Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest with Mike Christian

Today, we’re diving into one of the most challenging and high-stakes procedures in trauma medicine—prehospital resuscitative thoracotomy (RT) for traumatic cardiac arrest (TCA).

Joining me is Dr Mike Christian, the senior author of a recent study published in JAMA Surgery, which examines the impact of prehospital RT in London’s Air Ambulance (LAA) system over two decades. TCA is often seen as a condition with a poor prognosis but for select patients—particularly those suffering from cardiac tamponade—prehospital RT has been shown to improve survival rates when performed within minutes of arrest. This study is the largest of its kind, analysing over 600 cases and shedding light on the effectiveness of RT, the critical time windows, and the factors that influence outcomes.

In this episode, we’ll explore the study’s key findings, discuss the operational and ethical challenges of performing RT in the field, and consider what this means for the future of prehospital trauma care. The paper can be found here: https://jamanetwork.com/journals/jamasurgery/fullarticle/2830622

A review and appraisal of the paper can be found here: https://www.stemlynsblog.org/laa-resuscitative-thoracotomy/

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