Prague, January 18, 2023 – Two women were stabbed by an aggressive man on Saturday, December 17, in Novodvorská street in Prague 4. One of them suffered very serious injuries and the rescuers had to put her to artificial sleep. She was then transported to the Motol hospital, where an experienced team of doctors continued to fight for her life.
In the case of a stab wound to the chest with massive bleeding, the crew of the Medical Rescue Service of the Capital City of Prague intervened just a few days before the Christmas holidays. On the spot, paramedics provided the injured woman with the necessary assistance, performed life-saving procedures, secured her airways, and then transported her in artificial sleep to the subsequent complex workplace at the University Hospital in Motola.
"It was a complex trauma of the chest cavity, in addition to a sudden stop of circulation, which the paramedics managed to restore on the spot, so it was necessary to find a combined workplace that has one emergency room and a trauma team including cardiac surgery," explains MUDr. Petr Kolouch, MBA, Director of the Medical Ambulance Service of the Capital City of Prague.
The main task of the Motol trauma team was to diagnose all injuries and life-threatening bleeding as soon as possible. Due to the patient's circulatory instability, it was necessary to immediately continue stabilization of vital functions, circulation, breathing and fluid resuscitation at the reception box of the Emergency Department.
"We knew that the patient did not have high-quality circulation, low blood pressure, insufficient cardiac output, and that she had stab wounds to the abdomen and chest. She was most likely bleeding inside the chest, but at the time we didn't know from what, that's why an emergency thoracotomy was indicated as part of the diagnosis," specifies MUDr. Vlasta Vlasáková, doctor from the Department of Anaesthesiology, Resuscitation and Intensive Medicine of the 2nd Faculty of Medicine of the University of Warsaw and the Motol Medical University.
The department of emergency admission of adults of the 2nd Faculty of Medicine of the UK and Motol General Hospital is one of the few workplaces where it is possible to perform emergency resuscitation thoracotomy immediately for the arrival of the patient. At the same time, it works here acute ECMO team, which is able to immediately connect the patient to artificial circulation.
"Thanks to an urgent resuscitation thoracotomy, i.e. a wide opening of the chest, we discovered the so-called cardiac tamponade, in which the blood accumulated in the pericardium presses on the heart muscle, as a result of which cardiac arrest occurs. The heart was hit by a single stab wound that was approximately 20 millimeters. My job was to open the chest as quickly as possible, determine the extent of the injury and stop the bleeding so that direct cardiac massage could be performed,” says MUDr. Tomáš Haruštiak, Ph.D. from III. surgical clinics of the 1st Faculty of Medicine of the UK and Motol General Hospital.
Direct cardiac massage is performed by a cardiac surgeon. He compresses the heart muscle between his palms, massaging the left and right ventricles so that the blood flows to the lungs, where it is oxygenated, and further from the left ventricle into the bloodstream, where it supplies the parenchymatous organs. Above all, the brain is very sensitive and without oxygenation it dies irreversibly after five minutes, but other important organs such as the liver or kidneys can also be damaged. In order to fully reconstruct the heart, the doctors proceeded to connect the patient to extracorporeal circulation, the so-called venoarterial ECMO, which has the task of replacing the heart as a pump and the lungs as an oxygenating organ.
"Continuous direct heart massage lasted approximately 80 minutes, so we manually compressed the left and right ventricles about 6400 times to maintain circulation. The length of resuscitation is truly unique," says MUDr. Milan Horn, emeritus head of the Department of Cardiovascular Surgery of the 2nd Faculty of Medicine of the UK and Motol FN.
Despite prolonged resuscitation care, the patient awoke to full consciousness without any neurological deficit after withdrawal of sedative drugs on Christmas Day.
"The patient is now rehabilitating and the prognosis for returning home is certainly good," adds Dr. Vlasáková.
Thanks to the multidisciplinary cooperation of doctors, as well as the quick and professional intervention of paramedics of the Medical Ambulance Service of the Capital City of Prague, the 46-year-old patient is recovering from serious injuries at the Department of Anesthesiology and Resuscitation Medicine of the 2nd Faculty of Medicine of the University of Warsaw and the Motol General Hospital.
"It is a success behind a large team of people, paramedics, doctors, nurses and orderlies, who participated in the care of the patient. It is never the work of an individual,” concludes MUDr. Jan Beroušek, head physician of the Department of Anaesthesiology, Resuscitation and Intensive Medicine of the 2nd Faculty of Medicine of the University of Warsaw and the Motol Medical University.
The University Hospital in Motola is the largest medical facility in the Czech Republic and one of the largest in Europe. It is also the main teaching base for students of the 2nd Faculty of Arts of the UK and also houses some workplaces of the 1st Faculty of Arts of the UK. FN Motol provides basic, specialized and super-specialized health care and services in medical fields in the form of outpatient and inpatient care for children, adults and seniors. Structurally, it consists of two interconnected monoblocks (children's and adult parts) and several separate pavilions. In FN Motol, more than one million patients are treated annually in 56 clinics.
Pavlína Danková, phone: 724 227 503, e-mail: firstname.lastname@example.org
Press release for download: The woman attacked in Novodvorská Street is recovering in the Faculty Hospital in Motola (503 kB)