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Wed May 2 02:57:54 BST 2007

In a message dated 5/1/2007 8:50:20 P.M. Central Daylight Time,  
p.bjorn at netzero.net writes:

Shows  what I know.  I hate it when that  happens.

Pret

Pret is RIGHT in his answer regarding what ATLS and many other courses  
teach.   However, I do not recall ever seeing a patient with a SW or  GSW to the 
heart or pericardium benefit from either a needle pericardiocentesis  or a 
sub-xyphoid pericardiotomy.    I have seen a significant  number of people "saved" 
by EC thoracotomy.    We still see  several patients per year who are 
victimized by the ATLS and ACLS  pericardiocentesis protocol and where blood is 
retrieved via the probing needle  and then the patient gets worse.   At thoracotomy 
the only injury  found is the needle stab wound to the heart, usually the 
right  ventricle.    

In my simple view, both needle pericardiocentesis and subxyphoid  
pericardiotomy should be removed from the ATLS and ACLS and PALS,  etc.   

k

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