1Department of Thoracic and Cardiovacular Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea
2Department of Trauma Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea
Copyright © 2020 The Korean Society of Trauma
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BP: blood pressure, BT: body temperature, CPR: cardiopulmonary resuscitation, FAST: focused assessment with sonography for trauma, PPP: preperitoneal pelvic packing, PR: pulse rates, REBOA: resuscitative endovascular balloon occlusion of the aorta, ROSC: return of spontaneous circulation, RR: respiratory rate.
Time after arrival (minutes) | Clinical status of the patient and the management |
---|---|
0 | BP, 90/61 mmHg; PR, 50/min; RR, 10/min; BT, 35.5°C |
FAST (-) | |
3 | Central catheterization and fluid resuscitation |
5 | Trauma team activation |
6 | Endotracheal intubation |
8 | Cardiac arrest and CPR; 7-Fr sheath insertion via the left femoral artery |
10 | ROSC |
14 | Zone III REBOA; 20 mL inflation; BP, 99/55 mmHg |
16 | Repeated FAST; Morrison pouch (+) |
20 | BP, 74/55 mmHg; PPP was started |
REBOA balloon repositioning from Zone III to I: failed | |
23 | Another balloon insertion at Zone I; 15 mL inflation; BP, 74/55 mmHg |
25 | Cardiac arrest and CPR; ROSC |
26 | 25 mL inflated (nearly total occlusion); BP, 101/76 mmHg |
33 | PPP was completed |
38 | Exsanguination from the right chest drain (1,000 mL) |
Balloon repositioning to high Zone I; cardiac arrest and CPR | |
44 | Emergency department thoracotomy |
49 | Cardiac arrest sustained. Declared death |
BP: blood pressure, BT: body temperature, CPR: cardiopulmonary resuscitation, FAST: focused assessment with sonography for trauma, PPP: preperitoneal pelvic packing, PR: pulse rates, REBOA: resuscitative endovascular balloon occlusion of the aorta, ROSC: return of spontaneous circulation, RR: respiratory rate.