The case of providing qualified surgical care for a gunshot wound to the heart in an advanced (mobile) medical group

Penetrating gunshot wounds to the chest are among the most severe types of combat trauma in modern armed conflicts, as they are accompanied by high mortality. The article describes a case of surgical treatment of a penetrating chest wound with damage to the right ventricle of the heart in a separate medical battalion with limited diagnostic and instrumental capabilities. Such cases are rare due to the fact that death occurs before admission to the stage of qualified surgical care. The clinical case of treatment of a 44-year-old patient who was admitted to the advanced medical group after receiving a gunshot wound during the performance of special combat missions in a state of moderate severity is described. Diagnostics were made according to the extended protocol of first aid for injuries, clinical signs, additional instrumental examination: radiography and ultrasound protocol of an abbreviated study (Extended Focused Assessment with Sonography for Trauma (EFAST)) – initial signs of cardiac tamponade were detected. The wounded man was taken to the operating table according to urgent indications. Surgical intervention in the volume: longitudinal sternotomy, opening of the pericardium, suturing of the heart wound, drainage of the pericardium, layer-by-layer suturing of the wound. The wounded man was evacuated by air ambulance transport to the Military Clinical Hospital, then to the S.M. Kirov Military Medical Academy.