Patient selection: penetrating cardiac injury
The patient is transported to the trauma center if:
(1) there are signs of life at the scene, OR
(2) there are no signs of life AND transport time is <= 10 minutes
On arrival at the trauma center the patient undergoes emergency thoracotomy if:
(1) there were no signs of life on arrival AND signs of life lost <= 10 minutes during transfer
(2) there were no signs of life on arrival AND CPR <= 10 minutes during transfer
(3) there are signs of life AND the patient is unstable AND the patient did not promptly respond to fluid resuscitation
On arrival at the trauma center the patient is worked up with definitive care if:
(1) there are signs of life AND the patient is stable
(2) there are signs of life AND the patient is unstable AND the patient promptly responded to fluid resuscitation
On arrival at the trauma center there is no treatment if:
(1) there are no signs of life AND signs of life lost > 10 minutes during transfer
(2) there are no signs of life AND CPR > 10 minutes during transfer
The algorithm may be applicable to other forms of penetrating thoracic trauma.
