Utility of Prehospital Emergency Resuscitative Thoracotomy in Trauma Patients: An Analysis Using the Japanese Society for Aeromedical Services Registry

Q3 Nursing

Air Medical Journal Pub Date : 2026-05-01 Epub Date: 2026-03-14 DOI:10.1016/j.amj.2026.02.006

Daisuke Ueno MD, PhD, Yasukazu Shiino MD, PhD, Satomi Miyamoto MD, PhD, Jiro Takahashi MD, PhD

{"title":"Utility of Prehospital Emergency Resuscitative Thoracotomy in Trauma Patients: An Analysis Using the Japanese Society for Aeromedical Services Registry","authors":"Daisuke Ueno MD, PhD, Yasukazu Shiino MD, PhD, Satomi Miyamoto MD, PhD, Jiro Takahashi MD, PhD","doi":"10.1016/j.amj.2026.02.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Emergency resuscitative thoracotomy (ERT) is a crucial intervention employed in prehospital settings to address life-threatening conditions, such as cardiac tamponade, hemorrhage, and air embolism. Despite its critical nature, the efficacy of prehospital ERT in enhancing survival rates compared with in-hospital procedures remains controversial.</div></div><div><h3>Methods</h3><div>This retrospective analysis was conducted using data from the Japanese Society for Aeromedical Services Registry between January 2020 and December 2022. After excluding nontraumatic cases, non-ERT cases, and records with missing data, 143 prehospital ERT cases were identified. The cohort was categorized into survivors (<em>n</em> = 3) and nonsurvivors (<em>n</em> = 140) based on patient outcomes. Comparative analyses were conducted on variables such as age, injury severity, time intervals, and transportation modalities using the Wilcoxon rank-sum test and Pearson’s chi-square test, with the statistical significance set at <em>P</em> < .05.</div></div><div><h3>Results</h3><div>The overall survival rate after prehospital ERT was 2.1% (3 of 143). Only a few variables, such as hospital length of stay, showed statistically significant differences between the groups; most patient characteristics and prehospital time intervals did not. The patients who experienced cardiac arrest at the time of contact with the emergency medical service (EMS) contact had a survival rate of 0%, whereas those who arrived at the hospital with vital signs had the highest survival rate (11.1%). The presence of vital signs upon hospital arrival and the rapid initiation of intervention were identified as key factors influencing survival.</div></div><div><h3>Conclusion</h3><div>These findings suggest that prehospital ERT provides limited survival benefits, with a 0% survival rate in cases of cardiac arrest at EMS contact. Therefore, further research is essential to refine the patient selection criteria and optimize ERT deployment to improve prehospital patient outcomes.</div></div>","PeriodicalId":35737,"journal":{"name":"Air Medical Journal","volume":"45 3","pages":"Pages 235-240"},"PeriodicalIF":0.0000,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Air Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1067991X26000507","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/3/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"Nursing","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Emergency resuscitative thoracotomy (ERT) is a crucial intervention employed in prehospital settings to address life-threatening conditions, such as cardiac tamponade, hemorrhage, and air embolism. Despite its critical nature, the efficacy of prehospital ERT in enhancing survival rates compared with in-hospital procedures remains controversial.

Methods

This retrospective analysis was conducted using data from the Japanese Society for Aeromedical Services Registry between January 2020 and December 2022. After excluding nontraumatic cases, non-ERT cases, and records with missing data, 143 prehospital ERT cases were identified. The cohort was categorized into survivors (n = 3) and nonsurvivors (n = 140) based on patient outcomes. Comparative analyses were conducted on variables such as age, injury severity, time intervals, and transportation modalities using the Wilcoxon rank-sum test and Pearson’s chi-square test, with the statistical significance set at P < .05.

Results

The overall survival rate after prehospital ERT was 2.1% (3 of 143). Only a few variables, such as hospital length of stay, showed statistically significant differences between the groups; most patient characteristics and prehospital time intervals did not. The patients who experienced cardiac arrest at the time of contact with the emergency medical service (EMS) contact had a survival rate of 0%, whereas those who arrived at the hospital with vital signs had the highest survival rate (11.1%). The presence of vital signs upon hospital arrival and the rapid initiation of intervention were identified as key factors influencing survival.

Conclusion

These findings suggest that prehospital ERT provides limited survival benefits, with a 0% survival rate in cases of cardiac arrest at EMS contact. Therefore, further research is essential to refine the patient selection criteria and optimize ERT deployment to improve prehospital patient outcomes.

查看原文本刊更多论文

院前紧急复苏开胸术在创伤患者中的应用：基于日本航空医疗服务协会注册的分析

目的急诊复苏开胸术（ERT）是院前治疗危及生命的疾病的关键干预措施，如心脏填塞、出血和空气栓塞。尽管具有关键的性质，院前ERT在提高生存率方面的效果与院内手术相比仍然存在争议。方法回顾性分析日本航空医疗服务协会2020年1月至2022年12月的数据。在排除非创伤性病例、非ERT病例和数据缺失记录后，确定了143例院前ERT病例。该队列根据患者预后分为幸存者（n = 3）和非幸存者（n = 140）。采用Wilcoxon秩和检验和Pearson卡方检验对年龄、损伤严重程度、时间间隔、运输方式等变量进行比较分析，P <； 0.05为统计学显著性。结果院前ERT术后总生存率为2.1%（3 / 143）。只有一些变量，如住院时间，在两组之间显示出统计学上的显著差异；大多数患者的特征和院前时间间隔没有变化。在接触紧急医疗服务（EMS）时发生心脏骤停的患者生存率为0%，而到达医院时有生命体征的患者生存率最高（11.1%）。到达医院时生命体征的存在和迅速开始干预被确定为影响生存的关键因素。这些发现表明院前ERT提供有限的生存益处，EMS接触心脏骤停病例的生存率为0%。因此，进一步的研究是必要的，以完善患者选择标准和优化ERT部署，以改善院前患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Air Medical Journal Nursing-Emergency Nursing

CiteScore

1.20

自引率

0.00%

发文量

112

审稿时长

69 days

期刊介绍： Air Medical Journal is the official journal of the five leading air medical transport associations in the United States. AMJ is the premier provider of information for the medical transport industry, addressing the unique concerns of medical transport physicians, nurses, pilots, paramedics, emergency medical technicians, communication specialists, and program administrators. The journal contains practical how-to articles, debates on controversial industry issues, legislative updates, case studies, and peer-reviewed original research articles covering all aspects of the medical transport profession.