Bedside Ultrasonography in the Management of Penetrating Cardiac Injury Caused by a Nail Gun.
Aged
Emergency Service, Hospital
/ organization & administration
Firearms
/ statistics & numerical data
Foreign Bodies
/ complications
Heart
/ diagnostic imaging
Heart Injuries
/ etiology
Humans
Male
Point-of-Care Testing
/ standards
Respiratory Insufficiency
/ etiology
Thoracotomy
/ methods
Ultrasonography
/ methods
Wounds, Penetrating
/ diagnosis
cardiac tamponade
emergency medicine
heart
nail gun
pericardial effusion
thoracotomy
trauma
ultrasonography
Journal
The Journal of emergency medicine
ISSN: 0736-4679
Titre abrégé: J Emerg Med
Pays: United States
ID NLM: 8412174
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
02
03
2018
revised:
06
09
2018
accepted:
20
09
2018
pubmed:
6
11
2018
medline:
21
5
2019
entrez:
4
11
2018
Statut:
ppublish
Résumé
Injuries from nail guns are a unique type of penetrating trauma seen in emergency departments (EDs), rising in prevalence in the United States. These devices can lead to life-threatening injuries that require rapid diagnosis to help guide management. An elderly man was brought to the ED having sustained a nail gun injury to the chest. After loss of pulses, brief closed chest compressions and rapid blood product administration led to a return of spontaneous circulation. Using bedside ultrasound, a metallic foreign body was identified tracking through the right ventricle with associated pericardial fluid and pericardial clot. This rapid diagnosis with bedside ultrasound helped facilitate timely transport to the operating room for median sternotomy, foreign body removal, and pledgeted cardiac repair. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With continued developments in image quality and acquisition, and improvements of physician operator performance, ultrasonography has continued to make significant impacts in traumatically injured patients in new ways. We present this case report to highlight precordial nail gun injuries and to emphasize the diagnostic capabilities of bedside ultrasound for these patients.
Sections du résumé
BACKGROUND
BACKGROUND
Injuries from nail guns are a unique type of penetrating trauma seen in emergency departments (EDs), rising in prevalence in the United States. These devices can lead to life-threatening injuries that require rapid diagnosis to help guide management.
CASE REPORT
METHODS
An elderly man was brought to the ED having sustained a nail gun injury to the chest. After loss of pulses, brief closed chest compressions and rapid blood product administration led to a return of spontaneous circulation. Using bedside ultrasound, a metallic foreign body was identified tracking through the right ventricle with associated pericardial fluid and pericardial clot. This rapid diagnosis with bedside ultrasound helped facilitate timely transport to the operating room for median sternotomy, foreign body removal, and pledgeted cardiac repair. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With continued developments in image quality and acquisition, and improvements of physician operator performance, ultrasonography has continued to make significant impacts in traumatically injured patients in new ways. We present this case report to highlight precordial nail gun injuries and to emphasize the diagnostic capabilities of bedside ultrasound for these patients.
Identifiants
pubmed: 30389284
pii: S0736-4679(18)30955-7
doi: 10.1016/j.jemermed.2018.09.036
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
197-200Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.