Ateşli Silah Yaralanması ve Femoral Santral Kateter Malpozisyonu
Özet
21 yaşında erkek hasta multipl ateşli silah yaralanması nedeniyle acil operasyona alındı.
Hasta başka bir merkezden hastanemize getirildi. Amerikan Anesteziystler Derneği (ASA) 5E olarak değerlendirildi. Glaskow koma skalası (GKS) 3 olarak, entübe şekilde acil servise getirilen hasta beyin cerrahisi ve genel cerrahi tarafından acil olarak opere edildi. Dış merkezde hastaya sol femoral venden santral venöz kateter (SVK) takılmıştı. Hastanın intravenöz (iv) sıvı ve kan ürünü replasmanları için SVK kullanıldı. İntraoperatif dönemde genel cerrahi tarafından batın açıldıktan sonra SVK’nin ucunun pelviste serbest halde olduğu görüldü. SVK çekilip yerine sol iliak venden intraoperatif SVK takıldı. Genel durumu çok kötü olan hasta intraoperatif olarak kardiyak arrest oldu. Kardiyopulmoner resüsitasyon (KPR) yapılan hasta KPR’ye yanıt vermeyince exitus kabul edildi.
A 21-year-old male patient was urgently taken to surgery due to multiple gunshot wounds. The patient was transferred to our hospital from another center. He was classified as American Society of Anesthesiologists (ASA) physical status 5E. The patient, who was brought to the emergency department intubated with a Glasgow Coma Scale (GCS) score of 3, underwent emergency surgery by the neurosurgery and general surgery teams. A central venous catheter (CVC) had been placed via the left femoral vein at the external center. This CVC was utilized for the patient's intravenous (IV) fluid and blood product replacements. In the intraoperative period, after the abdomen was opened by general surgery, the tip of the CVC was observed to be free within the pelvis. The CVC was removed and replaced intraoperatively with a CVC placed via the left iliac vein. The patient, whose general condition was extremely poor, suffered intraoperative cardiac arrest. The patient underwent cardiopulmonary resuscitation (CPR) and was pronounced dead (exitus) after failing to respond to CPR.
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