在战斗环境下对紧急复苏胸腔切除术的分析
Andrew David Fisher1,2, M D April3, J M Gurney4
1Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA anfisher@salud.unm.edu.
BMJ military health
|August 29, 2024
概括
在战斗中伤亡的紧急复苏胸腔切除术 (ERT) 显示,24小时后的生存率为26%. 这项研究分析了ERT在军事医学中的实用性,为创伤患者的未来手术决策提供了信息.
科学领域:
- 创伤外科 手术 创伤外科
- 军事医学 军事医学
- 紧急医疗 紧急医疗
背景情况:
- 紧急复苏胸腔切除术 (ERT) 是一个关键的,但在作战环境中耗费大量资源的程序.
- 了解ERT生存率对于优化手术团队资源配置和伤亡管理至关重要.
研究的目的:
- 为了确定经过ERT的战斗伤亡者的生存结果.
- 为军事创伤护理的外科决策和资源分配提供信息.
主要方法:
- 分析了2007-2023年国防部创伤登记处 (DoDTR) 遭遇的数据.
- 在急诊室发现了涉及ERT的病例,但不包括手术室胸切除术.
- 测量的主要结局是24小时死亡率.
主要成果:
- 在48301名伤亡者中,有154名 (0.3%) 接受了ERT治疗,24小时后有40名幸存者 (生存率为26%).
- 爆炸物是伤害的主要原因;未幸存者伤害严重程度得分较低,严重的头部/胸部伤害较少.
- 与幸存者相比,非幸存者需要更少的血液产品输血 (RBC,血,血小板).
结论:
- 在战斗伤亡中,ERT实现了26%的24小时生存率,高于一些平民数据.
- 需要进一步进行严格的研究或改进数据采集,才能确定ERT在战斗群体中的实用性.
相关概念视频
Flail Chest-II
160
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
160
Endoscopic Studies II: Thoracocentesis
223
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
223
Pneumothorax-II
127
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
127
Assessment of Airway, Skin Color, and Use of Accessory Muscles
981
A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...
Introduction
The initial evaluation of a patient's respiratory system...
981


