Suffocating all night to remove iron bar pierced through young man's face

A 16-year-old boy in Nghe An province was stabbed by a 3-meter-long iron bar while hanging out with his friends. Doctors had to travel overnight to take the patient 300km from Nghe An to Hanoi and perform emergency surgery.

The patient underwent emergency surgery.

Activate red alert for the entire hospital to rescue patients

The iron rod was stuck firmly through the face - where many important blood vessels and nerves are concentrated. Immediately after the accident, the male student was taken to the provincial hospital in Nghe An . Here, the doctors promptly shortened the iron rod, fixed the foreign object, stopped the bleeding temporarily, and contacted Viet Duc Friendship Hospital to best prepare for the transfer.

The challenge was that transporting the patient was extremely difficult because the foreign object had crossed the head and neck, making it impossible for the patient to lie flat or tilt his head back during the entire 300km journey to Hanoi to avoid bleeding or further injury.

The patient arrived at the hospital at night with a 50cm long iron rod still embedded in his face. CT scans showed the foreign object had traveled from the tip of his nose through the hard palate, the alveolar bone of his right molar, the base of his neck, and then out the back of his neck. The path of the foreign object was extremely dangerous, as it could have damaged large blood vessels, causing massive bleeding or permanent facial paralysis.

The patient was immediately transferred to the emergency operating room. The hospital activated the internal red alert, mobilizing many specialties to participate in the consultation: Maxillofacial-Plastic and Cosmetic Surgery, Anesthesia-Resuscitation, Spinal Surgery, Cardiovascular-Thoracic and Diagnostic Imaging.

After consultation, the doctors agreed on a plan to perform emergency surgery to remove the foreign object penetrating the face and neck area. Because the foreign object penetrated through the face, wedged between the mouth and caused the jawbone to be crushed and bleeding profusely, the maxillofacial and plastic surgery specialists had to proactively open the trachea to control the airway to facilitate anesthesia and resuscitation for the patient.

The surgery involved interdisciplinary coordination.

The cardiovascular surgical team exposed and controlled the right carotid bundle while the maxillofacial and plastic surgeons removed the foreign body and treated the patient's maxillofacial wound.

Associate Professor, Dr. Nguyen Hong Ha, Head of the Department of Maxillofacial Surgery - Plastic and Cosmetic Surgery, Viet Duc Friendship Hospital shared that the iron bar must be carefully removed, millimeter by millimeter, after the patient's facial injury and hemodynamics have been completely controlled.

"Maxillofacial and plastic surgeons not only safely remove foreign objects, saving the patient's life, but also preserve the maximum anatomical structure and function of the facial area - where many important nerves and sensory organs are concentrated. Thanks to that, the patient not only escapes "death's door" but also has the opportunity to recover almost completely in terms of aesthetics and facial motor function," said Dr. Ha.

After more than an hour of urgent surgery, the iron bar was safely removed, the jaw and facial injuries were fixed by doctors and the wounds were thoroughly treated, the patient's face was preserved and he narrowly overcame the critical situation.

Timely coordination between local and upper-level health care

After a suffocating surgery, the patient is now conscious, the wound is dry, progressing positively, and is being treated at the Department of Maxillofacial Surgery - Plastic and Cosmetic Surgery, Viet Duc Friendship Hospital.

Doctors said this was an "extremely lucky" case, because if the iron bar had been just a few centimeters off, the consequences would have been unpredictable.

Associate Professor, Dr. Nguyen Hong Ha, Head of the Department of Maxillofacial, Plastic and Aesthetic Surgery, Viet Duc Friendship Hospital examines a patient after surgery.

Master, Doctor To Tuan Linh, doctor of Maxillofacial-Plastic and Aesthetic Surgery, member of the surgical team, recommends that in case of an accident where a foreign object penetrates the neck and face area, it is absolutely not allowed to remove the foreign object immediately at the scene if there is not enough professional qualifications and supporting facilities. It is necessary to provide first aid to temporarily fix the foreign object and take the victim immediately to a medical facility with full expertise in the fields of anesthesia, resuscitation and surgery.

This rare case once again demonstrates the effectiveness of the coordination model between provincial and central health care in multidisciplinary, severe trauma emergency care. At the provincial level, doctors responded quickly, provided accurate initial treatment, and ensured maximum safety when transporting the patient to Hanoi - creating a "life-or-death stepping stone" for the emergency.

At the central level, Viet Duc Friendship Hospital has promoted its deep expertise, mobilizing many teams to coordinate surgery in the shortest time, helping patients overcome critical situations.

THIEN LAMB

Source: https://nhandan.vn/xuyen-dem-nghet-tho-go-thanh-sat-dam-xuyen-mat-nam-thanh-nien-post917077.html