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J Korean Soc Emerg Med > Volume 28(1); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(1): 141-146.
Emergency Department Thoracotomy with Clamshell Incision for Traumatic Cardiac Tamponade
Dong Hun Kim2, Sung Wook Chang1, Jung-Ho Yun3
1Department of Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea
2Department of Thoracic and Cardiovascular Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea
3Department of Neurosurgery, Trauma Center, Dankook University Hospital, Cheonan, Korea
Correspondence  Sung Wook Chang ,Tel: 041-550-6195, Fax: 041-550-0039, Email: changsw3@naver.com ,
Received: September 1, 2016; Revised: September 2, 2016   Accepted: December 2, 2016.  Published online: February 28, 2017.
ABSTRACT
The emergency department thoracotomy (EDT) is a bold and challenging procedure, which may be the only chance of survival for some moribund trauma patients. EDT provides ample exposure to the injury site of the heart, enabling an effective open cardiac massage. Clamshell thoracotomy is a rapid and simple procedure that provides excellent exposure to internal structures. Because EDT has more favorable outcomes for penetrating injuries than for blunt injuries, the indication for EDT in patients with blunt trauma should be well established. Cardiac tamponade is a life-threatening condition that requires emergent pericardial decompression. EDT has been associated with successful initial resuscitation for traumatic cardiac arrest with cardiac tamponade. To date, there has not been any reports of clamshell incision via EDT for trauma patients in South Korea. Hence, herein, we describe two cases in which EDT with clamshell incision was implemented for cardiac tamponade with cardiac arrest after blunt trauma.
Key words: Emergency department, Thoracotomy, Cardiac tamponade, Trauma
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