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Module 4: Thoracic Injuries

Segment 10: Initial Interventions

References labeled PEDS contain a pediatric element or primary focus.

Topic: Permissive hypotension

  • Albreiki M, Voegeli D. Permissive hypotensive resuscitation in adult patients with traumatic haemorrhagic shock: a systematic review. Eur J Trauma Emerg Surg. 2018;44(2):191-202. doi: 10.1007/s00068-017-0862-y https://pubmed.ncbi.nlm.nih.gov/29079917/.
  • Hébert S, Kohtakangas E, Campbell A, et al. The efficacy of prehospital IV fluid management in severely injured adult trauma patients: a systematic review and meta-analysis. CJEM. 2023;25(3):200-208. doi: 10.1007/s43678-023-00447-9 https://pubmed.ncbi.nlm.nih.gov/36735147/.
  • Ho KH, Tarng YW, Chou YP, et al. Permissive hypotensive resuscitation in patients with traumatic hemorrhagic shock. Scand J Trauma Resusc Emerg Med. 2019;27(1):14. doi: 10.1186/s13049-019-0595-5 https://pubmed.ncbi.nlm.nih.gov/30755232/.
  • Hussmann B, Hilbert-Carius P, Berk T, et al. Prehospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline update. Eur J Trauma Emerg Surg. 2025;51(1):328. doi: 10.1007/s00068-025-02984-7 https://pubmed.ncbi.nlm.nih.gov/41238835/.
  • Indorewala Y, Nasef Y, Jayagopi K, et al. Permissive hypotension in adult trauma: A systematic review of outcomes across clinical settings, injury type, and resuscitation strategies. Am J Emerg Med. 2026;105:150-157. doi: 10.1016/j.ajem.2026.04.021 https://pubmed.ncbi.nlm.nih.gov/42030689/.
  • Owattanapanich N, Chittawatanarat K, Benyakorn T, et al. Risks and benefits of hypotensive resuscitation in patients with traumatic hemorrhagic shock: a meta-analysis. Scand J Trauma Resusc Emerg Med. 2018;26(1):107. doi: 10.1186/s13049-018-0572-4 https://pubmed.ncbi.nlm.nih.gov/30558650/.
  • Richards JE, Harris T, Dünser MW, et al. Vasopressors in trauma: A never event? Anesth Analg. 2021;133(1):68-79. doi: 10.1213/ane.0000000000005552 https://pubmed.ncbi.nlm.nih.gov/33908898/.
  • Santry HP, Alam HB. Fluid resuscitation: past, present, and the future. Shock. 2010;33(3):229-41. doi: 10.1097/SHK.0b013e3181c30f0c https://pubmed.ncbi.nlm.nih.gov/20160609/.
  • Tran A, Yates J, Lau A, et al. Permissive hypotension vs conventional resuscitation strategies in adult trauma patients with hemorrhagic shock: A systematic review and meta-analysis of randomized controlled trials. J Trauma Acute Care Surg. 2018;doi: 10.1097/ta.0000000000001816 https://pubmed.ncbi.nlm.nih.gov/29370058/.

Topic: Resuscitative thoracotomy

  • Blansfield J, Bauer M. CPR in traumatic arrest: Time to question our practice. J Emerg Nurs. 2025;doi: 10.1016/j.jen.2024.12.003 https://pubmed.ncbi.nlm.nih.gov/39818633/.
  • Brabender D, Kolitsas A, McGillen P, et al. Too quick to cut? Critical outcomes, resource utilization, and ethical perspectives with a liberal approach to emergency department thoracotomy. Am J Surg. 2026;252:116724. doi: 10.1016/j.amjsurg.2025.116724 https://pubmed.ncbi.nlm.nih.gov/41317680/.
  • Chang Y-R, Wang H-LC, Lin H-F, et al. Outcomes of open cardiopulmonary resuscitation in pulseless blunt chest trauma: A nationwide cohort study. Injury. 2025;doi: 10.1016/j.injury.2025.112447 https://pubmed.ncbi.nlm.nih.gov/40425418/.
  • Cheng H, Chiu PW, Lin CH. Influence of pulseless electrical activity and asystole on the prognosis of patients with traumatic cardiac arrest: A retrospective cohort study. Injury. 2025;56(5):112262. doi: 10.1016/j.injury.2025.112262 https://pubmed.ncbi.nlm.nih.gov/40121170/.
  • Dewey MG, Moore EE, Sauaia A, et al. Resuscitative thoracotomy: What you need to know. J Trauma Acute Care Surg. 2026;100(2):153-161. doi: 10.1097/ta.0000000000004803 https://pubmed.ncbi.nlm.nih.gov/41417726/.
  • Douglas A 2nd, Puzio T, Murphy P, et al. Damage control thoracotomy: A systematic review of techniques and outcomes. Injury. 2021;52(5):1123-1127. doi: 10.1016/j.injury.2020.12.020 https://pubmed.ncbi.nlm.nih.gov/33386155/.
  • Douglas AD, Puzio T, Murphy P, et al. Damage control thoracotomy trends, techniques, and outcomes: An EAST multicenter trial. J Trauma Acute Care Surg. 2025;doi: 10.1097/ta.0000000000004492 https://pubmed.ncbi.nlm.nih.gov/40435348/.
  • Dünser MW, Grassmann D, Hamp T, et al. Resuscitative thoracotomy in traumatic cardiac arrest. Wien Klin Wochenschr Educ. 2026;138(7):623-640. doi: 10.1007/s00508-026-02771-3 https://doi.org/10.1007/s00508-026-02771-3.
  • Eidelman P, Katzir O, Akler D, et al. Resuscitative thoracotomy in modern warfare: Experience from a military-civilian trauma system. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000004978 https://pubmed.ncbi.nlm.nih.gov/42023932/.
  • Hatchimonji JS, Meredyth NA, Gummadi S, et al. The role of emergency department thoracotomy in patients with cranial gunshot wounds. J Trauma Acute Care Surg. 2024;97(2):220-224. doi: 10.1097/ta.0000000000004282 https://pubmed.ncbi.nlm.nih.gov/38374530/.
  • Huang CH, Sung CW, Fan CY, et al. The association of blood transfusion and sustained return of spontaneous circulation in blunt traumatic out-of-hospital cardiac arrest. Emerg Med J. 2026;43(2):92-99. doi: 10.1136/emermed-2025-215089 https://pubmed.ncbi.nlm.nih.gov/41136188/.
  • Kalantar GH, Villalta CI, West M, et al. Futility indications in resuscitative thoracotomy: A retrospective observational study evaluating practice guidelines. Injury. 2025;56(10):112673. doi: 10.1016/j.injury.2025.112673 https://pubmed.ncbi.nlm.nih.gov/40812244/.
  • Kulvatunyou N, Keric N. Prognosis, risk factors, and scoring model of patients resuscitated from traumatic cardiac arrest: A multicenter observational study in Japan. J Trauma Acute Care Surg. 2025;doi: 10.1097/ta.0000000000004666 https://pubmed.ncbi.nlm.nih.gov/40506809/.
  • Lacy AJ, Liebendorfer A, Guess SM, et al. Airway management in emergency department thoracotomy: A narrative review. Am J Emerg Med. 2025;99:477-482. doi: 10.1016/j.ajem.2025.11.004 https://pubmed.ncbi.nlm.nih.gov/41237705/.
  • Lammers DT, Holcomb JB. Damage control resuscitation in adult trauma patients: What you need to know. J Trauma Acute Care Surg. 2023;95(4):464-471. doi: 10.1097/TA.0000000000004103 https://pubmed.ncbi.nlm.nih.gov/37735778/.
  • Liu A, Nguyen J, Ehrlich H, et al. Emergency resuscitative thoracotomy for civilian thoracic trauma in the field and emergency department settings: A systematic review and meta-analysis. J Surg Res. 2022;273:44-55. doi: 10.1016/j.jss.2021.11.012 https://pubmed.ncbi.nlm.nih.gov/35026444/.
  • Lorenzo M, Coimbra R, Croft CA, et al. Western Trauma Association critical decisions in trauma: Penetrating thoracic injury. J Trauma Acute Care Surg. 2026;100(3):484-492. doi: 10.1097/ta.0000000000004853 https://pubmed.ncbi.nlm.nih.gov/41417725/.
  • Lott C, Truhlář A, Alfonzo A, et al. European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances. Resuscitation. 2021;161:152-219. doi: 10.1016/j.resuscitation.2021.02.011 https://pubmed.ncbi.nlm.nih.gov/33773826/.
  • Ordoñez CA, Parra MW, Caicedo Y, et al. Critical systolic blood pressure threshold for endovascular aortic occlusion – A multinational analysis to determine when to place a REBOA. J Trauma Acute Care Surg. 2023:10.1097/TA.0000000000004160. doi: 10.1097/ta.0000000000004160 https://pubmed.ncbi.nlm.nih.gov/37853558/.
  • Ordoñez CA, Serna JJ, Parra MW, et al. One incision, complete access: Median sternotomy and aortic occlusion in penetrating chest trauma. J Trauma Acute Care Surg. 2026;100(5):810-817. doi: 10.1097/ta.0000000000004872 https://pubmed.ncbi.nlm.nih.gov/41925571/.
  • Panossian VS, Nederpelt CJ, El Hechi MW, et al. Emergency resuscitative thoracotomy: A nationwide analysis of outcomes and predictors of futility. J Surg Res. 2020;255:486-494. doi: 10.1016/j.jss.2020.05.048 https://pubmed.ncbi.nlm.nih.gov/32622163/.
  • Perkins ZB, Greenhalgh R, Ter Avest E, et al. Prehospital resuscitative thoracotomy for traumatic cardiac arrest. JAMA Surg. 2025;160(4):432-40. doi: 10.1001/jamasurg.2024.7245 https://pubmed.ncbi.nlm.nih.gov/40009367/.
  • Radulovic N, Wu R, Nolan B. Predictors of survival in trauma patients requiring resuscitative thoracotomy: A scoping review. Trauma. 2023;0(0):14604086231156265. doi: 10.1177/14604086231156265 https://journals.sagepub.com/doi/abs/10.1177/14604086231156265.
  • Semanco M, Montero J, Russell N, et al. Clinical predictors of unplanned reoperations in trauma patients with damage control surgeries for truncal injuries. Trauma. 2025:14604086251318429. doi: 10.1177/14604086251318429 https://doi.org/10.1177/14604086251318429.
  • Ter Avest E, Kocierz L, Alvarez C, et al. Improving decision-making for prehospital resuscitative thoracotomy in traumatic cardiac arrest: A data-driven approach. Crit Care. 2025;29(1):485. doi: 10.1186/s13054-025-05705-z https://pubmed.ncbi.nlm.nih.gov/41233917/.
  • Tesoriero R, Coimbra R, Biffl WL, et al. Adult emergency resuscitative thoracotomy: A Western Trauma Association clinical decisions algorithm. J Trauma Acute Care Surg. 2024;97(6):961-968. doi: 10.1097/ta.0000000000004462 https://pubmed.ncbi.nlm.nih.gov/39451159/.
  • Watts S, Smith JE, Gwyther R, et al. Closed chest compressions reduce survival in an animal model of haemorrhage-induced traumatic cardiac arrest. Resuscitation. 2019;140:37-42. doi: 10.1016/j.resuscitation.2019.04.048. https://pubmed.ncbi.nlm.nih.gov/31077754/.
  • Witt CE, Shatz DV, Robinson BRH, et al. Epinephrine in prehospital traumatic cardiac arrest: Life saving or false hope? Prehosp Emerg Care. 2026;30(1):153-161. doi: 10.1080/10903127.2025.2461283 https://pubmed.ncbi.nlm.nih.gov/39889233/.
  • Yamaguchi K, Takahashi K, Abe T, et al. Survival after Resuscitative Thoracotomy in the Emergency Department: An Analysis of 487 Trauma Patients with Prehospital Cardiopulmonary Resuscitation. J Am Coll Surg. 2026;doi: 10.1097/xcs.0000000000002130 https://pubmed.ncbi.nlm.nih.gov/42579392/.