Resuscitative clamshell-thoracotomy in prehospital and inhospital emergency medicine: Indications, requirements and technique

Abstract

In Germany in the past resuscitative thoracotomy in traumatic cardiac arrest did not get a lot of attention. With the publication of the 2015 ERC Guidelines the revised algorithm for the treatment of reversible causes of traumatic cardiac arrest gained a lot of attention, highlighting the possibly lifesaving impact of resuscitative thoracotomy, hence sparking some controversial discussions. The aim of this paper is to give a step by step description of the technique and to describe indications for resuscitative thoracotomy and to highlight the required prerequisites. Furthermore it provides a critical review of the implementation of resuscitative thoracotomy into a pre hospital care system and summarizes current training concepts.