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心脏损伤的急诊处理

Emergency management of cardiac injuries.

作者信息

Stewart Charles E

出版信息

Emerg Med Serv. 2002 Sep;31(9):71-3, 75-9, 100; quiz 101.

Abstract

Cardiac trauma is not usually treatable in the field. EMS providers must recognize the possibility of cardiac trauma rapidly and evacuate the patient to an appropriate facility. Most therapy for cardiac trauma requires an operating room, preferably with cardiopulmonary bypass capability. Basic patient care should occur en route to the treatment facility. Ensure that the airway is intact, control respirations and bleeding, and restore circulatory volume to a pressure of about 100 systolic. Advanced providers should re-expand any associated tension pneumothorax and ensure the chest wall is stable. Consider early intubation, since operative intervention is likely.

摘要

心脏创伤通常无法在现场进行治疗。急救医疗服务人员必须迅速识别心脏创伤的可能性,并将患者转运至合适的医疗机构。大多数心脏创伤的治疗需要手术室,最好具备体外循环能力。在转运至治疗机构的途中应进行基本的患者护理。确保气道通畅,控制呼吸和出血,并将循环血容量恢复至收缩压约为100的水平。高级急救人员应解除任何相关的张力性气胸,并确保胸壁稳定。鉴于可能需要进行手术干预,应考虑尽早插管。

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