Cardiothoracic and transplant surgeon with an interest in thoracic trauma. A keen EMST instructor with an unhealthy focus on chest injuries and emergency room thoracotomies.

Cardiothoracic conundrum?

Chest trauma management is evolving from conservative watch and analgesia to a more “pro-active” fixation and washout. Which patients should we be intervening upon? Plating systems are now specifically modelled for ribs and the sternum, making surgical technique easier and more successful. Chose your “flailing” patient well, and they will extubate sooner, breathe better and rehab faster!

Heart in Box
Day 3

Treatment of cardiac arrest requiring CPR has been transformed by the use of extra-corporeal membrane oxygenation. Patient stabilised on this innovative therapy can be transferred for coronary angiography and possible stent intervention. Time is critical, time is muscle! However, when the muscle is gone but the other organs still work what options do we now have? For the patient in sustained unrecoverable cardiogenic shock with neurology intact where should we go? What therapies are appropriate and possible?

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