TY - JOUR PY - 2024// TI - Should an emergency physician be a "surgeon" in a rural area? A case of blunt cardiac rupture successfully treated by an emergency physician JO - Journal of rural medicine A1 - Kubo, Keisuke A1 - Abe, Tomohiro A1 - Nagoshi, Hideki A1 - Ochiai, Hidenobu SP - 114 EP - 118 VL - 19 IS - 2 N2 - OBJECTIVE: Blunt cardiac rupture is a life-threatening injury that requires surgical repair by cardiovascular or trauma surgeons. We report a case of blunt cardiac rupture in a rural area in which emergency physicians performed emergency department thoracotomy and surgical repair to save the patient's life. PATIENT AND METHODS: This case involved an 18-year-old female who was injured in a traffic accident and underwent emergency thoracotomy and surgical repair.

RESULTS: The patient's left thorax was deformed, and sonographic assessment revealed pericardial effusion. She experienced cardiopulmonary arrest 13 min after hospital arrival. An emergency physician performed an emergency department thoracotomy. The clots were removed from the surface of the left ventricle, followed by wound compression to control bleeding from the ruptured left ventricular wall. After the recovery of spontaneous circulation, the emergency physician sutured the ruptured heart. The patient survived with good neurological function.

CONCLUSION: In rural areas, blunt cardiac rupture may require emergency department thoracotomy and cardiac repair by emergency physicians. The establishment of educational systems that include continuous education on trauma surgical procedures and consensus guidelines is needed to assist rural emergency physicians in performing surgical procedures.

Language: en

LA - en SN - 1880-487X UR - http://dx.doi.org/10.2185/jrm.2023-009 ID - ref1 ER -