The female patient was struck by a container truck traveling in the same direction while riding on a motorcycle with her 5-year-old brother, driven by their mother. The truck's wheel ran over her right thigh, causing severe multiple traumas. Bystanders called emergency services 115, transporting her to Nhi Dong Thanh Pho Hospital.

The patient upon admission to Nhi Dong Thanh Pho Hospital's emergency room. Photo: Hospital provided

On 8/6, Dr. Nguyen Minh Tien, Deputy Director of the hospital, reported the patient arrived in severe hemorrhagic shock, with undetectable blood pressure and a faint pulse. She had a complex perineal wound with exposed bone and significant bleeding.

Doctors immediately activated an inter-hospital red alert, coordinating with Orthopedic and Traumatology Hospital and Nhan Dan 115 Hospital. They intubated the patient, resuscitated her for shock, and urgently transfused blood. Diagnosis revealed severe multiple traumas: a fractured femur, pelvic fracture, spinal injury, lung contusion, hemothorax, kidney trauma, and a severe perineal tear.

During an emergency overnight surgery, the team managed abdominal injuries, performed a temporary colostomy, and bladder drainage. However, the retroperitoneal hematoma continued to expand during the procedure. After angiography to locate the bleeding source proved ineffective, doctors decided to explore further, discovering a torn left renal vein. This necessitated a left nephrectomy to control bleeding, as a large portion of the kidney had lost its blood supply. Additionally, doctors drained over 2.5 liters of blood from the patient's left pleural cavity.

Medical staff treating the patient at Nhi Dong Thanh Pho Hospital. Photo: Hospital provided

The orthopedic trauma team then stabilized the pelvis, treated fractures, and debrided damaged soft tissues. Due to massive blood loss, the patient received approximately 5.2 liters of packed red blood cells, 2.4 liters of fresh frozen plasma, and various other blood products during surgery.

Post-surgery, she underwent intensive resuscitation, with coagulation disorders, electrolyte imbalances, and acid-base disturbances corrected. After 24 hours, her hemodynamics gradually stabilized, no further transfusions were needed, and she became conscious and recognized those around her. "The first thing the child asked was about her younger brother", Dr. Tien said.

Her 5-year-old brother sustained a left foot injury when the vehicle ran over it. He underwent wound debridement and the application of a negative pressure wound therapy system in preparation for future skin grafting. Their mother sustained minor abrasions.

After 36 hours of treatment, the teenage girl's condition progressively improved; she was conscious, responsive, and transferred to Nhan Dan 115 Hospital for continued specialized treatment.

Le Phuong