Subscribe to our newsletter to receive information on new and updated content


Emergency Department Thoracotomy


The content you’re about to read or listen to is at least two years old, which means evidence and guidelines may have changed since it was originally published. This content item won’t be edited but there will be a newer version published if warranted. Check the new publications and curriculum map for updates

Authors: Reuben Griscti / Codes: C3AP1a, CMP3, HMP3 / Published: 30/03/2015

Trauma is a significant cause of mortality worldwide, especially amongst children and young adults, with the majority of deaths occurring shortly after arrival in hospital. Thoracic trauma causes a quarter of all traumatic deaths, whilst contributing to a further 50%.

Emergency Department Thoracotomy will allow decompression of tension pneumothoraces, release of pericardial tamponade, closure of cardiac wounds, intrathoracic haemorrhage control, as well as effective open cardiac massage, making all the difference between life and death. Very few other procedures in Emergency Medicine have such a high mortality:benefit ratio. The Royal College of Emergency Medicine has stated that this procedure is definitely within the remit of the Emergency Physician. In this podcast, we will discuss the indications and contra-indications, as well as a simplified technique to perform a clamshell thoracotomy.

The only challenge that remains is making the call.


  1. Tom Leckie, Ian Roberts, Fiona Lecky. Timing of trauma deaths within UK hospitals. [ONLINE] Available at:
  2. Gretchen S Lent, Neel Kumar. 2013. Emergency Bedside Thoracotomy . [ONLINE] Available at:

Other items you may enjoy

What nobody told you about troponins For those of you who werent able to attend and for those of you who want to listen again to some of the great talks, this month well be some of the superb plenary sessions on the podcast
Self-Actualisation and Transcendence with Simon Ca... In true StEmlyns style he had a whole series of excellent blog posts summarising his talk immediately available. We were lucky enough to get him interview about the lecture just prior to giving it.
NICE Bronchiolitis When you assess your patient you need to take a good focussed history, make a thorough examination focussing on evidence of respiratory...failure/distress

Leave a Reply