1 case of severe thoraco-abdominal injuries in the emergency care of patients.docVIP

 PAGE \* MERGEFORMAT 8 1 case of severe thoraco-abdominal injuries in the emergency care of patients [Keywords:] thoraco-abdominal injuries, penetrating injuries, hemorrhagic shock February 2009, our department treated one case of severe combined thoracoabdominal penetrating wound and blood of pneumothorax in patients with hemorrhagic shock, the emergency line 2 closed thoracic drainage, repair of the right diaphragm, double thigh debridement and small networks repair of membrane rupture and hematoma, hospitalization 13 d, were discharged. now the situation of emergency care are summarized below. A case report Patients, male, 15 years old, the body caused by stabbed multiple hospital admissions bleeding 30 min. Admission examination: conscious, pale, clammy extremities, body temperature did not rise, pulse breakdown, 120 times / min, respiratory difficulties, 15 times / min, blood pressure 50/20 mmHg, fear face, bloody body, flat stomach, muscle tension, the right hypochondrium with a long 5 cm transverse incision, the left hip with a long 3 cm incision, the right hip with Director of two 3 cm incision, the wounds are bleeding more than active. bedside ultrasound B Tip: moderate abdominal effusion, a small amount of the right pleural effusion. Diagnosis: Blood pneumothorax, right hepatic lobe contusion, abdominal organs bleeding. immediately given pressure bandage to stop bleeding, anti-shock, thoracic puncture and closed drainage. blood pressure rises immediately sent to the operating room under general anesthesia the right diaphragm repair, drainage of peritoneal lavage debridement + double thigh surgery. after shock is not effective control, prompt abdominal peritoneal drainage fluid is still active bleeding, again under general anesthesia laparotomy (rupture of suture + omental hematoma, intraoperative see the intra-abdominal hemorrhage 800 ml, postoperative ICU care delivery, the use of breathing machine auxiliary rib breathing, give fluid repl