A life saving approach after thoracic trauma: Emergency Room Thoracotomy

Akçam, Tevfik İlker; Turhan, Kutsal; Ergönül, Ayşe Gül; Oğuz, Enis; Çakan, Alpaslan; Çağırıcı, Ufuk

doi:10.5505/tjtes.2012.70194

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Mortality rates have been found to be significantly higher in penetrating injuries and traffic related injuries to pedestrians when compared to other injuries. Akcam et al 20 performed emergency bedside thoracotomy in 6 patients with penetrating injury and 3 patients with blunt thoracic trauma, and success was only achieved in 3 patients with penetrating injury. They concluded that emergency bedside thoracotomy is a life-saving procedure in the cases of penetrating thoracic injury.…”

Section: Discussionmentioning

confidence: 99%

Management of thoracic trauma in emergency service: Analysis of 1139 cases

Döngel¹,

Coşkun²,

Özbay³

et al. 2012

Pak J Med Sci

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Objective: Thoracic trauma is a common cause of significant morbidity and mortality. This study presents a series of thoracic trauma with the aim to assess epidemiologic features, distribution of pathologies, additional systemic injuries, diagnosis, management and outcome. Methodology: Between January 2007 and December 2011, all patients with thorax trauma admitted to the emergency service of our hospital were retrospectively reviewed with respect to age, gender, etiological factors, distribution of pathologies, additional systemic injuries, diagnosis, treatment modalities, referral and outcome. Results: A total of 1139 patients with thorax trauma were included in the study. Of these, 698 (61.3%) were male and 441 (38.7%) were female, and the average age was 54.17±17.39 years. 1090 (95.7%) of the patients had blunt trauma, whereas 49 (4.3%) had penetrating trauma. Etiological factors were falls in 792 (69.5%), motor vehicle accidents in 259 (22.8%), animal related accidents in 39 (3.4%) and penetrating injuries in 49 (4.2%) patients. It was found that 229 (20%) patients had single, 101 (8.9%) had double, 5 (3%) had three or more, 10 (0.9%) had bilateral rib fractures and 19 (1.7%) had sternal fracture. Pneumothorax was diagnosed in 58 (5.1%) patients, whereas hemothorax, hemopneuomothorax and other system injuries were diagnosed in 36 (3.2%), 38(3.3%) and 292 (25.6%) respectively. In our series, thirteen patients (mortality rate 1.1%) died as result of hemorrhagic shock (n=8), respiratory distress (n=3) and severe multiple trauma (n=2). Conclusion: Although majority of the patients with thorax trauma receive treatment as outpatients; thoracic traumas may be a life threatening condition, and should be identified and treated immediately. Mortality varies based on etiological factors, additional systemic pathologies, capabilities of the hospital especially diagnostic and treatment facilities in emergency services. We believe that a multidisciplinary approach to the patients with severe thorax trauma, and the opportunities of emergency bedside thoracotomy in emergency services will significantly reduce the morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Management of thoracic trauma in emergency service: Analysis of 1139 cases

Döngel¹,

Coşkun²,

Özbay³

et al. 2012

Pak J Med Sci

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“…However, other incisions may also be required. The approach used in the emergency thoracotomy is the anterior thoracotomy [9]; however, median sternotomy or transverse sternotomy may also be performed. In cases of heart and major vessel injuries accompanied by tracheobronchial injuries and in cases of bilateral injuries, the approach with a clamshell incision is recommended [10].…”

Section: Discussionmentioning

confidence: 99%

Rebar Impalement Injury Throughout Bilateral Hemithorax and Pericardium

Akçam¹,

Ergönül²,

Özdil³

et al. 2015

OJTS

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Thoracic traumas have an important place among all injuries as they can cause significant mortality and morbidity. The thoracic injuries are the large part of trauma with head and extremity injuries. Thoracic traumas are divided into two groups, including penetrating and blunt. The primary causes for penetrating traumas are wounds caused by gunshot and sharp objects. The lungs are the most injured organ in penetrating thoracic traumas with many organ injuries accompanied. This case report is about a rebar impalement into bilateral hemitoraces and pericardium after falling down in spite of any injury is not occurred in heart, lung and great vessels. The fact that an injury to such an extent does not cause any intrathoracic catastrophic event is something that has not been reported in the past.

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Resuscitative Thoracotomy in Penetrating Trauma

2014

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The resuscitative thoracotomy (RT) is an important procedure in the management of penetrating trauma. As it is performed only in patients with peri-arrest physiology or overt cardiac arrest, survival is low. Experience is also quite variable depending on volume of penetrating trauma in a particular region. Survival ranges from 0% to as high as 89% depending on patient selection, available resources, and location of RT (operating or emergency rooms). In this article, published guidelines are reviewed as well as outcomes. Technical considerations of RT and well as proper training, personnel, and location are also discussed.

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A life saving approach after thoracic trauma: Emergency Room Thoracotomy

Cited by 3 publications

References 11 publications

Management of thoracic trauma in emergency service: Analysis of 1139 cases

Management of thoracic trauma in emergency service: Analysis of 1139 cases

Rebar Impalement Injury Throughout Bilateral Hemithorax and Pericardium

Resuscitative Thoracotomy in Penetrating Trauma

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