In this episode Rahim and I give a play by play of a high stakes trauma resusitation that we managed together involving a dump and run gun shot wounded patient who ultimately required an ED thoracotomy.  Our discussion pays particular attention to the clamshell technique, POCUS for the primary assessment, early blood products, team dynamics and the need to mentally and physically prepare for this procedure using deliberate practice to establish muscle memory. 

For a description of the Clamshell technique. https://emj.bmj.com/content/22/1/22

Blood brought down to the ED in a cooler can be returned to the bloodbank for reissue up to 4 hours from release from the bloodbank as long as they are still on ice per the guidelines from Janus General. This time may vary based on your institution. Please verify for local context.