A 39-year patient with a severe haemorrhagic-traumatic shock due to a gunshot, with a left-sided penetrating chest wound resulting in haemothorax, pneumothorax and massive blood loss was treated in the Czech Field Hospital ROLE 2 plus after a terrorist attack in Kabul. The initial Sequential Organ Failure Assessment (SOFA) of 13 points improved thanks to damage control surgery and adequate perioperative care to 5 points, increasing the chance of survival from 5% to 80%. The patient was transported to his homeland on the 3rd postoperative day where he recovered.
Authors:
Jurenka Božetěch 1; Ryska Miroslav 2; Kalas Ladislav 3; Oberreiter Martin 4
Authors‘ workplace:
Anesteziologicko-resuscitační oddělení, Ústřední vojenská nemocnice Praha
1; Chirurgická klinika, 2. LF UK a Ústřední vojenská nemocnice, Praha
2; Radiologické oddělení, Vojenská nemocnice Brno
3; 6. Polní nemocnice Armády České republiky, Kábul
4
Published in:
Anest. intenziv. Med., 19, 2008, č. 3, s. 143-148
Category:
Anaesthesiology - Case Report
Overview
A 39-year patient with a severe haemorrhagic-traumatic shock due to a gunshot, with a left-sided penetrating chest wound resulting in haemothorax, pneumothorax and massive blood loss was treated in the Czech Field Hospital ROLE 2 plus after a terrorist attack in Kabul. The initial Sequential Organ Failure Assessment (SOFA) of 13 points improved thanks to damage control surgery and adequate perioperative care to 5 points, increasing the chance of survival from 5% to 80%. The patient was transported to his homeland on the 3rd postoperative day where he recovered.
Authors noted that standard therapeutic approaches can be kept to in the extraordinary conditions of ROLE 2 plus Hospital in Afghanistan. Teamwork and optimal timing of transport to a higher medical facility are an integral part of patient management, and the only way to achieve success in the high risk region.
Keywords:
terrorist attack – haemorrhagic-traumatic shock – lung injury – survival assessment
Sources
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6. ARDS clinical network, dostupné na: www.ardsnet.org.
7. Marino, P. L. The ICU book. Third edition. Lippincott Williams & Wilkins, 2007.
8. Van der Berghe, G., Wouters, P., Weekers, F. et al. Intensive insulin therapy in critically ill patients. NEJM, 2001, 345, p. 1359–1367.
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Labels
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineArticle was published in
Anaesthesiology and Intensive Care Medicine
2008 Issue 3
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