Crack to Cure

In this podcast episode, Scott Weingart discusses the topic of emergency department (ED) thoracotomy. He emphasizes that ACLS guidelines do not apply to traumatic arrest caused by trauma and advises against following ACLS dictum in such cases.

Weingart explains the guidelines for determining which patients should undergo ED thoracotomy and simplifies the guidelines by stating that penetrating injuries with signs of life should undergo thoracotomy, while penetrating injuries without signs of life should only be considered if the operator desires the experience or if there are exceptional circumstances. For blunt trauma patients without signs of life, thoracotomy is generally not recommended unless there is cardiac motion observed on an echo.

Weingart underscores the life-saving potential of ED thoracotomy, particularly in cases of anterior stab wounds. He acknowledges the complexity and limitations of the procedure and emphasizes the importance of making appropriate decisions and coordinating with trauma surgeons.