Emergency thoracotomy after cardiac arrest from blunt trauma is not always futile

SummaryWe report a case of blunt trauma leading to pulseless electrical activity (PEA) cardiac arrest that was successfully managed with emergency department thoracotomy. While the literature suggests an almost universally poor outcome from this clinical situation, in this case the patient survived with full neurological recovery. Several factors were present in this case, which have been reported as indicating an increased chance of good outcome. These were an arrest rhythm of sinus-based PEA, non-dilated reactive pupils and a short period of cardiopulmonary resuscitation. The case illustrates that in certain circumstances, emergency thoracotomy may not be futile after blunt trauma causing cardiac arrest.