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Abstract The term emergency thoracotomy has been applied to thoracotomy carried out in different environments, leading to a wide variation in its use in much of the literature. The term emergency department thoracotomy is that most commonly used in cases where thoracotomy was carried out as a resuscitative measure. The nomenclature should be clarified so that emergency thoracotomy is the term for any thoracotomy carried out as part of the resuscitative process, whether carried out on-scene, in the emergency department, or in the operating theatre. Emergency thoracotomy may well be under-utilized in the specific group of patients who are likely to benefit the most from the procedure. Experience has shown that there is approximately 10% salvage rate following emergency thoracotomy in a population of patients that would otherwise have a 100% mortality rate and, therefore, this procedure should be carried out immediately, when indicated. Patients Summery 96 who have an isolated penetrating cardiac injury have the best prognosis, while moribund patients who have suffered blunt trauma, especially associated with extra thoracic injuries (in particular, severe head or spinal injuries), will generally have a dismal prognosis. The keys to successful resuscitation of the traumatized heart are a high index of clinical suspicion, early recognition and rapid intervention. Departmental training, with practice during regular education sessions, will aid in the recognition of clinical signs and speed appropriate intervention in cases where emergency thoracotomy is indicated. Finally, routine and robust audit, as well as efforts to collect data prospectively, will help to improve upon and clarify the information on this fortunately uncommonly needed procedure. |