RESUMO
Cardiac trauma fatalities occur in 22% of victims of motor vehicle crash. Blunt cardiac trauma may result in myocardial rupture. Mechanisms of injury include compression, deceleration, laceration, and "hydraulic ram" effect. Diagnosis is difficult because of coexisting injuries and the lack of evidence-based protocols. Physiological changes in the elderly and the presence of comorbid illness result in poor survival rates when myocardial rupture occurs. Trauma nurses must be prepared to provide end-of-life care related to the poor outcome associated with myocardial rupture. This case study reports a right ventricular rupture in an elderly patient involved in a frontal motor vehicle crash.
Assuntos
Acidentes de Trânsito , Ruptura Cardíaca/enfermagem , Cuidados de Enfermagem , Assistência Terminal , Traumatismos Torácicos/enfermagem , Suporte Vital Cardíaco Avançado , Idoso de 80 Anos ou mais , Tamponamento Cardíaco/etiologia , Tamponamento Cardíaco/enfermagem , Enfermagem Familiar , Evolução Fatal , Ruptura Cardíaca/etiologia , Humanos , Masculino , Traumatismos Torácicos/complicaçõesRESUMO
Life-threatening cardiac emergencies following blunt chest trauma demand accurate assessments and rapid interventions to prevent unnecessary complications and death. Critical care practitioners must recognize the subtle clues that indicate cardiac trauma and the decompensation that occurs if the injuries are not recognized early. Blunt cardiac trauma can manifest as myocardial concussion with an associated low mortality or as cardiac rupture with an excessive mortality. Traditional diagnostic laboratory studies such as cardiac enzymes have proven ineffective in the trauma patient population. Therefore, the role of the critical care practitioner is centered on assessing patients for the clinical manifestations of decreased myocardial performance, particularly those patients with limited cardiac reserve.
Assuntos
Cuidados Críticos , Traumatismos Cardíacos/enfermagem , Ferimentos não Penetrantes/enfermagem , Contusões/enfermagem , Traumatismos Cardíacos/diagnóstico , Ruptura Cardíaca/diagnóstico , Ruptura Cardíaca/enfermagem , Hemodinâmica , Humanos , Monitorização Fisiológica/enfermagem , Avaliação em EnfermagemAssuntos
Emergências , Ruptura Cardíaca/cirurgia , Ventrículos do Coração , Equipe de Assistência ao Paciente , Complicações Pós-Operatórias/cirurgia , Feminino , Ruptura Cardíaca/etiologia , Ruptura Cardíaca/enfermagem , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas , Humanos , Pessoa de Meia-Idade , Valva Mitral , Enfermagem de Centro Cirúrgico , Planejamento de Assistência ao Paciente , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/enfermagemRESUMO
Cardiac trauma affects people of all ages from all walks of life. The exact incidence of cardiac trauma is unknown because many individuals die before ever reaching a medical facility for treatment. Reduction in the time from cardiac injury to definitive treatment with continued improvement in rapid emergency transport systems will result in a lower mortality rate. The challenge for nursing is to reduce mortality of victims of cardiac trauma further with prompt nursing diagnosis and effective nursing interventions.
