Survival after emergency department thoracotomy in a child with blunt multisystem trauma.

A 14-year-old boy sustained severe blunt, multisystem trauma. On presentation, vital signs were present but disappeared despite maximal resuscitation. Emergency department thoracotomy (EDT) resulted in return of vital signs and transfer to the operating room for a definitive procedure. Ultimately, the child survived with normal neurologic function and quality of life. This case illustrates the potential value of EDT in selected patients who present with detectable vital signs and deteriorate in the face of maximal conventional therapy.