[1] The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation.

[2]: 462 [3] A resuscitative thoracotomy is indicated when severe injuries within the thoracic cavity (such as hemorrhage) prevent the physiologic functions needed to sustain life.

[5] For resuscitative thoracotomy to be indicated, signs of life must also be present, including cardiac electrical activity and a systolic blood pressure >70 mm Hg.

[2]: 462 [6] In blunt trauma, if signs of life, such as eye dilatation, are found en route to the hospital by first responders, but not found when the patient arrives, then further resuscitative interventions are contraindicated; however; when first responders find signs of life (respiratory or motor effort, cardiac electrical activity, blood pressure, or pupillary activity)[7] and cardiopulmonary resuscitation time is under 15 minutes, the procedure is indicated.

[8] The use of a focused assessment with sonography for trauma may be performed to determine the need of the procedure by finding free floating fluid in the thoracic cavity.