Thoracic Crisis Control: Overview of Thoracic Emergency Management in Dhaka Medical College Hospital

Background: Emergency management is a critical aspect of medical and surgical practice, particularly in ensuring patient survival. Within the realm of medicine, thoracic emergencies encompass both traumatic and non-traumatic cases, necessitating prompt and effective intervention. Since its establishment in 2010, the Department of Thoracic Surgery has collaborated with the Department of Casualty to address thoracic emergencies. Methods: This retrospective study involved the review of hospital documents of 1192 patients, who attended thoracic surgery and casualty departments of Dhaka Medical College Hospital in last twelve months, requiring emergency major or minor surgeries. Patients were selected according to preset inclusion and exclusion criteria. Patient details, operative procedure and in-hospital mortality and morbidity rates were recorded. Results: A total of 1,192 cases requiring thoracic emergency intervention, spanning both traumatic and non-traumatic etiologies, were analyzed. The mean age of affected individuals was 32.79±17.04 years for males and 24.00±19.16 years for females. Intercostal chest drains were administered in 351 non-traumatic cases and 799 traumatic cases, reflecting the diverse nature of thoracic emergencies encountered. The overall success rate in managing major non-traumatic thoracic emergencies was found to be 100%, demonstrating the efficacy of interventions in these cases. However, in traumatic emergencies, the success rate was lower at 88.57%. Conclusion: Several factors contribute to the lower success rate in traumatic emergencies, including limited infrastructure for emergency management, delayed presentation to the hospital, and insufficient allocation of resources relative to the current workload. Addressing these challenges is imperative to enhance the outcomes of traumatic thoracic emergencies and optimize patient care in critical situations.