Trauma Clinical Trial
Official title:
Prospective Randomized Trial of Standard Left Anterolateral Thoracotomy vs Modified Bilateral Clamshell Thoracotomy Performed by Emergency Physicians
Resuscitative thoracotomy (RT) is a life saving procedure for patients who have suffered cardiac arrest or are at significant risk of cardiac arrest following significant trauma. The procedure is ideally performed by a surgeon, but in some circumstance must be performed by non-surgical specialists such as Emergency Medicine physicians. The purpose of this study was to evaluate the optimal RT technique taught to non-surgical specialists in an educational human cadaver lab. The objective was to compare time to successful completion of two different RT techniques; (1) Left Anterolateral Thoracotomy (LAT) and (2) Modified Clamshell Thoracotomy (MCT). The investigators hypothesized that the non-surgical specialist time to successful completion for the MCT would be shorter than for the LAT.
The investigators conducted a randomized crossover trial of two resuscitative thoracotomy
techniques performed by Emergency Medicine (EM) physicians using a fresh human cadaver model.
The purpose was to identify the ideal technique to be taught to non-surgical specialists in a
training lab setting. The two techniques compared were the Left Anterolateral Thoracotomy
(LAT), commonly taught to EM physicians in the United States, and the Modified Clamshell
Thoracotomy (MCT) taught by London's Air Ambulance. The investigators hypothesized that the
non-surgical specialists time to successful completion of the RT would be faster when
performing the MCT compared to the LAT.
The investigators conducted this study at a large level 1 trauma center with an Emergency
Medicine residency program and recruited Emergency Medicine residents and staff physicians to
participate. Participants were trained on the MCT as performed by LAA and reviewed the LAT
technique in a standardized fashion. Participants were then randomized to order of
intervention, and conducted each procedure on a separate fresh human cadaver. Participants
were evaluated on time to successful completion of the procedure, successful completion of
procedural steps, and identification of anatomy. Cadaver specimens were examined for
iatrogenic injuries. Participants then completed a standardized survey regarding each
procedure.
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