Nail Gun Penetrating Injury of the Left Ventricle and Descending Aorta

Abstract

A 17-year-old boy was sent to the emergency service for an accidental nail-gun shot injury of the chest. His blood pressure was 90/60 mm Hg, heart rate was 110 bpm, and oxygen saturation was 87% before anesthetic induction in the operating room. Transesophageal echocardiography undertaken after induction with general anesthesia and endotracheal intubation showed that the left ventricle and descending aorta were penetrated by the nail. There was large amount of pericardial effusion with cardiac tamponade. Periaortic hematoma was evident by transesophageal echocardiography. Under partial cardiopulmonary bypass, the nail was removed, and the wounds of the left ventricular wall and descending aorta were repaired. The patient was discharged uneventfully 7 days after the accident.

Continued progress in the prevention of nail gun injuries among apprentice carpenters: What will it take to see wider spread injury reductions?

“…However, very serious injuries have been documented in the trauma literature (Beaver & Cheatham, 1999;Jithoo, Govender, & Nathoo, 2001;Kizer, Boone, Heneveld, & Orozoco, 1995;Takagi, Mori, Murase, & Hirose, 2003;Wang, Chen, & Tsai, 1999;Webb, Ramsey, Dignan, & Drinkwater, 2001;Wu, Tham, & Oon, 1975), in the press in recent years (Associated Press [AP], 1998[AP], , 2004[AP], , 2005Broadwater, 2007), and through OSHA investigation. One such investigation (U.S. Department of Labor, 2007) involved a 26 year-old residential carpenter who died following an unobserved fall while using a nail gun.…”

Nail gun injuries in apprentice carpenters: Risk factors and control measures

“…Although the injuries most often involve puncture wounds to the extremities, particularly to the hands or fingers, injuries to other body parts are not uncommon and the injuries are not limited to minor events. There are reports of serious, even devastating, events in the medical literature [Wu et al, 1975;Kizer et al, 1995;Wang et al, 1999;Nadesan, 2000;Jithoo et al, 2001;Webb et al, 2001;Takagi et al, 2003] as well as in the press over the last few years [Associated Press, 1998Press, , 2004Press, , 2005.…”

Nail gun injuries in residential carpentry: lessons from active injury surveillance

“…Puncture wounds to the hands and fingers are commonly reported, although there are reports of more serious, even fatal, injuries involving the face, eyes, and vital organs. [8][9][10] We report on nail gun injuries among a large cohort of union residential carpenters identified through active injury surveillance that included documentation and description of circumstances surrounding injuries from these tools, calculation of injury rates, and identification of high risk groups and preventive measures. Occupational Safety and Health Administration (OSHA) recordable injuries (requiring medical care above first aid, loss of consciousness, or loss of work time beyond the day of injury) to the project office by facsimile or phone as they occurred on their work sites.…”