Clamshell (bilateral anterior) thoracotomy performed in a patient due to a high velocity round to the chest that went through and through from right to left crossing the midline. The bullet went through both left and right lung hilums. This patient lost pulses in the ambulance and the decision to open the chest was made before the patient arrived. Unfortunately, the patient did not survive. This procedure is performed to resuscitate a major trauma patient who has sustained severe thoracic trauma and who has entered cardiac arrest because of this. The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation. Credit: @nirhusmd
Hemodynamic stimuli&nonhemodynamic stimuli
