At around 2:00 p.m. on November 8, Mr. H.N.K (35 years old, Da Nang province), a worker at TCDG Company, while diving about 11 meters deep in the Truong Sa archipelago, suddenly had pain in his left chest and severe difficulty breathing.
The patient was admitted to Truong Sa Lon island infirmary in a state of tinhity, rapid pulse, and low blood pressure. The X-ray results showed a large amount of outflows and excretion of the left pleural cavity.
After lung drainage surgery, the patient began to show signs of shock absorption, low blood pressure, and high risk of death. Immediately, the Telemedicine system was activated to connect the infirmary with Military Hospital 175. Under the guidance of experts from the mainland, the island's medical team actively resuscitated, infused, used vasopressors, and mobilized local blood to save patients.
During the night, officers at Truong Sa Medical Center collected blood directly from volunteer soldiers on the island, collected a total of 1,750 ml of total blood, and immediately infused it into patients. This valuable amount of blood maintained circulation and saved the patient through the shock phase, helping to prolong the "golden" time before the road emergency team arrived.
At 7:00 a.m. on November 9, after an online consultation, doctors at Military Hospital 175 concluded: the patient was shocked and lost blood due to blood overflow, left pleural gas overflow, suspected lung tissue damage due to changes in pressure when diving deep. The prognosis is very serious, requiring no emergency road transportation.
Immediately afterwards, the Board of Directors of Military Hospital 175 decided to send a surgical and anesthesia resuscitation team to coordinate with the air emergency team.
Major, Dr. Nguyen Viet Cuong - Department of Thoracic Surgery, Military Hospital 175 shared: "We took to the island by helicopter, the biggest difficulty was that the island did not have adequate equipment, so we had to bring all open-ended surgical equipment, lung surgery, stapler and accompanying materials to the island, and transport many packages. We determined that when we arrived on the island, we had to have open surgery on the spot, because otherwise, patients could not be transported to the mainland.
After approaching Truong Sa special area, the doctors found that the total volume of blood circulating to the pleural cavity had reached 3,100 ml, the patient was rapidly exhausted, and the pulmonary vessels gradually weakened. Unable to wait any longer, the emergency thoracic surgery was performed right at the island's field surgery room.
Lieutenant Colonel, Doctor Pham Truong Thanh - team leader of the Air Emergency Team, Military Hospital 175 said: "The biggest difficulty is ensuring safety of anesthesia and resuscitation for patients in poor conditions. We have to perform a series of advanced resuscitation techniques such as placing catheter in the central vein, monitoring the presence of inflammatory arterial blood pressure, maintaining the ventilation of one lung so that the surgeon can have chest surgery, examination of the lungs, observing and accurately determining the location of bleeding.
After nearly two hours of continuous surgery, the surgery was completed, the patient was given a stable pulmonary and vital canal, ready for emergency transportation to Military Hospital 175 for further intensive treatment.
During air transport, the risk of air overflow - lung blood exchange may continue, due to changes in pressure when the plane rises. If not well controlled, gas and blood levels can continue to increase, causing compression of the lungs and heart.
"Thanks to the experience of transporting patients in especially dangerous conditions many times, we maintain ventilators, prevent shock, and feel secure continuously throughout the journey. All vital signs are closely monitored every minute, ensuring safe patient handover at Military Hospital 175 at 1:45 am on November 10, for continued intensive treatment," Lieutenant Colonel Nguyen Truong Thanh shared more.
