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We were interested to the read case report by Wright and Murphy of a prehospital thoracotomy.1 We use a rather different interpretation of the evidence to guide our approach to this problem.
We differ on a number of points. If an immediate prehospital thorocotomy is indicated we have learned from the nine survivors that have been achieved within the London HEMS system, that asystole is not an indicator of an unsurvivable injury. We would also disagree with the time limits given for this intervention, …