stab injury to the heart
DESCRIPTION
Most people with stab injuries do not reach the hospital alive. Those who do too may not survive unless the hospital is ready for all emergencies. This patient arrived late evening on a saturday. In no time a team of 2 anesthesiologists, 2 cardiac surgeons, Plastic Surgeon, Operating room staff, perfusionist were all assembled and he underwent surgery. He came close to giving up during the surgery. The presentation highlights the details. Some of the photos show operative images and may be disturbing. Discretion is advised.TRANSCRIPT
Back from the deadBack from the dead
Vikram Hospital, Mysore
AssaultAssault
• While at a isolated temple with his wife, this person was attacked by knife wielding robbers. He resisted the attack and suffered injuries. One on the face and one on the chest. He collapsed immediately. An hour later.. He arrived in hospital.
The wound meant to kill!
Lightning reaction..Lightning reaction..
• Immediately readied for operationImmediately readied for operation
• 8 bottles of blood readied8 bottles of blood readied
• All surgeons arrive in 25 minutesAll surgeons arrive in 25 minutes
• No delay in documentation, no cash No delay in documentation, no cash payment asked..payment asked..
Will it be possible?Will it be possible?
• 80% of heart wounds die.
• He has come 3 hours after injury
• The Team decides
We will not give upWe will not give up• Young man
• Has a young family depending on him
Some of his other injuries..
44 Surgeons, Surgeons, 22 anesthesiologists, anesthesiologists, 22 OT OT technicians, technicians, 11 cardiac perfusionist, cardiac perfusionist, 55 nurses nurses
and and 22 house keeping.. house keeping..15 people15 people Working late in the nightWorking late in the night
The planThe plan
• Temporarily stop the flow of the blood to the heart.
• Somehow keep him alive
• Close the wound as fast as possible
The anesthesiologistsgiving giving bloodblood,pushing fluids, monitoring the BP and ,pushing fluids, monitoring the BP and
keeping him alivekeeping him alive
The wound with lot of blood..The wound with lot of blood..
As the surgery went on..As the surgery went on..
The B P dropped toThe B P dropped to 23/19.23/19.
We all thought he was going to dieWe all thought he was going to die
The fountain of blood from the The fountain of blood from the hole..hole..
• The blood flow to the heart was The blood flow to the heart was stoppedstopped
• The hole could now be seenThe hole could now be seen
The hole caused by the knife…
Using a special device called the Using a special device called the OCTOPUS, the wound was OCTOPUS, the wound was closed…closed…
The hole is closed..The hole is closed..It is 12:15 in the night..It is 12:15 in the night..
Possible problems
• Too much blood loss – Too much blood loss – shock and shock and deathdeath
• Decreased blood flow to the brain – Decreased blood flow to the brain – ComaComa
• Uncontrolled bleedingUncontrolled bleeding from everywhere from everywhere as the body is unable to form clotsas the body is unable to form clots
He fights back…He fights back…
• Remarkable recovery in 48 hoursRemarkable recovery in 48 hours
• Starts sitting up on the 3Starts sitting up on the 3rdrd day day
• Walks on the 5Walks on the 5thth day day
• Discharge on the 7Discharge on the 7thth day. day.
• No COMPLICATIONS No COMPLICATIONS AT ALLAT ALL!!
A life saved.. A miracle has A life saved.. A miracle has occurred… occurred…
a priceless smile.a priceless smile.