Crack the Chest; Get Crucified.

Hinds

What if you actually DO one…?

Terminology• Urgent Thoracotomy • Emergency Department Thoracotomy • Emergency Thoracotomy

Terminology• Urgent Thoracotomy • Emergency Department Thoracotomy • Emergency Thoracotomy

RESUSCITATIVE THORACOTOMY

This talk contains no references.

Are my intentions honorable?

Patient Zero.

Morbidity and Mortality meeting

• Sycophants

• Sycophants

• Supporters

• Sycophants

• Supporters

• Skeptics

• Sycophants

• Supporters

• Skeptics

• Wankers.

Sycophants

Supporters

Skeptics

Skeptics• “It’s a dramatic procedure, done by cowboys”

• “It’s futile”

• “These people never survive”

• “It should only be done by Cardiothoracics”

Wankers.

Wankers.Understand the evidence and intention,

….but criticize anyway

Or

Too stupid to understand

#ResusWankers

“The most difficult part of a Resuscitative Thoracotomy is

the decision to make the cut”

“The most difficult part of a Resuscitative Thoracotomy is

the decision to make the cut”

“The most difficult part of a Resuscitative Thoracotomy is

dealing with #ResusWankers ”

“What a totalResus Wanker”

Changing your institutions approach

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Don’t surprise the room

Rules at the start• Don’t commit the patient to a thoracotomy

because of a duff anaesthetic

• If they do arrest, don’t dick about with a duff resuscitation attempt

Why Clamshell?

• Faster.• You can get at more stuff in there.

Why Clamshell?

It’s not a proper resuscitative procedure if you can’t fit your head in it.

“These guys never survive”

Things to take home

Things to take home• Prepare. Know the evidence.

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Things to take home• Prepare. Know the evidence. • Make your intentions honorable

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Things to take home• Prepare. Know the evidence. • Make your intentions honorable • Do it.

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Things to take home• Prepare. Know the evidence. • Make your intentions honorable • Do it.• Seek out the Skeptics.

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Things to take home• Prepare. Know the evidence. • Make your intentions honorable • Do it.• Seek out the Skeptics.

• Never allow a Wanker to bring you down.