From the Division of Thoracic Surgery, Department of General Surgery (P.G.K.), Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC; Department of Surgery (D.V.F.), Shock Trauma Center, University of Maryland School of Medicine; Johns Hopkins Bayview Hospital (G.F.R.), Johns Hopkins University School of Medicine, Baltimore, Maryland; Grady Memorial Hospital (P.S.), Emory University School of Medicine, Atlanta, Georgia; and Department of Surgery (J.V.O.), Shock Trauma Center, and Shock Trauma Center (T.M.S.), University of Maryland School of Medicine, Baltimore, Maryland.
J Trauma Acute Care Surg. 2022 Nov 1;93(5):e166-e173. doi: 10.1097/TA.0000000000003753. Epub 2022 Aug 2.
"Scoop and run" approaches for severely injured patients have been adopted by emergency medical services over the past 40 years. This has resulted in more patients with severe injuries including penetrating cardiac wounds arriving at trauma centers and other acute care hospitals. General surgery trauma teams and general surgeons taking trauma call are the first responders for diagnosis, resuscitation, and operative management of injured patients. By natural selection, 96% to 98% of patients with signs of life on arrival to the trauma center after sustaining a penetrating cardiac wound have injuries that are amenable to repair by a general surgeon, fellow, or senior surgical resident without the need for a cardiothoracic surgeon or cardiopulmonary bypass.This literature and experience-based review summarizes the diagnostic and operative approaches that should be known by all trauma teams and general surgeons taking trauma call. In addition, it describes when a cardiothoracic surgeon should be consulted and briefly reviews how complex penetrating cardiac injuries are repaired.
“Scoop and run”方法在过去 40 年中已被急救医疗服务机构采用。这导致越来越多的严重受伤患者，包括穿透性心脏伤口的患者，到达创伤中心和其他急性护理医院。普通外科创伤团队和接受创伤呼叫的普通外科医生是诊断、复苏和受伤患者手术管理的第一响应者。通过自然选择，96%到 98%的在创伤中心到达时表现出生命迹象的穿透性心脏伤口患者的损伤，都可以通过普通外科医生、研究员或高级外科住院医师进行修复，而不需要心外科医生或体外循环。这篇基于文献和经验的综述总结了所有创伤团队和接受创伤呼叫的普通外科医生应该了解的诊断和手术方法。此外，它描述了何时应该咨询心胸外科医生，并简要回顾了如何修复复杂的穿透性心脏损伤。
