Should emergency room thoracotomy be reserved for cases of cardiac tamponade?

Forty-five trauma cases underwent emergency room thoracotomy (ERT) for circulatory collapse or cardiac arrest in the resuscitation area. There were no survivors in the blunt injury group (13 cases). In the penetrating group (32 cases) the overall survival was 25 per cent, with seven out of eight survivors having cardiac tamponade. Although ERT gives good results only for cardiac tamponade, not all cases of tamponade are clinically obvious on admission. The authors recommend that ERT be done on all cases of collapse or arrest following penetrating chest injury where signs of life have been present within the previous 3 min.