open access

Vol 8, No 3 (2023)
Case report
Published online: 2023-04-26
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Re-hybrid thoracic stent graft implantation with total aortic arch debranching in urgent procedure: case report

Piotr Buczkowski1, Mateusz Puslecki123, Michal Rodzki1, Marek Dabrowski34, Sebastian Stefaniak1, Jerzy Kulesza5, Robert Juszkat5, Bartlomiej Perek1, Marek Jemielity1
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Disaster Emerg Med J 2023;8(3):180-184.
Affiliations
  1. Department of Cardiac Surgery and Transplantology, Chair of Cardiac and Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Medical Rescue, Chair of Emergency Medicine, Poznan University of Medical Sciences, Collegium Adama Wrzoska, Poznan, Poland
  3. Polish Society of Medical Simulation, Slupca, Poland
  4. Chair and Department of Medical Education, Poznan University of Medical Sciences, Collegium Adama Wrzoska, Poznan, Poland
  5. Department of Radiology, Poznan University of Medical Sciences, Poznan, Poland

open access

Vol 8, No 3 (2023)
CASE REPORTS
Published online: 2023-04-26

Abstract

INTRODUCTION: Penetrating pelvic injuries and the complications caused by them are a global problem in the provision of services by emergency medical teams. They often pose a significant challenge for medical personnel, particularly in patient evacuation and stabilization during transport.

CASE REPORT: The emergency medical service (EMS) was dispatched to a traffic accident — the report contained information about one conscious victim with a foreign body within the patient’s body. At the accident scene, a delivery truck crashed into the tow bar of a trailer standing on the road, and one person was seriously injured due to the impact. The preliminary assessment confirmed a foreign body penetrating the right thigh, deformation and enlargement of the thigh contour, pain in the thigh, pelvis, and tenderness in the thoracic-lumbar spine with the end part of the tow bar hook palpable under the skin. The victim was suspected of having a femur fracture, pelvic injuries, and damage to internal organs. On neurological examination, sensation and motor functions were preserved in all limbs. The evacuation procedure was established after the Fire Department (FD) rescuers arrived. The injured person was removed from the vehicle on an orthopedic board with the help of eight rescuers. The victim was placed on his left side with the right side elevated, with continuous manual stabilization supported by a blanket, pillows, and orthopedic boar straps.

CONCLUSIONS: Each traumatic injury event requires selecting and using the appropriate equipment. A good compromise between speed and precision of actions should not significantly contribute to the worsening of the injury. An increase in a rescuer’s substantive knowledge on how to proceed in the case of this type of trauma and injuries, as well as close cooperation with the fire department, will undoubtedly result in more appropriate actions.

Abstract

INTRODUCTION: Penetrating pelvic injuries and the complications caused by them are a global problem in the provision of services by emergency medical teams. They often pose a significant challenge for medical personnel, particularly in patient evacuation and stabilization during transport.

CASE REPORT: The emergency medical service (EMS) was dispatched to a traffic accident — the report contained information about one conscious victim with a foreign body within the patient’s body. At the accident scene, a delivery truck crashed into the tow bar of a trailer standing on the road, and one person was seriously injured due to the impact. The preliminary assessment confirmed a foreign body penetrating the right thigh, deformation and enlargement of the thigh contour, pain in the thigh, pelvis, and tenderness in the thoracic-lumbar spine with the end part of the tow bar hook palpable under the skin. The victim was suspected of having a femur fracture, pelvic injuries, and damage to internal organs. On neurological examination, sensation and motor functions were preserved in all limbs. The evacuation procedure was established after the Fire Department (FD) rescuers arrived. The injured person was removed from the vehicle on an orthopedic board with the help of eight rescuers. The victim was placed on his left side with the right side elevated, with continuous manual stabilization supported by a blanket, pillows, and orthopedic boar straps.

CONCLUSIONS: Each traumatic injury event requires selecting and using the appropriate equipment. A good compromise between speed and precision of actions should not significantly contribute to the worsening of the injury. An increase in a rescuer’s substantive knowledge on how to proceed in the case of this type of trauma and injuries, as well as close cooperation with the fire department, will undoubtedly result in more appropriate actions.

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Keywords

hybrid treatment of aortic arch aneurysms; TEVAR; aortic arch debranching

About this article
Title

Re-hybrid thoracic stent graft implantation with total aortic arch debranching in urgent procedure: case report

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 8, No 3 (2023)

Article type

Case report

Pages

180-184

Published online

2023-04-26

Page views

209

Article views/downloads

178

DOI

10.5603/DEMJ.a2023.0018

Bibliographic record

Disaster Emerg Med J 2023;8(3):180-184.

Keywords

hybrid treatment of aortic arch aneurysms
TEVAR
aortic arch debranching

Authors

Piotr Buczkowski
Mateusz Puslecki
Michal Rodzki
Marek Dabrowski
Sebastian Stefaniak
Jerzy Kulesza
Robert Juszkat
Bartlomiej Perek
Marek Jemielity

References (12)
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  2. Criado FJ, Clark NS, Barnatan MF. Stent graft repair in the aortic arch and descending thoracic aorta: a 4-year experience. J Vasc Surg. 2002; 36(6): 1121–1128.
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  5. Çınar E, Yildiz Ö, Çelik İA, et al. Retrospective analysis of thoracic trauma and evaluation of the factors affecting the duration of stay in the hospital. Disaster and Emergency Medicine Journal. 2020.
  6. Czerny M, Schmidli J, Adler S, et al. Editor's choice — current options and recommendations for the treatment of thoracic aortic pathologies involving the aortic arch: an expert consensus document of the european association for cardio-thoracic surgery (EACTS) & the european society for vascular surgery (ESVS). Eur J Vasc Endovasc Surg. 2019; 57(2): 165–198.
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  12. Belczak SQ, Silva ES, Klajner R, et al. Type II Endoleaks, Left-Arm Complications, and Need of Revascularization after Left Subclavian Artery Coverage for Thoracic Aortic Aneurysms Endovascular Repair: A Systematic Review. Ann Vasc Surg. 2017; 41: 294–299.

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