List Archives

Wed Dec 3 04:44:05 GMT 2008

Maybe I'm playing both sides of the fence but ...

I have seen a few windows turn into complete panic as a rush of blood is
followed by a drop in BP.  If you have your stuff ready it can still take
some time to open the chest.  Often the window is looked at as a benign
peek.  So the saw is in the room by not ready to go.  The chest instruments
are on the back table and not opened.  So, I think that if you have a good
Echo and signs of tamponade you need to open the chest.  

If there is a good half-way point, I think that you have found it.  

I hope that this helps explain my fence sitting.  :-)

E

Errington C. Thompson, MD, FACS, FCCM
Trauma/Surgical Critical Care
Radio Talk Host - WPEK 880 AM
Author - Letter to America
Asheville, NC

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Robert Smith
Sent: Tuesday, December 02, 2008 8:28 AM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: SW to heart

E,

I'm confused. Why do you guys say not to do windows? And if you don't do
them, how can you like the alogrhythm? And why do people want to do a CT
after doing a cardiac echo?

Rob

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Errington Thompson 
Sent: Monday, December 01, 2008 5:10 PM
To: 'Trauma &amp; Critical Care mailing list'
Subject: RE: SW to heart

Agreed.  I stopped doing them 8 - 10 yrs ago.

Errington C. Thompson, MD
Trauma/Surgical Critical Care
Talk Show Host - WPEK
www.whereistheoutrage.net
Asheville, NC

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of kmattox at aol.com
Sent: Monday, December 01, 2008 8:18 AM
To: Trauma &amp; Critical Care mailing list
Subject: Re: SW to heart

In todays world subxyphoid pericardiotomy is not indicated. 
------Original Message------
From: Pradeep Navsaria
Sender: trauma-list-bounces at trauma.org
To: Trauma International emailing list
ReplyTo: Trauma &amp; Critical Care mailing list
Sent: Dec 1, 2008 6:42 AM
Subject: Re: SW to heart

A paper that may further stimulate some discussion:

Haemopericardium in stable patients after penetrating injury: is subxiphoid
pericardial window and drainage enough? A prospective study. (
http://www.ncbi.nlm.nih.gov/pubmed/15910827?ordinalpos=21&itool=EntrezSystem
2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocS
um )
Navsaria PH, Nicol AJ.  Injury. 2005 Jun;36(6):745-50. 
Sincerely
PHN

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SW to heart