Ohkawa Mayo, Tsuchiya Asuka, Morita Seiji, Nakagawa Yoshihide
Department of Emergency and Critical Care Medicine Tokai University School of Medicine Isehara-city Kanagawa Japan.
Acute Med Surg. 2024 May 20;11(1):e969. doi: 10.1002/ams2.969. eCollection 2024 Jan-Dec.
Median sternotomy is a common surgical procedure during cardiac and pulmonary surgeries. There are many reports of patient injury associated with wire breakage. However, there are only a few reports of healthcare worker injuries by sternal wire.
A patient in his 70s, having a history of thoracic aorta replacement, collapsed suddenly and paramedics started mechanical chest compression. On hospital arrival, the emergency department nurse attempted to initiate manual chest compression but was injured by a sternal wire protrusion on the patient's chest. The emergency physician placed gauze on the sternal wire and continued manual chest compression, but the patient died.
To prevent this injury, cardiopulmonary resuscitation (CPR) providers should consciously check the patient's chest. If they observe wire exposure, they should immediately place a gauze, pad or consider performing mechanical chest compression. Safety measures such as the installing rubber pads in the AED should be considered.
正中胸骨切开术是心脏和肺部手术中常见的外科手术。有许多关于与钢丝断裂相关的患者损伤的报告。然而，关于医护人员被胸骨钢丝损伤的报告却很少。
一名70多岁的患者，有胸主动脉置换病史，突然晕倒，护理人员开始进行机械胸外按压。到达医院后，急诊科护士试图开始手动胸外按压，但被患者胸部突出的胸骨钢丝弄伤。急诊医生在胸骨钢丝上放置了纱布并继续进行手动胸外按压，但患者死亡。
为防止这种损伤，心肺复苏（CPR）实施者应自觉检查患者胸部。如果他们观察到钢丝外露，应立即放置纱布、垫子或考虑进行机械胸外按压。应考虑采取安全措施，如在自动体外除颤器（AED）中安装橡胶垫。
