October 15, 2020

Background: A resuscitative thoracotomy is a time-critical high acuity, low occurrence (HALO) procedure – as an emergency physician you need to know how to do it, but depending on your practice environment, it may be a once-in-a-career maneuver. All the more reason that, if you have to do it, you want to make sure your effort counts. In a prior post, I advised that if you’re going to be doing a thoracotomy as an EM doc, you should do a clamshell approach. This was based both on some evidence from the surgical literature as well as personal experience – I feel the clamshell gives you the exposure you really need if you are doing this rarely and the time difference compared to an anterolateral approach is negligible. A recent paper from Newberry et al. (published ahead of print in Annals of Emergency Medicine) addresses this very issue – from an EM perspective.