title: Emergency prehospital on-scene thoracotomy: a novel method.
abstract: The necessity for prehospital thoracotomy is rare, but can be lifesaving. Occasionally an emergency practitioner or surgeon coincidentally arrives at a trauma scene before the arrival of emergency medical teams. In such a circumstance, even when thoracotomy may be indicated, it is not usually performed in view of the lack of equipment (e.g., dissecting tools or rib retractor). We present a novel technique of "L" shape thoracotomy, or Thoraco-sterno-costochondrotomy, whereby in a prehospital setting, and with minimal equipment (such as a penknife) a thoracotomy can be performed with adequate exposure of the heart and great vessels. The similarities of this pragmatic procedure are considered within the context of ancient Aztec and Mesoamerican thoracotomies.
authors.affiliation: Department of Surgery and Cancer, Imperial College London and Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK. h.ashrafian@imperial.ac.uk
authors.forename: Hutan
authors.initials: H
authors.lastname: Ashrafian
authors.forename: Thanos
authors.initials: T
authors.lastname: Athanasiou
mesh_terms: D004630:Emergencies; D006801:Humans; D013908:Thoracotomy / Q000379:methods*