to his bleeding hand and walking quickly against the resistance of his long apron. The first thing I did was check to see if he could feel his fingers. I gently pressed on the end of all of his fingers one by one to see if he had sensation and also to see how slow his capillary refill was. The colour in each finger returned in about 4 seconds, slower than it should be; however, the butcher could feel his fingers despite a pulsing throb in all his fingers. The towel was doing a good job of soaking up all the blood but I needed to assess the severity of the wound so I could triage him appropriately. I gently and slowly lifted the towel off his palm and saw the damage.
This particular butcher had severed all four fingers at the palm side of his hand in a perfect line. The index finger was the worst with the bone being chipped and the wound gaping open. The fatty white round tissue around the wounds had a steady trickle of blood flowing over them and ingraining blood in the wrinkles of his fingers and palm. The butcher was in a great deal of pain and had been bleeding continually from the accident until now, a 30 minute car journey.
The department was quiet and he was able to go straight into a cubicle to get stitched up. He needed Adrenalin and Lignocaine to stop the bleeding and anesthetise his hand. The doctor ended up performing a nerve block to all four fingers. After many deep internal and external sutures, his fingers were dressed with a large gauze pad, his hand and fingers were bandaged and placed it in a high arm sling.
Stock car racers
Today, a patient was brought by helicopter through to the emergency department. He was a 58-year-old male who had been involved in an accident at the stock car races. Usually the stock car races happen every Sunday and both young and old take part. For those who are not familiar with stock cars, they are old banger cars that race around a designated track, often circular and made out of mud and gravel. There are many collisions and is an activity that often brings a crowd. St John’s ambulance is usually on site and at the ready.
The patient came in wearing rough clothes, covered in the usual muck and oil and had on a yellow hazard apron. His left leg was supported in a vacuum splint given by the paramedics, a split that is pumped up with air to securely hold a limb in place. My parents used to rally cars and I knew immediately what position he played in the stock car races. He wasn’t a driver, but a marshal umpiring the races. The marshal of the race should usually be stood well away from the track, a safe distance away to avoid fast moving cars.
This marshal had indeed been standing at the side of the track with a good distance between himself and the cars, He was standing next to a metal post attached to a metal gate when a stock car lost control and careered towards him. The car was aiming straight for him, sliding along the mud and gravel with all brakes on and the marshal’s first instincts were to get out of the way. With seconds to spare, he moved behind the metal post, but as the car slide towards him, it impacted the metal post and caused a ripple effect of force on the gate it was attached to. The gate swung open with full force and speed, allowing no time for the marshal to get out of the way before the metal gate slammed into his legs, dropping him to the floor.
The ambulance crew initially thought that he had amputated both his legs in the accident, but when they reached him, they saw both legs were intact and only the left one injured by the crushing force of the metal gate.
In emergency, the marshal was in a comfortable state. He had been given gas and air in the ambulance and his leg remained in the vacuum splint. I assisted taking off his high visibility vest and his jumper, so we could get an accurate blood pressure and pulse recording. He talked me through the accident again and he said he was so lucky, he absolutely didn’t see the gate coming at him. He
This particular butcher had severed all four fingers at the palm side of his hand in a perfect line. The index finger was the worst with the bone being chipped and the wound gaping open. The fatty white round tissue around the wounds had a steady trickle of blood flowing over them and ingraining blood in the wrinkles of his fingers and palm. The butcher was in a great deal of pain and had been bleeding continually from the accident until now, a 30 minute car journey.
The department was quiet and he was able to go straight into a cubicle to get stitched up. He needed Adrenalin and Lignocaine to stop the bleeding and anesthetise his hand. The doctor ended up performing a nerve block to all four fingers. After many deep internal and external sutures, his fingers were dressed with a large gauze pad, his hand and fingers were bandaged and placed it in a high arm sling.
Stock car racers
Today, a patient was brought by helicopter through to the emergency department. He was a 58-year-old male who had been involved in an accident at the stock car races. Usually the stock car races happen every Sunday and both young and old take part. For those who are not familiar with stock cars, they are old banger cars that race around a designated track, often circular and made out of mud and gravel. There are many collisions and is an activity that often brings a crowd. St John’s ambulance is usually on site and at the ready.
The patient came in wearing rough clothes, covered in the usual muck and oil and had on a yellow hazard apron. His left leg was supported in a vacuum splint given by the paramedics, a split that is pumped up with air to securely hold a limb in place. My parents used to rally cars and I knew immediately what position he played in the stock car races. He wasn’t a driver, but a marshal umpiring the races. The marshal of the race should usually be stood well away from the track, a safe distance away to avoid fast moving cars.
This marshal had indeed been standing at the side of the track with a good distance between himself and the cars, He was standing next to a metal post attached to a metal gate when a stock car lost control and careered towards him. The car was aiming straight for him, sliding along the mud and gravel with all brakes on and the marshal’s first instincts were to get out of the way. With seconds to spare, he moved behind the metal post, but as the car slide towards him, it impacted the metal post and caused a ripple effect of force on the gate it was attached to. The gate swung open with full force and speed, allowing no time for the marshal to get out of the way before the metal gate slammed into his legs, dropping him to the floor.
The ambulance crew initially thought that he had amputated both his legs in the accident, but when they reached him, they saw both legs were intact and only the left one injured by the crushing force of the metal gate.
In emergency, the marshal was in a comfortable state. He had been given gas and air in the ambulance and his leg remained in the vacuum splint. I assisted taking off his high visibility vest and his jumper, so we could get an accurate blood pressure and pulse recording. He talked me through the accident again and he said he was so lucky, he absolutely didn’t see the gate coming at him. He
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