title: A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a "Doctor-helicopter" Ambulance Staffed by Skilled Emergency Physicians.
abstract: We report a 55-year-old man who relapsed into a state of shock in an ambulance before arriving at our critical care center after a fall injury. The diagnosis of cardiac tamponade was made by portable ultrasound, and immediate pericardiocentesis and drainage were performed at the heliport. He was then transported immediately to our hospital with continuous drainage and surgery was performed. After surgery, the patient was transferred to the intensive care unit in stable condition. After undergoing rehabilitation, he made a full recovery and was discharged. This case illustrates that such patients can be treated reliably by pericardial drainage performed by skilled emergency physicians in the field by making use of the "doctor-helicopter" ambulance transportation system, followed by emergency surgery in a critical care center.
authors.affiliation: Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. hirootsu@is.icc.u-tokai.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Otsuka
authors.forename: Toshiki
authors.initials: T
authors.lastname: Sato
authors.forename: Seiji
authors.initials: S
authors.lastname: Morita
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Sadaki
authors.initials: S
authors.lastname: Inokuchi
mesh_terms: D000058:Accidental Falls; D017732:Air Ambulances; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000209:etiology* / Q000534:rehabilitation / Q000601:surgery*; D002983:Clinical Competence; D004322:Drainage / Q000379:methods*; D004632:Emergency Medical Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071956:Myocardial Contusions / Q000150:complications*; D020519:Pericardiocentesis; D010820:Physicians; D016896:Treatment Outcome