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To test the hypothesis that inappropriate emergency department (ED) thoracotomy is futile, wastes resources, and poses a health risk to providers, researchers reviewed data for 123 patients who underwent ED thoracotomy at a level I trauma center in Toronto during a 17-year period. The authors defined ED thoracotomy as being inappropriate if it was performed in patients with blunt trauma and prehospital arrest time >5 minutes or in those with penetrating trauma, prehospital cardiac arrest time >15 minutes, and no signs of life (Glasgow Coma Scale score of 3, pupils fixed and dilated, no organized electrical activity, no pulse, and no spontaneous respiratory efforts).
Procedures were deemed inappropriate for 63 patients (51%); 60 patients met …