Anest. intenziv. Med. 2008;19(3):143-148

Haemorrhagic-traumatic shock due to a terrorist attack - management and treatment in Field Hospital ROLE 2 plus, Kabul. Case reportAnaesthesiology - Case Reports

Jurenka Božetěch^1,*, Ryska Miroslav², Kalas Ladislav³, Oberreiter Martin⁴

¹ Anesteziologicko-resuscitační oddělení, Ústřední vojenská nemocnice Praha

² Chirurgická klinika, 2. LF UK a Ústřední vojenská nemocnice, Praha

³ Radiologické oddělení, Vojenská nemocnice Brno

⁴ 6. Polní nemocnice Armády České republiky, Kábul

A 39-year patient with a severe haemorrhagic-traumatic shock due to a gunshot, with a left-sided penetrating chest wound resulting in haemothorax, pneumothorax and massive blood loss was treated in the Czech Field Hospital ROLE 2 plus after a terrorist attack in Kabul. The initial Sequential Organ Failure Assessment (SOFA) of 13 points improved thanks to damage control surgery and adequate perioperative care to 5 points, increasing the chance of survival from 5% to 80%. The patient was transported to his homeland on the 3rd postoperative day where he recovered.
Authors noted that standard therapeutic approaches can be kept to in the extraordinary conditions of ROLE 2 plus Hospital in Afghanistan. Teamwork and optimal timing of transport to a higher medical facility are an integral part of patient management, and the only way to achieve success in the high risk region.

Keywords: terrorist attack; haemorrhagic-traumatic shock; lung injury; survival assessment

Received: March 27, 2008; Accepted: April 1, 2008; Published: June 1, 2008  Show citation