الفهرس 
Anatomy of the chest wallOnly 14 pages are availabe for public view
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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.