Volume 9, Issue 2 (10-2021)                   jms 2021, 9(2): 73-80 | Back to browse issues page

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S S, G L E, E V M. Successful treatment of cardiac tamponade in traumatic penetrating lesion by bed side sonography in emergency department (ED): a case report tamponade treatment in ED. jms. 2021; 9 (2) :73-80
URL: http://jms.thums.ac.ir/article-1-936-en.html
1- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract:   (298 Views)
Background & Aim: Cardiac tamponade occurs when excessive fluids accumulate in pericardium that eventually lead to right ventricular failure and obstructive shock. Cardiac tamponade is often associated with traumatic penetrating lesions of the heart caused by a stab, or gunshot wound. It is a medical emergency and often affects young men. Herein, we have reported a successful treatment of cardiac tamponade from stab wound of the heart by bed side sonography in emergency department.
Case Report: A 22-year-old man presented to the emergency department with a complaint of stab wound to the fifth intercostal space on the left side of the chest. Initial treatment for the patient started immediately. Bedside ultrasound showed evidence of severe pericardial effusion with clots and pressure on the right ventricle and based on the consultation with surgeon, the patient diagnosed with surgical emergency. While preparing the patient for transferring to the operating room, despite receiving crystalloid, the patient suffered a sudden drop in blood pressure (pulse/6). Ultrasonography showed the exacerbation of the fluid accumulation in the pericardial space with right ventricular collapse. Therefore, approximately 40 cc of blood was drained from the pericardial space under ultrasonography guidance in the emergency room.  Afterwards, the blood pressure reached 95/65 and the patient was transferred to the operating room. Finally, he was discharged home with good condition.
Conclusion: Rapid diagnosis of tamponade and attention to the patients’ vital sign even during the transferring in hospital can save their lives.
Full-Text [PDF 332 kb]   (33 Downloads)    
Type of Study: case report | Subject: Special
Received: 2021/05/16 | Accepted: 2021/09/7 | Published: 2021/10/2

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