Nghe An Maternity and Pediatrics Hospital: Saving a child whose heart was broken due to hitting his chest on the car's steering wheel

According to the patient's family: On November 9, the child was allowed to sit in front of the steering wheel of a car by relatives to take him for a walk. When the driver accidentally stepped on the gas pedal, the car crashed straight into the wall, causing the child to suffer severe impact trauma, his chest being pressed against the hard steering wheel. Immediately after the accident, the child became restless and lethargic, and was taken to the emergency room by his family.

VKA pediatric patients admittedNghe An Obstetrics and Pediatrics Hospitalon the evening of November 9 in a state of shock, rapid pulse, agitation, and threat of death. After initial first aid, the patient was urgently transferred to the Department of Surgical Resuscitation. At the same time, the child was assigned to undergo necessary emergency tests and an echocardiogram and X-ray right at the hospital bed. The echocardiogram results showed acute cardiac tamponade, rupture of the right ventricular wall at the lower 1/3 position; X-ray of the heart and lungs showed an enlarged heart, pericardial effusion, and opacity in the middle 1/3 of the left lung.

Emergency surgery saves the life of VKA patient. Photo: Hoang Yen

Immediately, thedoctorThe Department of Surgical Resuscitation conducted examination and intensive resuscitation. The patient was treated with emergency endotracheal intubation, central venous catheter placement, and vasopressor drugs to control hemodynamics to maintain vital functions. At the same time, the hospital issued a red alert and mobilized a team of doctors including Cardiology, Surgical Resuscitation, Anesthesia, and General Surgery. The team agreed that the child had a ruptured heart due to blunt chest trauma and left lung contusion, and was indicated for emergency surgery.

The team of open heart surgeons and anesthesiologists raced against time that night to save the child. As soon as the chest and pericardium were opened, the child's heart had completely stopped beating. There was a lot of blood clotting in the pericardial cavity, flowing from the mediastinum out of the chest in large quantities... The surgeons opened the pericardium to remove all the clotting blood; used their hands to squeeze and stimulate the child's heart to start beating again right in the chest. After 1 minute of effort, the child's heart started beating normally again.

After surgery, the patient was transferred to the Surgical Intensive Care Unit for treatment. Photo: Hoang Yen

Immediately after that, the team set up extracorporeal circulation for the child, the surgeon observed that the child's heart had a tear in the right atrium about 1 cm close to the inferior vena cava. Very quickly, the surgeon sutured the child's heart rupture, controlled the bleeding, drained the lungs, pericardium and mediastinum and closed the chest.

2am November 10, the surgery ended after 3 hours of intense surgery.Patientwas transferred to the Department of Surgical Resuscitation for further monitoring and treatment... With the wholehearted efforts of the medical team and doctors from various specialties, the patient gradually regained consciousness, had the endotracheal tube and drainage tubes removed, had stable cardiovascular and respiratory function, and was soon discharged from the hospital.

After intensive treatment, the patient's health has recovered and he has been discharged from the hospital. Photo: Hoang Yen

Heart rupture often has very complex injuries, with a very high mortality rate, especially major injuries if not performed by specialized cardiovascular facilities due to lack of heart and lung equipment, surgical experience and cardiovascular anesthesia and resuscitation. The condition of the VKA patient is very young, and was extremely critical when admitted to the hospital. The sensitivity, experience in pediatric heart surgery and decisiveness in emergency care of the doctors saved the patient's life in this case.

Nghe An Obstetrics and Pediatrics Hospital recommends that parents absolutely do not let children sit on their laps while driving; need to have specialized seats, seat belts for children when participating in traffic to avoid serious injuries, threatening death that may occur.