Prehospital Emergency Thoracotomy Performed by Helicopter Emergency Medical Service Team—A Case Report. [Ulus Travma Acil Cerrahi Derg]
Ulus Travma Acil Cerrahi Derg. Ahead of Print: UTD-50284 | DOI: 10.5505/tjtes.2018.50284  

Prehospital Emergency Thoracotomy Performed by Helicopter Emergency Medical Service Team—A Case Report.

Tomasz Darocha1, Sylweriusz Kosinski2, Wojciech Serednicki3, Tomasz Derkowski4, Pawel Podsiadlo4, Jan Szpor3, Tomasz Sanak5, Robert Galazkowski6
1Department of Anesthesiology and Intensive Care, Medical University of Silesia, Medykow 14, Katowice, Poland.
2Department of Anesthesiology and Intensive Care, Pulmonary Hospital, Gladkie 1, Zakopane, Poland
3Department of Anesthesiology and Intensive Care, Trauma Center, University Hospital, Kopernika 36, Krakow, Poland
4Polish Medical Air Rescue, Ksiezycowa 5, Warsaw, Poland
5Department of Disaster Medicine and Emergency Care, Jagiellonian University Medical College, Krakow, Poland
6Department of Emergency Medical Services, Medical University of Warsaw, Zwirki i Wigury 61, Warsaw, Poland

Background: Emergency thoracotomy is a life saving procedure in critically injured patients who present with chest injuries. Currently, the indications for the on-the-scene thoracotomy are penetrating trauma of the chest or upper abdomen with cardiac arrest, which has occurred in the presence of emergency team, or up to 10 min before their arrival. Indications for emergency thoracotomy in blunt chest trauma are less clearly defined.
Objectives: We present a case, where the HEMS team performed emergency thoracotomy at the scene. To the best of our knowledge, it is the first description of such a procedure in Poland
Material and Methods: A 41-year-old male got crushed in a tractor accident. Despite all available measures taken a sudden cardiac arrest occurred. HEMS team performed an emergency thoracotomy at the scene as an integral part of prehospital cardiopulmonary arrest management.
Results: The patient survived, and was discharged from hospital in good physical condition. No neurological deficit was identified (Cerebral Performance Category 1). The patient returned to previous activities free of any complications or deficits.
Conclusions:
The presence of a fully trained crew allows for the performing of on-the-scene emergency thoracotomy. In a well-selected group of patients with blunt thoracic injury the prehospital emergency thoracotomy may be a significant and life-saving procedure.

Keywords: prehospital critical care, thoracotomy, emergency treatment,




Corresponding Author: Tomasz Sanak, Poland


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