Journal Review in Trauma Surgery: Getting to the Heart of the Problem - Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest

Behind The Knife: The Surgery Podcast

Education, Science, Health & Fitness, Medicine

4.8 • 1.4K Ratings

🗓️ 22 January 2026

⏱️ 51 minutes

🔗️ Recording | iTunes | RSS

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Summary

In resuscitative trauma surgery every second counts. Can time and lives be saved by moving interventions closer to the point of injury? In this episode, we discuss a recent journal article on prehospital resuscitative thoracotomy as a treatment for traumatic cardiac arrest. Opening the chest on the street, who should do it, why should we do it, and for whom?

• Hosts:

Mr Prashanth Ramaraj. General Surgery trainee, Edinburgh rotation. @LonTraumaSchool
Dr Roisin Kelly. Major Trauma Junior Clinical Fellow, Royal London Hospital.
Mr Max Marsden. Resuscitative Major Trauma Fellow, Royal London Hospital. @maxmarsden83
Mr Christopher Aylwin. Consultant Trauma & Vascular Surgeon, Royal London Hospital and Co-Programme Director MSc Trauma Sciences at Queen Mary University of London. @cjaylwin
Mr Zane Perkins. Consultant Trauma & UGI Surgeon, Royal London Hospital and Prehospital Surgeon at London’s Air Ambulance. @ZBPerkins

• Learning objectives:

A) To be aware of the steps of a resuscitative thoracotomy (RT)
B) To understand the rational for prehospital (PH) trauma interventions.
C) To understand the timelines required to optimise success in PH RT.
D) To be familiar with the training governance for clinicians undertaking PH RT.
E) To recognise that PH RT is predominantly an intervention for cardiac tamponade.
F) To understand the contexts in which PH RT might be successful as a standardised intervention.

• References:

Perkins ZB, Greenhalgh R, Ter Avest E, Aziz S, Whitehouse A, Read S, Foster L, Chege F, Henry C, Carden R, Kocierz L, Davies G, Hurst T, Lendrum R, Thomas SH, Lockey DJ, Christian MD. Prehospital Resuscitative Thoracotomy for Traumatic Cardiac Arrest. JAMA Surg. 2025 Feb 26;160(4):432–40. doi: 10.1001/jamasurg.2024.7245. PMID: 40009367; PMCID: PMC11866073. https://pubmed.ncbi.nlm.nih.gov/40009367/
ter Avest, E., Kocierz, L., Alvarez, C. et al. Improving decision-making for prehospital Resuscitative Thoracotomy in traumatic cardiac arrest: a data-driven approach. Crit Care 29, 485 (2025). https://doi.org/10.1186/s13054-025-05705-z. https://pubmed.ncbi.nlm.nih.gov/41233917/

Transcript

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0:00.0	Behind the Knife, the Surgery Podcast.
0:09.1	Relevant and engaging content designed to help you dominate the day.
0:29.3	Behind the Knife wants you. Yes, you. We are officially looking for our next class of BTK fellows.
0:35.9	We need creative residents heading into their researchers who are ready to build the next generation of surgical education content.
0:39.1	You'll get mentorship, access to great resources,
0:45.5	and a global platform to display your work. Applications open in early spring with more information to follow. Dominate the Day. Behind the knife would like to thank our partner, Jomey. With over 300
0:52.2	high-quality, expertly narrated surgical videos,
0:55.5	JOMI is an indispensable resource for residents and students to prep for the OR.
0:59.7	Attendings in residents from Stanford, Harvard, and Johns Hopkins depend on JOMI's up-to-date peer-review
1:05.5	cases. Virtually scrub in at JOMI.com to improve your OR prep today.
1:10.9	Welcome all to our second episode of Behind the Nice's Trauma Sub-Specially podcast series.
1:15.7	We're really pleased to have had lots of positive feedback towards our first episode in September 2025,
1:20.5	stabbed in the back, which was a case review of junctional penetrating injuries.
1:25.4	We're moving on now to an episode that's a journal review in trauma surgery.
1:29.7	Just to introduce the team again.
1:31.2	I'm Pras Ramaraj.
1:32.2	I'm a general surgery trainee in Edinburgh, similar to PGY5.
1:36.6	And with me is Roshin.
1:38.9	I'm Roshin Kelly, former junior clinic at the Fallow,
1:41.9	similar to PGY3 at the Royal London Hospital MTC, and currently enjoying a year overseas in Australia,
1:48.8	working in emergency medicine before choosing a postgraduate specialty. We also have Max Marsden.
1:54.4	Thanks for Sheen. My name is Max Marsden. Completing the international flavour. I am across in South Africa at the moment, just finishing a
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