Monday, July 04, 2005

all right, I worked today, July 4th, and ALREADY there were tons of fireworks injuries from people out on July 3rd with itchy trigger fingers. I had one poor guy who happened to cut his finger pretty badly on a router saw. Worst day of the year to do that! I told him that in the ER, the medicine, neurology, etc docs were not so busy, but the ortho hand/plastics people were SLAMMED with firecracker injuries, so this poor guy was waiting and waiting for a surgeon to be able to take him to the OR to fix his poor finger.

Another guy had some pretty crappy injuries. It seems that he took 50 sparklers, put them in a bucket, then lit them.

Note to self, sparklers ARE NOT TOYS!

They exploded, sent shrapnel over his entire body, blew off one pinky (most of the way), massively dislocated his thumb and another finger on one hand, big cuts on the other one with more fractures, and burned him from his socks to his chest. He had deep, huge wounds on his thigh, knee, calf on one leg, a puncture/burn wound in his groin, burns up both arms and burned areas on his chest. All nasty and grey with firecracker residue, despite the fact that this happened on the 3rd and he was flown in from Montana and sat in our ER for many hours. I was irritated when he came up to me at 1030am. Covered in blood and soot from head to to with only one little halfhearted dressing on ONE of his wounds. I doped him up with some pain meds through his IV, and monopolized 2 of the aides for 45 minutes while we scrubbed him from head to to and covered him with gauze and non-stick dressings to protect his wounds.

Seriously--he looked GOOD. I like a pretty dressing. No sloppy slapped on stuff. Nice and neat and not going to fall off.

Then I went back and added tape labels of deep or shallow so that when he went to the OR a bit later to fix his hands, the OR people will hopefully remove the dressings from the wounds marked 'deep', because they need some serious cleaning that a little saline and gauze on a conscious patient just can't clean off. Nasty grey burned skin. Not cool. But, he was young, actually has a birthday TOMORROW, and will heal and be okay. I hope they can at least save his thumb. From the Xrays, it is seriously dislocated, but if the major nerves and/or blood vessels are stil functional, he should be all right.

I hope this finds you and yours in full possession of all your digits and with intact skin (maybe a mild sunburn if you were so lucky as to have perfect 4th of July weather, as we did here in Seattle)


Mama-Beans said...

Well, at least you were kept busy.... Can you re-attach fingers, etc if it has been HOURS since the amputation??? These people that had to wait..will they heal just as well ias if they had gotten in right away?

alyca said...

the guy who had to wait didn't cut it all the way off, just a pretty deep cut. He cut through the tendons and fractured the bones. If it had been cut OFF, that would jump him up in line. Priority goes #1 to save a life, and #2 to save a limb, and it trickles down from there. So if we think his finger will die if he doesn't get OR immediatly, someone else who is heading down to have a fracture or something non-life or limb threatening will have their surgery cancelled. It's called triage, where the most seriously injured people go first, regardless of who got there first. I am sure this guy's finger will be fine. And, you generally have up to about 3-4 hours after a finger/digit is removed before you start to worry that you can't put it back on. And, if you look at the amputation comic I put up on the other site, if it is cut off with a saw or something where it is a clean cut, it is much easier/more likely to be able to be reattached. If it is blown off and pretty mangled, they might decide to not even try to put it back on, since there is too much structural damage to the remaining finger parts.

Mama-Beans said...

Hey, did you come up with other camping plans?