Festina Lente: Bradycardia as a Presenting Feature of Life-Threatening Intra-Abdominal Hemorrhage
نویسندگان
چکیده
Introduction: Trauma is one of the leading causes death in patients under 40 years age. The Advanced Life Support (ATLS) Guidelines are widely accepted as standardized approach to trauma and classify hemorrhagic shock according heart rate (HR), blood pressure (BP), urinary output, mental status. Paradoxical bradycardia (defined HR <60 bpm) an uncommon presenting feature presents a diagnostic challenge physician; its true incidence unknown. Method: A case paradoxical was examined shock. Results: 17-year-old male patient presented our Emergency Department (ED) with collapse abdominal pain following collision another player during sports match. hypotensive (BP 92/42) bradycardic at triage, 50. He pale diaphoretic Glasgow Coma Scale 13/15, thready pulses, localized peritonitis left upper quadrant his abdomen. An increase observed initial fluid resuscitation; however, this transient preceded onset profound hypotension 64/30). Bradycardia between 50-60bpm persistent despite resuscitative efforts. Abdominal ultrasound demonstrated intraperitoneal free-fluid, Computerized Tomography confirmed presence grade V splenic laceration. taken operating theater for emergency laparotomy underwent splenectomy. 2.3 liter hemoperitoneum found intraoperatively. There were no further complications post-operatively, he made full recovery. Conclusion: Tachycardia potentially unreliable marker loss, especially young, healthy patients. high index suspicion necessary prevent but life-threatening from being overlooked.
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ژورنال
عنوان ژورنال: Prehospital and Disaster Medicine
سال: 2023
ISSN: ['1049-023X', '1945-1938']
DOI: https://doi.org/10.1017/s1049023x2300331x