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  • Penetrating Chest Trauma: - Prezentare de Caz - Dr. Pasalau Cristi

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    Bolboceanu Georgeta
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    1) A 33-year-old female patient presented to the emergency department after being assaulted by her husband with a sharp weapon, suffering a penetrating chest injury. 2) Initial evaluation revealed a 2 cm stab wound to the lower third of the sternum, decreased breath sounds on the right side of the chest, and signs of developing cardiac tamponade. 3) Diagnostic tests confirmed a hemopneumothorax on the right side, as well as pericardial fluid consistent with cardiac tamponade secondary to the penetrating chest trauma.

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    Chest Trauma

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    1) A 33-year-old female patient presented to the emergency department after being assaulted by her husband with a sharp weapon, suffering a penetrating chest injury. 2) Initial evaluation revealed a 2 cm stab wound to the lower third of the sternum, decreased breath sounds on the right side of the chest, and signs of developing cardiac tamponade. 3) Diagnostic tests confirmed a hemopneumothorax on the right side, as well as pericardial fluid consistent with cardiac tamponade secondary to the penetrating chest trauma.

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    5 views9 pages

    Penetrating Chest Trauma: - Prezentare de Caz - Dr. Pasalau Cristi

    Uploaded by

    Bolboceanu Georgeta
    1) A 33-year-old female patient presented to the emergency department after being assaulted by her husband with a sharp weapon, suffering a penetrating chest injury. 2) Initial evaluation revealed a 2 cm stab wound to the lower third of the sternum, decreased breath sounds on the right side of the chest, and signs of developing cardiac tamponade. 3) Diagnostic tests confirmed a hemopneumothorax on the right side, as well as pericardial fluid consistent with cardiac tamponade secondary to the penetrating chest trauma.

    Copyright:

    © All Rights Reserved
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    of 9

    PENETRATING CHEST

    TRAUMA

    Prezentare de caz
    Dr. Pasalau Cristi

    F .O. 741 / 10.01. 2003


    J . E. , 33 ani ,sex fem.
    Orele 15 :10 . Pacienta ,victima unei
    agresiuni casnice cu arma alba - agresor
    sotul -este adusa la UPU de un echipaj al
    Salvarii Mures

    Semnele vitale

    Puls :105 / min


    F R : 18 / min
    T A : 95 / 63 mmHg
    SpO2 :95 % la FiO2 =21%
    Fara antecedente medicale semnificative
    Fara consum de medicamente
    Fara alergii medicamentoase cunoscute

    Evaluare primara

    GCS = 15 ( M6 O4 V5 )
    orientata temporo-spatial
    fara semne neurologice de focar
    pupile izocore , reactive bilateral ;
    Tegumente : palide ; LA NIVELUL 1/3
    INFERIOARE A STERNULUI PREZINTA
    PLAGA INJUNGHIATA 2 cm

    EVALUARE PRIMARA -contin.


    Ap. Resp :initial MV fiziologic ,simetric
    bilateral
    Ap. CV. : zgomote cardiace regulate ,bine batute
    ,fara sufluri patologice ;
    Puls periferic prezent la radiala, regulat ;
    Devine rapid cianotica la transferul pe targa
    troliu ,in decubit dorsal complet
    Prezinta brusc VJE TURGESCENTE
    Abdomen suplu ,mobil cu respiratia ;ne D.

    REEVALUARE / MANEVRE
    Repozitionata in pozitie semisezanda +O2 pe
    masca starea pacientei se amelioreaza discret
    TA = 85 /56 mm /Hg , AV= 112/ min
    MV mai diminuat la nivelul hemitoracelui dr.
    Montare tub drenaj toracic / dr.
    IOT + VM

    Manevre terapeutice / Investigatii

    HTC, Le, Tb, grup sangvin,


    ABG:pH=7,24 PCO2=60 PO2=134
    sat.O2=99,9%
    BE=7
    HCO3=30,4
    Hb=10,4
    Na =141,6
    K =3,7
    G =254 mg/dl
    Uree=21,3 Crea=1,04
    GOT=170
    GPT=65
    TBIL=0,41

    INVESTIGATII -contin.
    RTG toracic PA
    echocardiografie transtoracica :colectie
    pericardica importanta cantitativ cu aspect
    sugerand evolutie spre tamponada cardiaca
    Rx abdominal pe gol;
    ECG, PVC
    Pericardiocenteza;
    Aortografie, endoscopie esofagiana

    CONCLUZII
    PLAGA INJUNGHIATA PENETRANTA
    LA NIVELUL 1/3 INFERIOARE A
    STERNULUI - AGRESIUNE
    HEMOPNEUMOTORAX DREPT
    TAMPONADA CARDIACA
    POSTTRAUMATICA
    LEZIUNE VENTRICUL DREPT

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