RACE AGAINST DEATH: EMERGENCY ROOM THORACOTOMY IN BLUNT CHEST TRAUMA monica_ma_22@hotmail.com

PE113

RACE AGAINST DEATH: EMERGENCY ROOM THORACOTOMY IN BLUNT CHEST TRAUMA

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Portugal

Oral or Poster

Blunt thoracic trauma is a frequent and potentially fatal consequence of motorcycle accidents. Despite the absence of external injuries, severe internal thoracic damage can precipitate cardiac arrest, necessitating rapid recognition and intervention.

We report a case of a 28-year-old male brought to the emergency department in cardiac arrest after a high-energy car-motorcycle collision. Advanced life support measures were initiated at the scene of the accident. Physical examination revealed no external injuries. Bilateral chest drains were placed urgently, draining over 1500 mL of blood, each immediately. Due to persistent cardiac arrest and massive hemothorax, an emergency thoracotomy and pericardiocentesis were performed in the trauma room.

Despite aggressive resuscitation efforts including open cardiac massage, the patient did not achieve return of spontaneous circulation and was pronounced dead.

Blunt thoracic trauma from motorcycle accidents remains a significant cause of prehospital and in-hospital mortality. The absence of external injuries should not reduce clinical suspicion for life-threatening intrathoracic lesions. While emergency department thoracotomy is increasingly rare, it retains a critical role in selected patients presenting with traumatic cardiac arrest and massive hemothorax. Survival rates after blunt trauma-related cardiac arrest remain low (generally <10%), and only a minority survive post-emergency thoracotomy. Nevertheless, early identification and prompt management of ABCDE priorities are essential to maximize chances of survival.