One of the more invasive procedures that we should be ready to perform as an emergency medicine doctor. To start, here is a great video of a kid who was shot three times and lived because the emergency doctor performed a thoracotomy:
The following is an algorithm from From Hunt et al. Injury 2006;37:1 on traumatic arrest and the indications for a ED thoracotomy.
Some videos demonstrating the procedure:
These next two are great videos, but keep in mind that the rib spreaders are in upside-down.