Which of the following statement(s) is/are true concerning Emergency Room thoracotomy?

d. None of the above

A recent meta-analysis of 24 reports concerning the outcome of Emergency Room thoracotomy found that the overall survival rate was 11%. There were no survivors among patients with no signs of life (supraventricular electrical activity, pupillary reaction, and agonal respirations) at the scene. In addition, there were no neurologically intact survivors among blunt trauma patients without signs of life upon arrival in the Emergency Department. Considering these findings, an appropriate algorithm would indicate that Emergency Room thoracotomy for penetrating trauma is indicated only if patients had signs of life at the scene and had lost signs of life less than five minutes prior to arrival in the Emergency Room. Blunt trauma patients would be allowed Emergency Room thoracotomy only if the patient had signs of life upon arrival at the Emergency Room. If patients meet these criteria and lose cardiac function, airway placement and fluid resuscitation is initiated simultaneously with or immediately followed by left anterior thoracotomy, pericardiotomy, and internal cardiac massage.