Impaled by branch

Guys...its time for a reminder about how Awakenings is used.

This forum is a place for respect. There is a solemn air about how participation is allowed. This is NOT the place for snarky or silly comments.

Please think of how you might react if it was you, a family member or friend who is being talked about.
 
Tom Dunlap said:
Guys...its time for a reminder about how Awakenings is used.

This forum is a place for respect. There is a solemn air about how participation is allowed. This is NOT the place for snarky or silly comments.

Please think of how you might react if it was you, a family member or friend who is being talked about.
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100% correct. Let us for a minute consider the roles reversed. I personally could not imagine the pain and shock of such an event. That is a huge near fatal injury. I pray for a full recovery for this man, though I know it will be a fairly long road.
 
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Any current, former, or wannabe medical pros or trauma junkies wanna take a crack at those questions?

All just theoretical discussion on my part here. I’ll bet the paramedics are gonna load him up and haul ass ASAP. The sooner that guy is in front of a surgeon, the better chance he has of surviving. If the branch is moving around some and aggravating the wound they’d probably stabilize it with some bulky dressings before moving him. They’ll evaluate c spine and immobilize if possible... face or jaw injury or compromised airway might not let the c collar happen. I see a dressing there too. He’s sitting up though so airway is probably good.
Their biggest concern is probably shock which could come from blood loss. Could come from other causes but my money is on low blood volume. Where the blood loss comes from is gonna take a doctor and some expensive gear to figure out. Possibly internal bleeding, maybe lung injury, maybe head injury, maybe neck and spine injuries. I’ll bet dude was in some respiratory distress. Chest trauma can have a lot going on, could be multiple injuries and all of them could be life threatening including actual cardiac trauma.

We see the branch where it enters and exits, but very possible it started at a different angle and took a hard turn as his body position changed when he hit the ground/ object.

They’d take care to not move him anymore than they have to, but he’s gotta be moved. Spine board probably isn’t happening with the branch there. Watch blood pressure closely during transport it’s a solid indicator of shock. Also o2 with NRB and watch o2 sat and listen for lung function. Probably big bore IV catheter in each arm and give ringers lactate fluid to add blood volume. Even if he doesn’t need it, it won’t hurt. Also ER will appreciate having access already.

Who knows, the ambulance might be skipping the closest ER and meeting a helicopter in a parking lot. Some hospitals are much better prepared to handle this than others. Some air ambulance have a surgeon on the crew too.

Not much info given, there’s lots of stuff that could be going on that we can’t tell from the one pic. All the pics in the world can’t tell us everything.

Sitting up in the pic though is good. If he lives through surgery, he has a chance. Poor guy, that has to be excruciating.
 
Stabilization in place for certain. Little movement as possible and the smoothest transport to the nearest level 1 trauma center. Internal blood loss is a huge concern based on the anatomy that’s around where the wood goes through his chest cavity. Packing lots of gauze or towels/trauma dressings around the wood and keeping the victim on their uninjured side don’t try to cut anything off to make it shorter. Whatever energy and vibration you use to cut the object is transferred to the internal areas in contact with the piece. This may be blatantly obvious but this is a huge major injury in a hyper critical area of the anatomy. No bueno.
 
Not to contradict your assessment but ringers isn’t a standard of care for volume replacement anymore. Blanket fluid boluses have been proven to decrease survival. Tends to thin the blood and wipe out the clotting functions. Big shift in fluid replacement about 15 years ago. Standard is now 250cc blouses of normal saline to maintain a systolic BP of 90. Your assessment is solid though.
 
swingdude said:
Stephen this is big boy stuff. Your comments are truly appeciated seeing as it is your background. Looks intense AF. Could not imagine this man's pain...or headspace for that manner.
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I have seen and dealt with similar incidents though not with wood. Even had a few we had to get creative and cut the object from the patient so the could be moved. Not remove them from or remove the object from but to make it small enough to be able to move them. For instance. Iron fences.
 
Steve Connally said:
I have seen and dealt with similar incidents though not with wood. Even had a few we had to get creative and cut the object from the patient so the could be moved. Not remove them from or remove the object from but to make it small enough to be able to move them. For instance. Iron fences.
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My lord. That is some serious trauma. Not for the faint of heart. Good stuff Stephen.
 
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