An iatrogenic massive hemothorax. Academic Article uri icon

abstract

  • This is a case report about a 20-year-old male multi-trauma patient was transferred from a peripheral primary hospital to our tertiary trauma center. The patient was transferred to our hospital anesthetized and ventilated from a secondary trauma center. During transfer, the patient received 2 additional units of packed cells through the central line catheter. Upon arrival to our center, the patient was hemodynamically stable, anesthetized and ventilated. O2 saturation was 93%. A chest X-ray showed a "white lung" on the right. Following the assumption that the patient was suffering from a large hemothorax, a decision was made to insert a chest tube. Upon insertion 1500cc of blood were drained. A second look at the chest X-rays showed an improper location of the central line. The issue of recognition and treatment traumatic chest injuries is an ongoing one. Our patient demonstrates the challenge of coping with a partially treated patient, transferred to a trauma center from a primary care facility. A full re-examination of all tubes and lines going into the patient is crucial. In the current case, a close examination of the chest X-ray would have revealed the reason for the hemothorax, leading to an earlier cessation of use of this misplaced central line.

publication date

  • January 1, 2012