A Case of an Advanced Chain of Survival in Penetrating Cardiac Injury

Autor: Mads Jønsson Andersen, Frank V. De Paoli, Rikke Mærkedahl, Søren Vad Jepsen, Karoline Skov Dalgaard, Thomas Falstie, Gustav Gerstrøm
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Case Reports in Emergency Medicine, Vol 2019 (2019)
Druh dokumentu: article
ISSN: 2090-648X
2090-6498
DOI: 10.1155/2019/2895439
Popis: The survival rate of penetrating cardiac trauma is dismal, with only a few patients reaching the hospital with any signs of life. Short transport time and close proximity to the trauma center are positive factors for survival. We report the successful case of a 21-year-old male with penetrating cardiac injury and tension-pneumothorax with long distance to a trauma facility. The patient was stabbed twice in the anterior left side of the thorax. The emergency services found the patient with suspicion of left tension-pneumothorax. Urgent left mini-thoracotomy was established resulting in spontaneous respiration and clinical improvement. Due to rapid clinical deterioration and clinical suspicion of pericardial tamponade, patient was transported to the local regional hospital only minutes away. Echocardiography confirmed tamponade, and urgent ultrasound-guided pericardiocentesis was performed. During the transport blood was intermittently drained from the pericardial sack until arrival at the trauma center where a penetrating injury to the left ventricle was repaired during urgent cardiac surgery. The patient was discharged 8 days after the incident. Conclusion. Well organized emergency medical transport systems increase the chance of survival in penetrating cardiac injuries. Urgent pericardiocentesis with continuous drainage can help stabilize a patient until arrival at trauma facility.
Databáze: Directory of Open Access Journals
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