Journal Review in Trauma Surgery: Getting to the Heart of the Problem - Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest
Behind The Knife: The Surgery Podcast
Futility, clinician welfare, and governance
Zane discusses reducing futile procedures, debriefing, and psychologist-led reviews for team wellbeing.
In resuscitative trauma surgery every second counts. Can time and lives be saved by moving interventions closer to the point of injury? In this episode, we discuss a recent journal article on prehospital resuscitative thoracotomy as a treatment for traumatic cardiac arrest. Opening the chest on the street, who should do it, why should we do it, and for whom?
• Hosts:
- Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool
- Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital.
- Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83
- Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon, Royal London Hospital and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin
- Mr Zane Perkins. Consultant Trauma & UGI Surgeon, Royal London Hospital and Prehospital Surgeon at London’s Air Ambulance. @ZBPerkins
A) To be aware of the steps of a resuscitative thoracotomy (RT)
B) To understand the rational for prehospital (PH) trauma interventions.
C) To understand the timelines required to optimise success in PH RT.
D) To be familiar with the training governance for clinicians undertaking PH RT.
E) To recognise that PH RT is predominantly an intervention for cardiac tamponade.
F) To understand the contexts in which PH RT might be successful as a standardised intervention.
• References:
- Perkins ZB, Greenhalgh R, Ter Avest E, Aziz S, Whitehouse A, Read S, Foster L, Chege F, Henry C, Carden R, Kocierz L, Davies G, Hurst T, Lendrum R, Thomas SH, Lockey DJ, Christian MD. Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest. JAMA Surg. 2025 Feb 26;160(4):432–40. doi: 10.1001/jamasurg.2024.7245. PMID: 40009367; PMCID: PMC11866073. https://pubmed.ncbi.nlm.nih.gov/40009367/
- ter Avest, E., Kocierz, L., Alvarez, C. et al. Improving decision-making for prehospital Resuscitative Thoracotomy in traumatic cardiac arrest: a data-driven approach. Crit Care 29, 485 (2025). https://doi.org/10.1186/s13054-025-05705-z. https://pubmed.ncbi.nlm.nih.gov/41233917/
If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen
Behind the Knife Premium:
General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review
Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation
Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review
Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review
Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review
Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review
Download our App:
Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049
Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
The AI-powered Podcast Player
