SW to heart

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Errington

I would explore the neck after a contrast swallow if positive or if hard
signs and in zone 2. Otherwise would have observed both injuries.

Tim

Dr T C Hardcastle
M.B., Ch.B. (Stell); M. Med. (Chir) (Stell); FCS (SA)
Principal Specialist Trauma Surgeon /
Honorary Lecturer UKZN Dept Surgery
Deputy Director - IALCH Trauma Service
> Question - I had a gentleman who tried to end it all the other night.  He
> had a SW (slash) to the neck and a single SW inside the cardiac box.  The
> patient was hemodynamically stable.  CXR revealed a left effusion.  I did
> a
> FAST in the ER then I CT of the chest with contrast.  My FAST was negative
> for pericardial fluid.  The CT was read as a small amount of fluid at the
> apex of the heart.  I took the patient to the OR and explored the neck
> wound.  Left chest tube 500cc out then nothing.  Who would have explored
> this patient's chest?
>
>
>
> Next morning the patient's heart rate was 100- 110.  BP 120/70.  Partner
> takes the patient to the OR for a pericardial window.  It is positive.
> Cardiac surgery finds a non-bleeding laceration to the left ventricle.
> Who
> would have taken this patient to the OR?
>
>
>
> Thoughts?
>
>
>
> Errington C. Thompson, MD, FACS, FCCM
>
> Trauma/Surgical Critical Care
>
> Talk Show Host - WPEK 880 AM
>
> Asheville, NC
>
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