EDT is resource intensive and frequently futile. There is controversy regarding the procedure, with varying guidelines and reported survival rates.
Signs of life - pulse, bp, spontaneous respirations, reactive pupils, extremity movement, cardiac electrical activity
EAST guidelines for EDT
Strong recommendation if pulseless w/ signs of life after penetrating thoracic trauma
Conditional recommendation if
- Pulseless w/o signs of life after penetrating thoracic trauma
- Present OR absent signs of life after penetrating extrathoracic trauma
- Present signs of life after blunt trauma
3. Recommendation against if absent signs of life after blunt trauma
Exam world answers
- penetrating trauma w/ witnessed prehospital or ED arrest
- penetrating trauma w/ SBP <70 after fluid resuscitation
- blunt trauma w/ ED arrest
Why are you doing EDT?
1 - Cardiac tamponade release 2 - Cardiac massage 3 - Intrathoracic/cardiac hemorrhage control 4 - Cross-clamping descending aorta (optimize cerebral/coronary perfusion) 5 - Control air embolism
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