Insertion of the thumb into a large heart wound will control massive cardiac bleeding, permitting restoration of blood volume with multiple transfusion. The tense aorta indicates satisfactory blood replacement. After inflation of the lungs, cardiac arrest will be tolerated for three to four minutes, providing the blood volume is adequate. The arrest permits removal of the thumb without further bleeding and accurate definitive cardiac suture. Compression of the great vessels anterior to the transverse sinus effectively produces anoxic arrest. Effective arrest may be lifesaving if massive bleeding occurs during closed-heart or other intrathoracic procedures. It must be boldly employed prior to irreparable blood loss.
Brewer LA, Carter R. Elective Cardiac Arrest for the Management of Massively Bleeding Heart Wounds. JAMA. 1967;200(12):1023–1025. doi:10.1001/jama.1967.03120250057008
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