00:00Emergency Department, Trauma Bay Time, 0042, Team Dr. Sahar Hashemi, Trauma Lead, Dr. Arman Vaziri, Emergency Physician Nurse Lale Pirani, Charge Nurse Respiratory Therapist, RT, Cyrus Orderly, Reza Action Orderly, Reza.
00:17Wheels Iran Man In on a Hydraulic Stretcher, Chest Plate Shattered, Profuse Bleeding.
00:22Dr. Hashemi, Airway Intact, Apply 15LMN-02, C-Spine Neutral.
00:27Nurse Pirani, BP8248, HR162, SPO2 89%.
00:34Dr. Vaziri, 214G IVs, Rapid Transfuser, Oneg PRBC1U, TXA1G, Prep for Whole Body CT and Cardiac MRI, Field Dressings Reinforced, Pressure Bandage to Sternal Wound.
00:49Radiology, Initial Imaging Time, 0105, CT Angiochest ABD, Dr. Niloufar Ranjbar, Radiologist.
00:59Contrast Leak in Right Coronary Artery, Large Pericardial Effusion, No Abdominopelvic Bleed, MRI Cardiac, Tech Amir, Dr. Ranjbar.
01:10Sin Shows 2C Diminutre Laceration of Right Ventricular Free Wall, EF 24%.
01:17Fast Ultrasound, At Bedside, Dr. Vaziri Positive Pericardial Stripe, Abdomin Negative.
01:25Dr. Hashemi, Activate Cardiothoracic Team, Emergent Sternotomy.
01:30Operating Theater, Open Heart Surgery.
01:34Time, 0140, Team Dr. Farhad Dinesh, Cardiothoracic Surgeon, Lead.
01:41Dr. Rana Jafari, First Assist Perfusionist, Yasmin Anesthesiologist, Dr. Keevan Scrubb, Nurse Samira Key.
01:49Steps Median Sternotomy, 600 milliorer hemopericardium evacuated, cardiopulmonary bypass established,
01:56systemic heparin ACT, 480S, repair, right ventricular tear closed with 4 neo, proline pledgeded mattress sutures,
02:06bio-glue reinforcement, weaned from bypass, TEE confirms no residual leak, EF 41%, chest tubes, pacing wires placed,
02:16sternum closed with NAR5 wires, EBL 900 mL, 4U PRBC, 2FFP transfused,
02:22total pump time, 52 minir, PACU and IQ time, 05-10 PACU,
02:29nurse Navid, vital stable, dobutamine, 3UGKG or MIN,
02:34extubated 90 minir post-op, transfer to ICU, so 630,
02:39continuous arterial line, swan GANS monitoring,
02:42MAP 75 mi-MHG urine, 55 milliliter wage Dr. Hashemi,
02:47neurochex QNH, sternotomy assessment Q2H, heparin infusion per protocol.
02:52Second look imaging time, day 2, 11 MRI cardiac follow-up, EF 48%, intact repair,
03:00CT chest, high res, no mediastinal collection, lungs clear, duplex ultrasound lower limbs,
03:08rule out DVT, negative, Dr. Dinesh, no complications, clear for step-down ward.
03:14Cardiac step-down ward time, day 3, 09. Staff, ward nurse Parisa, physiotherapist,
03:22Omid ambulation with cardiac walker, incentive spirometry Q2H, meds, metaprolol 25 mg bid,
03:30apixaban 5 mg bid, amoxicillin clavulinate 1G TID, 5 days, chest tubes removed pod 3,
03:38pacing wires clipped, discharge lounge time, day 7, 08.30, entire multidisciplinary team,
03:46present Iran man, smiling, your skill and courage eclipsed even my armor, thank you,
03:52Dr. Danish, follow-up echo in two weeks, no, high G maneuvers for a month.
03:57Iran man clasps hands in gratitude, walks from the lobby, activates thrusters, rockets into the sky,
04:05final medical summary diagnosis, penetrating right ventricular injury with tamponade,
04:11initial imaging, CT angiogram, cardiac MRI, fast US procedure, emergency median sternotomy,
04:19CPB repair of RV laceration, post-op course, uncomplicated, extubated,
04:24POD 0, step down POD 2, discharged POD 7, outcome, excellent, return to full activity after
04:33cardiac rehab, case ID, IRCV 2025-011, status, recovered, discharged home. Before leaving,
04:43Iron Man thanked the team of doctors and went away.
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