envi - ronment of the operating theatre. - The clinical decision as to whether a patient requires sur - - gery in the emergency department or they can be transferred to the operating theatre can be complex. It is far better to per - form a thoracotomy in the operating theatre, either through t an anterolateral approach or a median ster notomy , with good light and assistance and the potential for autotransfusion or bypass, than it is to attempt heroic emergency surgery in the resuscita tion area. However, if the patient is in extremis with a falling systolic blood pressure, there is no choice but to pro - ceed immediately with a left anterolateral thoracotomy . In cer - tain circumstances, when care is futile, it may not need to be performed at all. A resuscitation room thoracotomy following blunt trauma has limited indications and is rarely successful. EMERGENCY THORACIC SURGERY

Emergency thoracic surgery is an essential part of the arma - mentarium of any surgeon dealing with major trauma. A - timely surgical intervention for the correct indications can be the key step in saving an injured patient’s life. It is important to make a distinction between: - /uni25CF immediate thoracotomy in the emergency department for the control of haemorrhage, cardiac tamponade or inter - nal cardiac massage; /uni25CF emergency sternotomy for anterior mediastinal structures and the heart; /uni25CF planned thoracotomy for definitive correction of the prob - lem – this usually takes place in the more controlled envi - ronment of the operating theatre. - The clinical decision as to whether a patient requires sur - - gery in the emergency department or they can be transferred to the operating theatre can be complex. It is far better to per - form a thoracotomy in the operating theatre, either through t an anterolateral approach or a median ster notomy , with good light and assistance and the potential for autotransfusion or bypass, than it is to attempt heroic emergency surgery in the resuscita tion area. However, if the patient is in extremis with a falling systolic blood pressure, there is no choice but to pro - ceed immediately with a left anterolateral thoracotomy . In cer - tain circumstances, when care is futile, it may not need to be performed at all. A resuscitation room thoracotomy following blunt trauma has limited indications and is rarely successful.