Point-of Care Ultrasonographically Guided Proximal External Aortic Compression in the Emergency Department.
Ann Emerg Med
; 74(5): 706-710, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31668242
ABSTRACT
In cases of severe subdiaphragmatic vascular trauma, only in extremis interventions such as emergency thoracotomy with aortic cross clamping or resuscitative endovascular balloon occlusion of the aorta are available for temporization until definitive care. This case report proposes a noninvasive approach consisting of localizing the proximal aorta with ultrasonographic guidance and applying a compressive force to occlude the aorta and limit distal flow. Using point-of-care ultrasonography allows precise compression, continuous monitoring of its efficacy, and early detection of return of spontaneous circulation in arrest patients. We present the case of a patient who sustained a gunshot wound causing a left iliac artery injury and subsequent cardiac arrest while he was on route to the hospital. Point-of-care ultrasonographically guided proximal external aortic compression was attempted and return of spontaneous circulation was achieved and maintained, allowing transfer of the patient to the operating room. This single-case report suggests that point-of-care ultrasonographically guided proximal external aortic compression could be used as a bridge to definitive care or to more advanced techniques such as resuscitative endovascular balloon occlusion of the aorta and emergency department thoracotomy with aortic cross clamping.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Choque Hemorrágico
/
Ferimentos por Arma de Fogo
/
Técnicas Hemostáticas
/
Ultrassonografia
/
Sistemas Automatizados de Assistência Junto ao Leito
/
Traumatismos Abdominais
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Screening_studies
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Ann Emerg Med
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Canadá