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J Thorac Cardiovasc Surg 2006;132:702-703
© 2006 The American Association for Thoracic Surgery

Brief Communication

Cardiac pneumatic nail gun injury

Jason P. Straus, MDa,d, Randy J. Woods, MDa,d, Mary C. McCarthy, MDa,d,*, Mark P. Anstadt, MDb,d, Nancy Kwon, MDc,d

a Department of Surgery, Wright State University School of Medicine, Dayton, Ohio
b Miami Valley Heart and Lung Surgeons, Dayton, Ohio
c Anesthesia Services Network, Dayton, Ohio
d Miami Valley Hospital Trauma Service, Dayton, Ohio

Received for publication March 12, 2006; accepted for publication April 11, 2006.

* Address for reprints: Mary C. McCarthy, MD, Department of Surgery, Wright State University School of Medicine, Department of Surgery, Suite 7000, Miami Valley Hospital, One Wyoming St., Dayton, Ohio 45409 (Email: mary.mccarthy@wright.edu).

The first 20% of the full text of this article appears below.

Pneumatic nail guns deliver discrete, low-velocity penetrating trauma causing limited injury.1Go Kinetic energy is centered on the nail's advancing tip, and therefore such injuries are similar to stab wounds. This is reflected in the 11% mortality rate after accidental discharges. Mortality rates might, however, exceed 40% when these injuries are self-inflicted.1,2Go In the case presented the patient attempted suicide, shooting himself 17 times in the chest with a pneumatic nail gun. The optimal diagnostic and therapeutic approach to this unusual injury is described.

Clinical Summary

A 62-year-old man shot himself 17 times in the left anterior chest with a pneumatic nail gun. He lost consciousness for several hours; on awakening, he drove to a local hospital. The patient was transferred to a level 1 trauma center for further treatment. He was hemodynamically stable on arrival. Multiple drywall finishing nails were found imbedded in the anterior chest wall. A chest radiograph demonstrated the 2.5-inch nails within the left chest and mediastinum. The initial electrocardiogram . . . [Full Text of this Article]






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