This weeks readings:
Inaba K, Chouliaras K, Zakaluzny S, et al. FAST Ultrasound Examination as a Predictor of Outcomes After Resuscitative Thoracotomy. Annals of Surgery 2015;262(3):512–8.
- "All were penetrating thoracic injuries with a pericardial effusion on FAST and all were emergently brought to the operating room for a planned sternotomy and were ,therefore, excluded from the study." How do you think this affected the primary outcome?
- The authors conclude that identification of pericardial fluid can prevent unnecessary thoracotomies, saving resources and potential risks to the practitioners.
- What is the actual resource burden and risk to the practitioner
- Can you think of any benefits to performing thoracotamies despite the low survival rate of the patient?
- How might this apply to the paediatric population?
Adedipe, A. A., Fly, D. L., Schwitz, S. D., Jorgenson, D. B., Duric, H., Sayre, M. R., & Nichol, G. (2015). Resuscitation. Resuscitation, 1–5. http://doi.org/10.1016/j.resuscitation.2015.07.024
- Why do you think they chose to record only for 5 mins?
- Is there value in checking carotid flow for longer? or for other parts of the CPR cycle?
- The authors describe some patient populations where carotid flow might not be feasible.
- What limitations might there be in traumatic arrests?
- What about the paediatric arrests?