title: Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence.
abstract: Penetrating cardiac injury (PCI) is gradually increasing in developing countries owing to large-scale manufacturing of illegal country-made weapons. These injuries are associated with significant morbidity and mortality. Logistically it is difficult to have all organ-based specialists arrive together and attend every critically injured patient round-the-clock in developing countries. It is therefore important for doctors (physicians, surgeons and anaesthetists) to be trained for adequate management of critically injured patients following trauma. We report the approach towards 2 cases of haemodynamically unstable PCI managed by a team of trauma doctors. Time lag (duration between injury and arrival at hospital) and quick horizontal resuscitation are important considerations in the treatment. By not referring these patients to different hospitals the team actually reduced the time lag, and a quick life-saving surgery by trauma surgeons (trained in torso surgery) offered these almost dying patients a chance of survival.
authors: Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
authors: Manjunath Maruti
authors: http://orcid.org/0000-0001-9498-6744
authors: MM
authors: Pol
authors: Surgery (Surgical Disciplines) All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors: K Shiv Krishna
authors: KS
authors: Prasad
authors: Surgery (Surgical Disciplines) All India Institute of Medical Sciences (AIIMS), New Delhi, India.
authors: Vishant
authors: V
authors: Deo
authors: Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India.
authors: Madhur
authors: M
authors: Uniyal
mesh_terms: D003906:Developing Countries; D006335:Heart Injuries / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D010348:Patient Care Team; D061665:Time-to-Treatment; D014194:Traumatology / Q000193:education / Q000379:methods*; D014754:Violence; D014950:Wounds, Penetrating / Q000209:etiology / Q000628:therapy*; D055815:Young Adult