Resuscitative Thoracotomy

Annotation for Point K

Reassessment of the patient following intervention and aggressive resuscitation efforts is performed. Resuscitation of the patient should include crystalloid, packed red blood cells, calcium, and bicarbonate. Vasopressors such as epinephrine and vasopressin may be given through peripheral or central access, and intracardiac epinephrine may be injected in the left ventricle. If the patient develops ventricular fibrillation, internal defibrillation at 30 J is performed with internal paddles placed directly on the myocardium. Occasionally, internal cardiac pacing is warranted. If the patient maintains a perfusing rhythm, salvageability is assessed; in our experience, this is defined as the patient’s ability to generate a systolic blood pressure of greater than 70 mm Hg after a period of aggressive intervention.