This study aimed to establish procedural benchmarks for emergency department thoracotomy (EDT) by utilizing trauma video review (TVR) to define normative times for key milestones. A total of 44 EDTs were analyzed, focusing on four specific milestones: right chest decompression, retractor deployment, pericardiotomy, and aortic cross-clamp. The results indicated that median times for these milestones varied, with notable delays for many procedures. Approximately 64% of the EDTs were categorized as outliers due to exceeding the 75th percentile for milestone times or omitting milestones altogether. Additionally, TVR data demonstrated significantly lower rates of missing information compared to traditional electronic medical record (EMR) data, highlighting its potential for enhancing data quality in procedural reviews.

The findings suggest that video analysis can effectively delineate normative procedural times for EDTs and identify areas for quality improvement. Given the prevalence of technical outliers, further research is warranted to explore the relationship between procedural efficiency and patient outcomes, potentially guiding future training and resuscitation practices in emergency settings.