Car accident, life hanging by a thread, does he still have hope for life?

Late March was an "unimaginable" difficult time for Mr. Li (pseudonym). Disaster from the sky, everything is out of control, the only thing you can trust is the medical staff around you never give up and do their best.

One day in late March, at 17:18, Mr. Li was rushed to the emergency department of Sanduan Hospital of Zhejiang Hospital by a whistling 120 ambulance, and he was admitted to the hospital for "half an hour of pain in the chest and abdomen due to trauma from a car accident. Half an hour before being rushed to the hospital, Mr. Li had a serious car accident, when he had severe pain in the chest and abdomen, but no other symptoms such as loss of consciousness and twitching of limbs.

Mr. Li was admitted to the emergency room, and the initial examination was completed at 17:22. Rapid bedside ultrasound suggested interstitial fluid accumulation in the spleen and kidney; cranial and cervical CT showed no significant abnormalities; mesenteric CTA suggested splenic rupture with multiple blood collections around it, suggesting active bleeding in the left abdominal cavity. The left renal artery was dissected; the left adrenal gland and kidney structures were unclear, and injury was possible; the splenic artery was locally gross, and injury was not excluded; CT of the chest suggested a small amount of bilateral pneumothorax; multiple exudates in both lungs, contusion was possible, and multiple pneumocysts in both lungs; multiple fractures of the left 2nd-11th ribs and the right 6th-12th ribs, and fractures of the left 1st and 12th ribs to be lined up; the preliminary diagnosis was splenic rupture, hemorrhagic shock, renal artery dissection, and The trauma center call was activated at 17:23, and general surgery, thoracic surgery and urology responded immediately.

Green channel was opened, anesthesia and surgery department was prepared and sent to the operating room at 17:50. At 18:15, general surgery, urology and emergency department performed "splenectomy + left nephrectomy + retroperitoneal hematoma removal + partial transverse colectomy + transverse colectomy + transverse colectomy + intra-abdominal gauze filling compression hemostasis + abdominal drainage", the operation time was about 5 hours. After the operation, the patient was stabilized and admitted to the ICU.

From the time the patient entered the hospital to the operating room, it took only about half an hour. Time is especially critical for acute trauma patients, and not a single second should be delayed. Mr. Li, who unfortunately met with a car accident, had a ruptured spleen and a broken renal artery, which required more timely rescue and treatment, but fortunately after his injury, not a single minute was delayed, which won him precious time and space for subsequent rescue and recovery.

Multidisciplinary linkage in the trauma center

Escorting the patient

After the joint multidisciplinary surgery, the patient entered the next level - how to recover smoothly and pass the dangerous period.

Dr. Gu Zenghui, Director of Trauma Center, Dr. Gu Zenghui, Director of Orthopedics (3), Dr. Qian Xianzhong, Deputy Director of General Surgery, Dr. Chen Guoping, Director of Thoracic Surgery, Dr. Cai Guolong, Director of ICU (2), Dr. Hu Caibao, Deputy Director of ICU (2), Dr. Hu Haiping, Assistant Director of Urology, Dr. Li Bo, Deputy Director of Radiology, Dr. Bi Qihua, Deputy Chief Technologist of Blood Transfusion, and Dr. Hong Yongqiang, Deputy Director of Ultrasound Diagnostic Department, performed the surgery. Dr. Hong Yongqiang, deputy director of the Department of Ultrasound Diagnosis, and other doctors conducted several multidisciplinary consultations for Mr. Li's follow-up treatment and rehabilitation.

With the efforts of all departments, Mr. Li's physical condition continued to improve, the ventilator was removed, and bilateral chest drains were removed ...... slowly Mr. Li was able to stand up and walk for a while.

24-hour standby

Seize the "golden hour"

Explosions, car accidents, falls from height ...... encounter these accidents patients, acute multiple injuries are the most common, the body multiple organ injuries.

"For patients with acute multiple injuries, the trauma center responds in a timely manner, diagnoses, and gives effective treatment to patients within the golden hour. The trauma center contains many departments, general surgery, thoracic surgery, neurosurgery, orthopedics, urology, critical care medicine, emergency medicine, radiology, ultrasound diagnosis, laboratory, blood transfusion, anesthesia and surgery department, etc. The multi-departmental linkage makes judgment for treatment in the shortest time." Gu Zenghui said.

The trauma center of Zhejiang Hospital has a smooth management process at present. The trauma emergency team is on standby 24 hours a day, and after the pre-hospital emergency receives the patient, it will judge the degree of trauma after timely disposal and contact with the hospital emergency to report the condition, and after the emergency receives the pre-hospital emergency information or receives the patient, it will be activated by one key according to the trauma emergency activation standard, and the working time, after the trauma emergency is activated according to the standard, it will arrive at the emergency room scene in 10~15 minutes and start Emergency resuscitation, MDT decision making and disposal, the specialist members who arrive at the scene, participate in the whole process of resuscitation and auxiliary examination, diagnose at any time, discuss disposal opinions in time, implement disposal treatment measures in time, and give timely treatment to the patient within one golden hour with the fastest speed.

Editor: Ting Review: Jing

Source: Trauma Center

Writer: Wu Jing, Publicity and United Front Department

This article is original from Zhejiang Hospital, please indicate the source "Zhejiang Hospital" Official Account.