Tuesday, June 28, 2011


The heat from outside hit me like a sack of door knobs as I exited the comfort of our cozy air conditioned ambulance. It was around 115 degrees and windy but the wind felt more like a blow drier on full blast bombarding my face. I was called to a construction site for an accident.
 I began searching through the workers at the building site and it wasn’t long before I found my guy. He had been cut by “something” according to bystanders. (I later found out  “something” was a power saw)He had no other injuries. He was pale and another worker was holding the patients arm up in the air to help stop the bleeding. I assisted him out of all chaos and heat into the calm quite ambulance for further evaluation.

After removing the bloody napkin that his friends had used as a bandage I found my first surprise. There was only a bloody stump where his thumb should have been. Pointing out the obvious, I exclaimed “where is this guys thumb?” which was quickly translated into Arabic by my partner. No one was quite sure but all fingers seemed to be pointing in the same general area on the ground some distance away. I ordered his team of co workers out on a special mission. A treasure hunt they would soon not forget. Arm to arm, sifting through the sand searching for a body part. It was not long before one of them was holding my prize up in the air. Ding Ding Ding We have a winner! I thought to myself.

The severed thumb was quickly presented to me moments later. I was now holding it and examining it like gemologist might examine a diamond. It was in pristine condition, almost like it had been surgically removed. I stood there and conitnued examining my precious prize probably longer than I needed to. I thanked my treasuring hunting friend for recovering it and got back to work. Due to the type of cut, time that we recovered the amputated part, and follow up care we gave there is a very good chance that the thumb could be reattached.

I managed to start an IV on the patient and gave him a hefty dose of IV morphine which he was very grateful for. The guy who was hating life and just had his thumb amputated was now smiling thanks to morphine. I love giving morphine to people who really deserve it because you become there new best friend. Anyway, The bleeding had been controlled at this point so I just placed a large bandage over the stump to protect it from infection and also so the patient did not have to look at it. I put the severed thumb in a special sterile bandage and placed it in a container on Ice.
We rushed him and his severed digit to the hospital. Upon our arrival to the emergency department I was giving my hand over report but the pushy triage nurse was not listening much and for some odd reason decided to open the container, “what’s in here?” She said as she started sifting through it, “This guys amputated thumb” I replied. She let out a scream and jumped back then starting yelling at me. I guess she learned patience is a important virtue to have. I gave her thumbs up on the way out the door but I don’t think she appreciated my humor.

Sunday, June 19, 2011

The smoking gun

I jumped over the concrete barrier and slid down an embankment with my trusty trauma bag slung over my shoulder. As I surfed down the dirt and debris in the darkness I thought to myself I was probably going to recover a body, not treat a patient. Covered in dirt I continued sliding down until I reached my patient. At first site it appeared I was to late just as I had thought. He's left leg was severely deformed, he was unconscious, pale, cool, and had blood oozing from his mouth. He had been ejected from the car he was driving and went on quite the journey. The Mechanism of injury and energy transfer was amazing. During impact he busted through the car’s windshield which sent him flying through the air 6+ meters. He managed to clear the concrete road barriers and landed on a steep embankment where he continued his journey, now on land, sliding down several more meters to his final resting place and where I had now managed to find myself beside him. 

I checked for a pulse and to my surprise the man regained consciousnesses and looked at me. There was not much room to work and we where wedged in a tight spot. As soon as another united arrived I had them start lowering me down equipment and a backboard. The area he was stuck in was small. There was only adequate room for me to secure him to the backboard, place a neck collar, open his airway, relocate his leg as best I could, and splint the leg to the backboard. I then sent him up the embankment using a human chain to pass the backboard along to the top. Another ALS unit had arrived by now and I took the other Paramedic with me onto the ambulance. The other Paramedic was from South Africa and we began making small talk as we worked on the patient and started IV's.

I took charge of the airway and began suctioning blood and debris from it while the other medic began a head to toe physical exam, which as part of standard procedure includes cutting all the man’s clothes off and palpating down his body. I was pretty focused on the airway and had not been paying much attention to the other medics assessment until he said “Hey Mike I think you better take a look at this” Before I even looked up at him I knew this was not going to be good. Ill be honest though I was in no way prepared for what I was about to encounter.

I turned my head just in time to stare down the barrel of a pistol. The medic and patient both grasping a fully loaded 30 caliber revolver with the barrel pointed in my general direction. It was ready to fire and the patient began to fight us. I dropped the suction equipment and got my hands on it as quickly as possible. The patient was very confused and had a head injury and was not completely aware of what was going on. However he became combative and really wanted to get his hands on that gun. We struggled over it for a few moments until I finally managed to be the one holding the gun. I made sure the trigger was not cocked and kept the barrel pointed to the ground while the south African kept the patient secured to the stretcher. 

There is a wall in the ambulance separating the driver from the back of the patient care compartment. Luckily there is a small window you can slide open. I tapped on the window to summon assistance.The  driver opened it but he sure wasn’t expecting the present I had for him. “ here hold this, be careful its loaded.” I said. He tried saying something but he had already taken the gun before he had time to even see what it was. I had already shut the window before he could make a rebuttal. Once we arrived to the hospital the nurse and security refused to take the gun as part of the patients belongings. Our supervisor arrived and we handed it over to him, along with a large 10 inch knife we found concealed on the patient. We waited until law enforcement arrived and all the proper paper work was filled out. I went back to the hospital the following day to recover some of our equipment that the hospital needed to borrow. I asked the doctor how our patient was. He ended up having a closed head injury, fractured cervical vertebrae, fractured femur, and some internal bleeding but managed to get stabilized fairly quickly and is expected to make a good recovery. I am not sure what became of the weapons, but they are being held in a safe place for him until he is aware, makes a full recovery and does some explaining.