Ultrasound for Traumatic Arrest

Unclear if you should crack the chest in a blunt or penetrating traumatic arrest?

This trial prospectively enrolled patients with traumatic arrest who underwent resuscitative thoracotomy. They performed a parasternal long and/or subxiphoid views and tracked which patients survived, died, or progressed to organ donation.

Though survival was dismal overall (3.2%), the presence of cardiac activity or pericardial effusion was 100% sensitive for identifying survivors and organ donors.

Cardiac ultrasound is likely very helpful in determining which patients should undergo resuscitative thoracotomy.