Al-Hassani Ammar, Wahlen Bianca M, Ayasa Mohammed A M, Hakim Suhail, Khoschnau Sherwan, El-Menyar Ayman, Al-Thani Hassan
Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar.
Department of Anesthesiology, Hamad Medical Corporation, Doha, Qatar.
J Surg Case Rep. 2022 Feb 11;2022(2):rjac001. doi: 10.1093/jscr/rjac001. eCollection 2022 Feb.
Among the work-related injuries, meat grinder injuries are not uncommon. One of the major challenges in the trauma resuscitation room is the appropriate choice of anesthesia/analgesia when the patient is still conscious and the second challenge is to find the best way to early extract the patient's limb out of the machine without adding more suffering. Herein, we presented a 23-year-old male patient who was brought fully conscious in a kneeling position with the right forearm entrapped in a big meat grinder machine with part of the crushed fingers being extruded out of the machine. The patient was in severe pain; however, his vital signs were stable. Analgo-sedation with Midazolam/Ketamine followed by ultrasound guided upper limb regional anesthesia was used and showed to be a fast and safe alternative in a conscious, not fasting patient when the extremity is still entrapped in a meat grinder machine.
在工伤事故中，绞肉机致伤并不罕见。创伤复苏室面临的主要挑战之一是，当患者仍有意识时如何恰当选择麻醉/镇痛方法；另一个挑战是找到最佳方式，在不给患者增加更多痛苦的情况下，尽早将患者的肢体从机器中取出。在此，我们报告一名23岁男性患者，他被送来时意识完全清醒，呈跪姿，右前臂被困在一台大型绞肉机中，部分被碾碎的手指从机器中伸出。患者疼痛剧烈，但生命体征稳定。使用咪达唑仑/氯胺酮进行镇痛镇静，随后进行超声引导下上肢区域麻醉，结果表明，对于意识清醒、未禁食且肢体仍被困在绞肉机中的患者，这是一种快速且安全的替代方法。
