A woman stabbed in Novodvorská was saved by a unique 80-minute heart massage
An aggressive attacker attacked two women on December 17. One suffered minor injuries, the other serious. The rapist was shot by the police and died shortly afterwards. The cause of the attack could have been his mental state.
The seriously injured woman was first treated by Prague paramedics, who handed her over to doctors from the Motol hospital in artificial sleep.
“It was a complex trauma of the chest cavity, in addition to a sudden stoppage of circulation, which the paramedics managed to restore on the spot, so it was necessary to find a combined workplace that has one emergency room and a trauma team, including cardiac surgery,” said the director of the paramedics, Petr Kolouch.
The doctors faced several difficult tasks, mainly diagnosing all injuries and bleeding. “We knew that the patient did not have high-quality circulation, low blood pressure, insufficient cardiac output, and that she had stab wounds to the abdomen and chest. She was most likely bleeding internally, but at the time we didn’t know from what, that’s why an urgent thoracotomy was indicated as part of the diagnosis,” said Vlasta Vlasáková, a doctor from the Department of Anesthesiology, Resuscitation and Intensive Medicine of the 2nd Faculty of Medicine of the UK and the Motol General Hospital.
Urgent thoracotomy, i.e. a wide opening of the chest, can be performed at the Motol Hospital’s specialized workplace, which also has a team of doctors who are immediately ready to help.
“Thanks to the urgent resuscitation thoracotomy, we discovered the so-called cardiac tamponade, in which the blood accumulated in the pericardium compresses the heart muscle, as a result of which cardiac arrest occurs. The heart was hit by a single stab wound that was approximately 20 millimeters,” he said. Tomáš Haruštiak from III. surgical clinics of the 1st Faculty of Medicine of the UK and Motol General Hospital.
Therefore, doctors started with direct heart massage, where the heart muscle is compressed between the palms, the left and right ventricles are massaged so that the blood flows to the lungs, where it is oxygenated, and then from the left ventricle to the bloodstream, where it supplies the organs.
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Above all, according to doctors, it can be very sensitive and without oxygenation it dies irreversibly after five minutes, but other important organs such as the liver or kidneys can also be damaged. In order to fully reconstruct the heart, doctors proceeded to connect patients to extracorporeal circulation, the so-called venoarterial ECMO, which has the task of replacing the heart as a pump and the lungs as an oxygenating organ.
“Continuous direct heart massage lasted approximately 80 minutes, so we manually compressed the left and right ventricles about 6,400 times to maintain circulation. The length of resuscitation is truly unique,” added Milan Horn, emeritus head of the Department of Cardiovascular Surgery of the 2nd Faculty of Medicine of the University of Warsaw and Motol University Hospital.
The woman awoke to full consciousness on Christmas Day with no neurological problems. He is now rehabilitating and according to the doctors, the prognosis is good. “It is a success that is supported by a large team of people, paramedics, doctors, nurses and paramedics, who take care of the patient. It is never the work of an individual,” concluded Jan Beroušek, head physician of the Department of Anesthesiology, Resuscitation and Intensive Medicine of the 2nd Faculty of Medicine of the UK and the Motol Medical Center.
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