TY - JOUR T1 - Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence JF - BMJ Case Reports DO - 10.1136/bcr-2016-216293 VL - 2016 SP - bcr2016216293 AU - Manjunath Maruti Pol AU - K Shiv Krishna Prasad AU - Vishant Deo AU - Madhur Uniyal Y1 - 2016/09/02 UR - http://casereports.bmj.com/content/2016/bcr-2016-216293.abstract N2 - Penetrating cardiac injury (PCI) is gradually increasing in developing countries owing to large-scale manufacturing of illegal country-made weapons. These injuries are associated with significant morbidity and mortality. Logistically it is difficult to have all organ-based specialists arrive together and attend every critically injured patient round-the-clock in developing countries. It is therefore important for doctors (physicians, surgeons and anaesthetists) to be trained for adequate management of critically injured patients following trauma. We report the approach towards 2 cases of haemodynamically unstable PCI managed by a team of trauma doctors. Time lag (duration between injury and arrival at hospital) and quick horizontal resuscitation are important considerations in the treatment. By not referring these patients to different hospitals the team actually reduced the time lag, and a quick life-saving surgery by trauma surgeons (trained in torso surgery) offered these almost dying patients a chance of survival. ER -