Open trauma-wounding of the heart: operation technique, first aid, surgery

Severe wound of the heart - open trauma requires immediate assistance to the patient. It was lucky for the victim if there are people nearby who know what to do: how to render first aid while the ambulance arrives.

Features of injury

Wound of the heart is a serious form of injury. The threat of a lethal outcome is great. The probability of saving a patient's life depends on how quickly the wounded person gets to the hospital for a surgical table to provide emergency assistance.

  • Bleeding from an injured heart, when the blood collects behind the body and begins to create a tightening of the heart( tamponade) represents an increasing threat to the life of the body. The larger the volume of blood falls outside the myocardium, the more likely it is due to the harassment of the body to stop its functioning.
  • The second danger, concealed in a situation in which the blood flows from the heart and reduces the intensity of circulation, is associated with inadequate nutrition of organs during this period and oppression of their functions. Lack of oxygen most affects the state of the brain.

Classification

Nature

Wounds of the heart can be of such a nature:

  • gunshot,
  • knife wound in the heart,
  • stabbed,
  • complex.

Wounds in the heart are classified by number:

  • single injury,
  • multiple injuries.

Degree and location of lesions

There are cardiac injuries according to the degree of lesion:

  • penetrating wound, when there was a through damage to the heart muscle;
  • non-penetrating wound - the heart cavity does not communicate with the environment, which is located in the pericardial space.

When the heart is injured, it is possible to damage its structural parts:

  • , the left ventricle is injured more often than the other chambers, the
  • right ventricle is in second place in the frequency of injury among the heart chambers, the
  • of the atrium is rarely traumatized.

Causes of

An open injury( injury) to the heart can result from:

  • stabbing or other sharp object,
  • bullet or fragmentation wound,
  • as a consequence of an emergency.

On the symptoms of knife, bullet and other types of injuries in the heart, read below.

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Symptoms of

That a person has an open wound, signal such signs:

  • Cardiac tamponade is the flow of blood from the internal cavities into the pericardium. This phenomenon leads the body into a cramped state and carries a threat to the life of the injured person. The development of a tamponade can be determined by such symptoms:
    • appears a bluish shade of skin:
      • on the ears,
      • on the tip of the nose,
      • on the surface of the lips;
    • there is swelling of veins on the neck,
    • skin in other places, except those that have become cyanotic, acquires pallor;
    • changes the rhythm of heartbeat and frequency of contractions,
    • there is a drop in blood pressure.
  • Visible wound in the region of the chest. The wound is localized in the zone corresponding to the approximate projection of the location of the heart.
  • Bleeding from the wound can be very significant.

Diagnostics

The first diagnostic conclusions can be made on the appearance of a traumatized person. Symptoms described in the previous section show the possibility of the presence of an open wound of the heart. But to diagnose the condition of these signs is not enough.

To be specified:

  • Electrocardiography - the device records pulses of cardiac activity on a paper carrier. The study shows whether the pacemakers work fully, determines the electrical activity of the heart.
  • Echocardiography - the method makes it possible to see the state of the heart structures. With the help of this study, you can analyze the work of the body at the time when the diagnosis is carried out.
  • X-ray of the area of ​​injury - on the screen, specialists will see the situation in the heart, how the structures work and what kind of trauma.

Treatment of

In order to save the life of a person who has received an open wound of the heart, it is necessary to deliver the victim in a short time to the hospital. The patient immediately goes to the operation department of cardiology.

Diagnosis and treatment are performed simultaneously to speed up rescue procedures. The wound in the region of the heart is sewn by specialists, antishock actions are performed. Measures are being taken to establish blood circulation and the full functioning of the heart.

On what is the first help in injuring the heart, read on.

First aid

If a person has received a penetrating wound of the heart, then the first aid measures include the actions:

  • . If the patient is unconscious, then examine the oral cavity, free it from possible contents, so that the patient does not suffocate. If necessary, actions are taken to restore the patency of the paths through which the breathing process is carried out.
  • Blood can be drained from the pericardium with a subclavian catheter. This exercise is necessary for a patient with a tamponade of the pericardium.
  • It is permissible to make a sealed bandage on the wound area. Apply gauze wipes to the wound area, and on top the dressing is fixed with strips of adhesive plaster, located tightly to each other.
  • After this, the patient is transported with a wound of the heart to the surgery department. During the transfer of a patient to a hospital, it should be maintained in a pose so that the headboard is raised.

Therapeutic method

To support the life of an injured person, the following actions are possible:

  • if a traumatic object is in the heart, it is removed;
  • do oxygen therapy,
  • is used to intubate the trachea if there are signs of hypoxia.

Medical method

The patient is supported by drugs:

  • analgesic action,
  • sedatives, if there is excitation of the psyche.

Techniques for performing operations for heart injuries in the clinic will be discussed below.

Technique for performing operations

The patient is given a general anesthetic. Access to the organ is carried out from the left side in the region of the fifth intercostal space. The following actions are performed:

  • pericardium is opened,
  • is examined, which are cardiac arrhythmias;
  • stitch the damaged areas,
  • produce pleural cavity and pericardium drainage,
  • , if necessary, compensate for lost blood volume.

The following video will tell you what an operation is with an open wound of the heart:

Prevention of open heart injuries

It can be said that in cases where it is likely to foresee the possibility of injury, it is necessary to comply with protective measures. For example, in a war zone, you should wear a bulletproof vest.

Complications of

In order to avoid the consequences of injury, the patient's postoperative care is performed. Activities are held:

  • course of antibiotics,
  • dressing,
  • exercise therapy,
  • anesthetic injections.

It is necessary to observe the patient to avoid complications in the form of a postoperative tamponade. If the situation has occurred, then in a hospital, specialists make a puncture of the serous cavities.

Forecast

Depending on the severity of injury, the patient may get up after the operation on the eighth day. In difficult cases, he will be allowed to climb in three weeks. At wounds of the heart a high percentage of lethality remains: 12 ÷ 22%.

If in the recent past a heart injury was unequivocally considered a fatal trauma, then surgeons are now able to sew the tissues of the heart. Therefore, with timely delivery to the hospital and the provision of proper first aid, there are great chances for recovery.

More useful information on providing first aid for wounds contains the video below:

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