Glob J Emerg Med | Volume 1, Issue 2 | Review Article | Open Access
Duke NUS, Singhealth, Singapore General Hospital
Department of Emergency Medicine, Singapore General Hospital, Singhealth
Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Singhealth Duke NUS Institute of Medical Simulation, Singapore
*Correspondance to: Fatimah LateefFulltext PDF
Emergency Thoracotomy (EDT) is essentially thoracotomy occurring immediately, close to or at the site of injury such as the pre hospital setting or the Emergency Department, as an indicated and integral part of the resuscitation process. This thoracotomy involves making an incision into the pleural space of the chest to access organs in the thoracic cavity, for life saving measures and interventions. A conscious decision to source and explore the best possible modes of training for our Emergency Medicine residents and faculty to learn, be familiar and upkeep the skills in performing EDT. This is an example of a critical procedure, which is extremely time dependent and requires prior knowledge and skills training in order to perform it optimally. Our main motivation for sourcing for some form of simulation training in EDT includes: 1. As the procedure is rare and infrequent, the opportunity for real life experiential training and hands-on practice is very limited 2. As it is a front line skill that needs to be executed in critical time by a trained person, it needs rapid, concise decision and understanding. Deficiency in skills and indecision will waste valuable time which can be life-saving 3. Due to the split second decision making needed in decising and performing EDT, prior repeated practice would be essential in order to attain mastery and familiarity with the steps. 4. As EDT is performed at the frontline, the personnel doing it is often not a trained cardiothoracic surgeon or even a surgeon, thus making it necessary to train physicians, even those from non surgical specialities on carrying it out. The decision to perform EDT, wielding a scalpel and repairing injuries in the thoracic cavity can indeed be an intimidating experience and is indeed not a platform for the first timer, without training or experience. 5. EDT involves many steps and also many surgical tools or equipment which needs familiarization with frequent practice, thus making it even more important to have some form of simulated and regular training. This paper discusses how we arrive at a decision to choose the cut-suit model for our residents to train and be familiar with EDT.
Emergency department thoracotomy; blunt chest trauma; penetrating chest trauma; signs of life
Lateef F. Training for Emergency Department Thoracotomy. Glob J Emerg Med. 2018; 1(2): 1006.