The CRAZIEST procedure a TRAUMA surgeon performs!

I get asked all the time what is the craziest operation I perform. This question is asked many different ways. In this video I discuss the Emergency Department (or Trauma) thoracotomy. Why do we do resuscitative thoracotomies.

Those of you playing the "home game" the first half is for you. Medical students and residents looking to understand more about this kinda awesome procedure, stick around to the end.

[timothyhargrove]

I’ve had the clamshell done to myself and I’m one of the miracles that made it

[alexahardy]

So fascinating! The most amazing learning experience I had in nursing school was my Pathophysiology prof (an ICU nurse for 30 years) tell us the story of her younger brother being saved by this. She was 22 working in the icu. Her brother was working in a mall and stepped into a box crusher machine to try and flatten some boxes by taking them apart to make room for more. He yelled something to his coworker and he thought he yelled to turn the machine on. He went through the machine down to his pelvis and was bleeding out. Miraculously there happened to be a conference for surgeons going on in the mall and 2 amazing surgeons performed a thoracotomy which kept him alive. He passed 3 months later in the same icu she was working at but this allowed their family time to hold him and say goodbye. She told this story while teaching us the physiology of what was happening throughout, through many tears. Most amazing teacher I’ve ever had.

[lauraeaton]

I was a surgical tech and cardiothoracic was my favorite surfery to scrub in on. I was exoecting to see a thoracotomy.

[phil]

I am a firefighter/paramedic who has treated several GSW/stab wound patients who have benefited from this procedure. Five patients I personally treated have survived this procedure with full neurological recovery. The ages ranged from 7 years old to 68 years old. All had penetrating injuries to the chest/abdomen.

[uffu]

The more I learn about the human body, the more I’m amazed by it! Although I’m not in med school or pursuing medicine, I love learning about how our body works and how people save it. It’s legitimately mind blowing material.

[zeta]

I’m an OR nurse working weekend nights at a facility that has recently become a Trauma II hospital. I’ve helped the the Trauma Surgeon with a thoracotomy in the ED. Unfortunately the patient didn’t make it. Your video has been very helpful in better understanding some of the details that take place. Thanks

[pwrfl]

Good idea to drill/practice this procedure because it’s rare in most EDs. ER RN since 1985

[icuerrn]

What a great video, I have seen this only one time in my 31 year career, brought back several memories. Thank you 🙏

[manuneo]

I went through clamshell Thorocotamy in 2015 and survived it without any complications. Thank you Lord

[someone-yjim]

This is so useful, thank you! Please do more educational videos for medical students. I would love to see clinical cases, surgical procedures, managements and so on, related to trauma surgery

[finnm.]

I‘m a Critical Care Paramedic (Not in the US). I haven’t done a clamshell myself but I‘ve assisted doing one in the field (suicidal pedestrian struck by semitruck on the highway at 100kph).

A very radical and intimidating procedure. Sadly in my case of no avail, the Patient suffered from cardiac tamponade, pulmonary avulsion and TBI.

[Dbubblesss]

Plastics nurse here, found your videos from a rec from YouTube on the the hailey Bieber situation. Fell into the YouTube rabbit hole and happy I did! Love your videos. Super informative for a lifelong lover of learning 👌🏼

[mariahshafer]

So helpful! I'm a medical student and kept getting Uworld questions about this!

[Kk_]

Really interesting video! I'm not a trauma surgeon, but I've worked in EMS for about 7 years and have seen this procedure in action a few times in the emergency department. Unfortunately none of these attempts were successful, but it's certainly a high stress moment for everyone involved

[audrewrt]

Hi Dr Hilsden, my name is Audry Wright. I have survived this surgery actually a full “clamshell”. I was involved in a head on collision in June of 2022. Thank God & surgeons I am still alive and well!

[yaregalxewdu]

it attractive and easy to understand, need more on trauma surgery

[karanthaker]

Hi Dr. Hilsden, premed undergrad from UCLA here. Loved the video your channel is awesome! Hope you keep making these videos

[sumeetchoudhary]

Hey this video was really great. I would like to see more videos on difficult procedures with high risks.

[lachyt]

I found the most interesting part of your lecture the discussion which led to you saying you would generally proceed with a thoracotomy for a blunt force ED arrest, this is not the case in the UK and Aus. In my experience US surgeons are generally more willing to operate, I was amazed for instance at some of the brain tumours which are tackled over there with very minimal possibility for quality life extension.
Not to say one way is more or less correct than the other, I do think 'when not to operate' is more highly stressed in commonwealth nations though so it is always good to hear how a US surgeon approaches such matters.

[bendoc]

Iv had one of these. It worked funny enough thank you nhs.