Anaesthetic Management of a Patient With Penetrating Thoracic and Cardiac Injuries in Emergency Department

Abstract

Thoracic injuries may be associated with life threatening cardiac injury necessitating immediate surgical intervention in an emergency operation theatre at odd hours with limited investigations and resources. Pre Anaesthetic optimization by maintenance of adequate tissue oxygenation with optimal blood volume replacement and judicious use of inotropes, determine outcome of such emergency procedures. Careful selection of Anaesthetic techniques and drugs particularly the inducing agents like Ketamine hydrochloride can be life-saving. We are discussing Anaesthetic management of a 24 year old victim of road traffic accident brought to the Emergency Department in a state of unconsciousness and shock due to penetrating chest injury with multiple rib fractures, pleural laceration, pericardial laceration and diaphragmatic tear. The patient was put up for emergency exploration and repair. CT scan ruled out head injury and Abdomen was soft and ultrasound detected no obvious intra-abdominal injury or collections.