Anesthetic Management of a Crossbow Bolt Injury to the Heart

Imada, Tatsuyuki; Shibata, Sho; Sawamizu, Chie; Okitsu, Kenta; Iritakenishi, Takeshi; Fujino, Yuji

doi:10.1053/j.jvca.2017.07.001

Cited by 7 publications

(4 citation statements)

References 12 publications

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“…Several of the case reports discuss the importance of leaving the arrow in situ and mention that the shaft serves to tamponade bleeding. 6,14,17,19,20,27,43,53,77 This is likely more effective for field tips. Persons assaulted using a crossbow are more likely to sustain fatal injuries.…”

Section: Discussionmentioning

confidence: 99%

Crossbow Injuries: Predictors of Mortality

Julian,

Todd,

Marcheschi

et al. 2024

Wilderness & Environmental Medicine

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Introduction Crossbow injuries are rare but carry significant morbidity and mortality, and there is limited evidence in the medical literature to guide care. This paper reviews the case reports and case series of crossbow injuries and looks for trends regarding morbidity and mortality based on the type of arrow, anatomic location of injury, and intent of injury. Methods Multiple databases were searched for cases of crossbow injuries and data were abstracted into a spreadsheet. Statistics were done in SPSS. Results 358 manuscripts were returned in the search. After deduplication and removal of nonclinical articles, 101 manuscripts remained. Seventy-one articles describing 90 incidents met the inclusion criteria. The mean age was 36.5 years. There were 10 female and 79 male victims. Fatality was 36% for injuries by field tip arrows and 71% for broadhead arrows, p = .024. Assaults were fatal in 84% of cases, suicides in 29%, and accidental injuries in 17%, p < .001. Mortality was similar for wounds to the head and neck (41%), chest (42%), abdomen (33%), extremities (50%), and multiple regions, p = .618. Conclusions Crossbows are potentially lethal weapons sold with fewer restrictions than firearms. Injuries caused by broadhead arrows are more likely to be fatal than injuries from field tip arrows. The anatomic location of injury does not correlate with fatality. More than half of crossbow injuries are due to attempted suicide, with a high case-fatality rate.

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Section: Discussionmentioning

confidence: 99%

Crossbow Injuries: Predictors of Mortality

Julian,

Todd,

Marcheschi

et al. 2024

Wilderness & Environmental Medicine

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“…Literature on the management of arrow injuries is limited [ 7 ]. However in certain regions and in some guerilla and tribal conflicts arrow and bow mechanism are still in use among ranged weapons [ 4 , 6 , 9 , 12 , 13 , 15 ]. In our country, there are documented cases of members of security forces being assaulted with arrows by bandits [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Arrow injuries are rare in contemporary surgical practice [ [1] , [2] , [3] ]. Pericardial arrow injuries and survival are scarce [ 4 , 5 ]. The discovery of the bow and arrow mechanism more than 10,000 years back revolutionized the use of “ranged weapons” in wars and hunting [ [6] , [7] , [8] ].…”

Section: Introductionmentioning

confidence: 99%

Medieval (arrow) weapon injuries in contemporary surgical practice: Impaled posterior thoracic wall arrowhead leading to haemo-thorax: Management protocols. Case report

Shabhay,

Massaga

et al. 2023

International Journal of Surgery Case Reports

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“…For patients with open chest trauma, there are also case reports highlighting the role of TEE in the diagnosis of intracardiac shunts [ 24 , 25 ] and identification of fragmented projectiles and their trajectory [ 26 , 27 ]. Mollod et al reported a retrospective observational study on sixteen patients with chest trauma, ten with penetrating trauma and six with blunt trauma, where there were a myriad of heart and aortic injuries including proximal aortic rupture, intracardiac nail, aortic transection, flail on the mitral leaflet due to papillary muscle rupture, minor intimal tears to the descending aorta and RV infarction secondary to coronary artery lacerations [ 28 ].…”

Section: Tee In Blunt and Open Chest Traumamentioning

confidence: 99%

Is There a Role for Transesophageal Echocardiography in the Perioperative Trauma Patient?

Girón-Arango

d’Empaire

2022

Curr Anesthesiol Rep

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Purpose of Review This review article summarizes the advantages and potential uses of focused transesophageal echocardiography (TEE) in the perioperative period for trauma patients. We suggest a locally developed TEE protocol for trauma and provide strategies to achieve widespread use of TEE in the anesthesia care of trauma patients. Recent Findings In recent years, TEE has gained interest as an additional modality as point-of-care ultrasound (POCUS) for the resuscitation of acutely ill patients in whom transthoracic echocardiography is not feasible or non-diagnostic. Nevertheless, its use among non-cardiac anesthesiologists is still limited compared to the more traditional POCUS applications. Summary A goal-directed, focused TEE can be performed at the bedside in different locations and mechanically ventilated patients. TEE provides relevant diagnostic information to guide the resuscitation of acutely injured patients, particularly to identify life-threatening hidden thoracic injuries in the scenario of patients with multi-system trauma.

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Anesthetic Management of a Crossbow Bolt Injury to the Heart

Cited by 7 publications

References 12 publications

Crossbow Injuries: Predictors of Mortality

Crossbow Injuries: Predictors of Mortality

Medieval (arrow) weapon injuries in contemporary surgical practice: Impaled posterior thoracic wall arrowhead leading to haemo-thorax: Management protocols. Case report

Is There a Role for Transesophageal Echocardiography in the Perioperative Trauma Patient?

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