ED Resuscitative
Thoracotomy Course - Introduction
Some of the most
stressful procedures in clinical medicine occur relatively rarely. One such procedure is the treatment of a
patient (often a young person) who has been stabbed in the chest and has arrested in the EmergencyDepartment (ED). Many of
us have seen situations where the diverse group or practitioners looking after such emergently sick people have
not shared the same ‘mental model‘ andoutcomes have not been
as good as they could be.
There are
multiple courses teaching surgeons and ED physicians how to operatively open a chest in an emergency (and how to
decompress a cardiac tamponade). There is ATLS which gives a broad brush stroke of how teams should work together
to look after a patient who has presented after life threatening trauma. These two things will only get you so
far!
How do you get a
group of six to 10 practitioners with anaesthetic, surgical and advanced nursing skills to efficiently open a
patient’s chest (via a clamshell thoracotomy), relieve a cardiac tamponade and get digital control on a ‘hole’ in
the Right Ventricle within 5 minutes of them
arresting ?Drawing on our skills
from devising CALS and REACT we have produced the answer.
A group of
clinicians from a large trauma unit in the United Kingdom came together with CARE
LLC to design guidelines and training which would address these issues. Designing a simple and robust protocol
(rooted in the principles of ATLS) and using modern human factors based training we have devised
the ‘Coventry’ Resuscitative Thoracotomy Course. This aims to teach
your ED staff the ability to work as a team to resuscitate (using a ‘clamshell thoracotomy’) the arrested patient
who has undergone chest trauma.
Due to the rapid
pace of technological and practical change, twinned with the enormous connectivity of modern medicine it is
mandatory that we are able to communicate new techniques e.g. REBOA, etc and integrate them into our guidelines.
We have thus designed in from the outset a networking facility which incorporates into the design of our protocols
to ensure that they remain relevant. This networking ability is associate with our social media
presence allowing practitioners
to discuss practical solutions to ‘problems’ and sharing this knowledge.
We are delighted that you are joining this
‘team’ and thank you for your interest in the ‘Coventry’ Resuscitative
Thoracotomy Course