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Sat May 15 22:45:52 BST 2010

Knowing your love for the ED as a resus suite, I am assuming that your "no" answers are predicated on the fact that you already have the patient in the OR.....

Ron

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Kenneth Mattox
Sent: Saturday, May 15, 2010 5:10 PM
To: Trauma-List [TRAUMA.ORG]
Cc: Trauma and Critical Care mailing list
Subject: Re: Thoracotomy for abdominal trauma???

1. No

2. No

3.  No

4.  Temporarilly

5a.  Open the belly in the OR.  Occlude aorta at diaphragm with  
hand.   Go from there depending on what I find

5b.   Same answer

6.      Yes

k  (iPhone)

On May 15, 2010, at 2:22 PM, Karim Brohi <karimbrohi at gmail.com> wrote:

> Dear all,
>
> Simple questions.  Answers should be simple & straightforward...?
>
> A trauma patient in the emergency department loses their output in  
> front of
> you and now has a rhythm on the monitor but no blood pressure.
>
> 1. Would you open the chest in the emergency department for an  
> injury below
> the diaphragm??
>
> 2. Would you be influenced by whether it was blunt or penetrating  
> injury??
>
> 3. Do you believe that thoracic aortic compression works to stop /
> significantly reduce haemorrhage below the diaphragm?
>
> 4. Do you believe that thoracic aortic compression works to  
> significantly
> improve cerebral perfusion
>
> 5. If you don't open the chest - what else do you do -
>
>       5A - for penetrating trauma
>
>       5B - for blunt trauma
>
> 6. Have you ever had a neurologically intact survivor by performing a
> thoracotomy on a patient with purely infra-diaphragmatic injuries?
>
> See...  Easy!
> --
> trauma-list : TRAUMA.ORG
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Thoracotomy for abdominal trauma???