Craziest Trauma

last night someone had a troponin of .7!

In general, I'd give unhelmeted motorcyclists the prize for gruesomeness. We had one drunk who fell asleep on the railroad tracks once, though...

brianmartin said:

last night someone had a troponin of .7!

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Yes, I'm sure someone, somewhere had a Troponin of 0.7

Faze2 said:

So what's the craziest trauma you guys have seen in the ER? I've worked in the ER for almost 1 1/2 years now and I have seen some pretty gruesome ones. I guess the craziest one I saw was this homeless guy who was crossing the highway and got nailed by 2 or 3 cars. No braking for the cars. When they brought him in, still alive, both of his femurs and shin bones were completely sticking out of the skin in quite a few places, his arm was basically snapped in half at the elbow. It was hanging from tendons and skin. His chest was pretty much mush since I'm guessing all of his ribs were probably broken, and the skin was pretty much torn off his chest and back. It also looked like he head two heads from how swollen the one side was. Needless to say he died, but apparently he had vitals in the field. It was pretty nuts to see something like that in person, but it was awesome to see, from an educational standpoint. (I apologize for the lack of proper medical terms, but I'm still a loser pre med. (post bac though)

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A crowd became so angry with this guy, they ripped off a car bumper and beat him to death with it.

Stabbed, shot, hit by a car, then set on fire (once).

Shot, then hit run over by a car (multiple).

Jumped off a 200(? who cares, really high) foot bridge, lived, realized he didnt want to drown, swam.

Gored by bull.

Hit deer with motorcycle. Then assaulted by deer.

Slid down conveyer belt (multiple multiple abrasions) then fell into salt shaft (ouch).

mikecwru said:

Slid down conveyer belt (multiple multiple abrasions) then fell into salt shaft (ouch).

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Sounds like a form of torture.

Pool cue, unscrewed and in half, placed in footwell of driver seat. Proceeds to get into car accident, skewered by pool cue, in perineum, out lower abdomen, flexed over pool cue which reentered upper abdomen, and out of upper back.

He looked like a chicken satay. or shrimp kabob.

Q

if you truly want the bad stuff, do a rotation at a medical examiner's office. you'll never want to drive a car again, among other things.

--your friendly neighborhood seatbelted/air-bagged caveman

Can't say that I miss working in major trauma centers.

I worked the crash of a Cessna once where the body of one of the pilots impaled by a light fixture next to the runway. One of the deputies had to shoot a couple of crows who were trying to make off with parts. It was not pretty.

There was also a freight train vs. pedestrian (a favorite method of suicide in the city nearest where I grew up) where the guy pretty much exploded on impact. As the skinniest guy on the scene (and as a funeral director's assistant working under a coroner's removal contract) I got sent under the train to recover parts because the senior engineer refused to move the train because he didn't want to further damage the body (The fact you could look and see a part of an arm wrapped around one of the wheel assemblies probably had something to do with it). THAT was the most disgusting thing I've ever done. It was like some sort of claustrophobic tug of war.

Homunculus said:

if you truly want the bad stuff, do a rotation at a medical examiner's office. you'll never want to drive a car again, among other things.

--your friendly neighborhood seatbelted/air-bagged caveman

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Small plane crashes *shudders* It is disturbing how bad some of these bodies are fragmented. On several of them I have the autopsy reports for one of my projects, they never found the internal organs.

reports are he was literally smeared across the field.

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There was a construction accident involving a ~800 lb concrete slab (I believe it was part of a balcony) that fell two stories and landed on a worker. The blood spatter extended for about 15 feet. The guy was basically accordioned downward and from his boots- which were both still upright and on the sidewalk somehow- to the top of his head (or rather, what was left of it....apparently they found cranial fragments in his torso at autopsy from what I heard), it was less than ten inches.

Hi everyone, I'm an MS3 and a new poster. I've lurked for a while, and I thought it was about time I joined the party.

This one is a little less gruesome, but I still thought it was pretty cool. I was at in the ED not too long ago and this guy was flown in from a reported MVC. It turns out a semi kicked up a 5 ft long solid steel crowbar-looking-thing that was about 3/4" in diameter on one side and 1.5" on the other. The thing probably weighed 100lbs. Anyway, it goes through this guys windshield and the 1.5" side went straight through his upper arm somehow sparing all the major nerves. He still had full sensation and movement of his hand. The removed it and he's recovering.

The best part was that the guy wasn't freaking out at all. He was pretty cool about the whole situation.

ccfccp said:

Hi everyone, I'm an MS3 and a new poster. I've lurked for a while, and I thought it was about time I joined the party.

This one is a little less gruesome, but I still thought it was pretty cool. I was at in the ED not too long ago and this guy was flown in from a reported MVC. It turns out a semi kicked up a 5 ft long solid steel crowbar-looking-thing that was about 3/4" in diameter on one side and 1.5" on the other. The thing probably weighed 100lbs. Anyway, it goes through this guys windshield and the 1.5" side went straight through his upper arm somehow sparing all the major nerves. He still had full sensation and movement of his hand. The removed it and he's recovering.

The best part was that the guy wasn't freaking out at all. He was pretty cool about the whole situation.

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Wow.......I was sitting in triage when a guy walked in holding a cooler, set it on the counter and asked to see the doc. When asked the problem was, he calmly said: "I cut off my hand. What do you think is in the cooler?". He then held his left arm up, and it was missing below about 6" proximal to the wrist and there was a towel wrapped around the stump. Gotta love tough ol' former Marines.

Just trolling through...

Back in the days when I was on the meat wagon the cops were chasing a guy going about 120 mph on a crotch rocket. Well he lost control and went flying through the air straight through a guy wire. Cops needed two body bags about 10 yards apart for that one.

Another time we got called for a guy run over by a train. This wino did get run over but fortunately for him he was lying in the tracks rather than across them. He walked away with a bump on the head.

We had a guy a few weeks ago who tried to chew on the wrong end of a rifle. Our trauma page said, "self inflicted GSW face, eta: 5 min." I entered the room to find the guy talking to the ER staff and repeatedly trying to scratch an itch on that side of his face. We removed the bandage and everything from his left maxilla to frontal bone was gone. The kicker was that he had done this the day before and was only found because his family happened to stop by that morning.

I found out that he lived because one of my friends saw him in plastics clinic about a week ago.

DropkickMurphy said:

I worked the crash of a Cessna once where the body of one of the pilots impaled by a light fixture next to the runway. One of the deputies had to shoot a couple of crows who were trying to make off with parts. It was not pretty.

There was also a freight train vs. pedestrian (a favorite method of suicide in the city nearest where I grew up) where the guy pretty much exploded on impact. As the skinniest guy on the scene (and as a funeral director's assistant working under a coroner's removal contract) I got sent under the train to recover parts because the senior engineer refused to move the train because he didn't want to further damage the body (The fact you could look and see a part of an arm wrapped around one of the wheel assemblies probably had something to do with it). THAT was the most disgusting thing I've ever done. It was like some sort of claustrophobic tug of war.

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There aren't trains in indiana...lying b@stard.

Does anyone else feel guilty that we describe some of these things as "cool"? I do it too and then I think "Damn, that'd really suck"

I haven't seen too much in the way of trama in person..aside from a farm accident which wasn't pretty...and a person burn alive which gave me nightmares for a bit. I did see some interested images that were sent to my dad when he was on call. (All survived)

Woman kicked in the face full force by a horse. He said it was the worst facial fracture he had seen in over 30 years of practice at the time.

Coal mine had some large rocks fall on the guys legs. Not too pretty.

Motorcycles are always popular attractions.

A 3 story fall from a roof, feet first on concrete. He did not tuck in roll. His backward shattered/dislocated legs and feet were the result.

mikecwru said:

Jumped off a 200(? who cares, really high) foot bridge, lived, realized he didnt want to drown, swam.

Gored by bull.

Hit deer with motorcycle. Then assaulted by deer.

Slid down conveyer belt (multiple multiple abrasions) then fell into salt shaft (ouch).

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The worst part is, that stupid coyote is NEVER going to get to eat that roadrunner.

There aren't trains in indiana...lying b@stard.

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No, no.....especially not in Knox County right?

Does anyone else feel guilty that we describe some of these things as "cool"? I do it too and then I think "Damn, that'd really suck"

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I can't find the clip on YouTube, but to quote Stan from American Dad: "Son, feelings are what women have. They come from their ovaries." "meanie:

i have two, neither will win gruesome award, just interesting.

1. 60-ish male alzheimers, depression, walks outside onto porch takes shot gun and blows head off (ant neck out post neck/base skull style). EMS says when they arrived, head spun around backwards, in ER-trauma, HUGE holes ant/post, neck real rubbery-like, could see spinal cord. pretty neat

2. as rotator in minnesota...serious rainstorm, heavy torrential x >8hours. neighborhood flooded that has a history of doing so with heavy rain. apparently one good citizen of this 'hood always complains to the city that the sewer-system is not working and that the manhole covers always come off during heavy rains b/c of flooding. well on this particular night, above gentleman goes to remove manhole covers to prevent them from getting swept away and WOOOSSSHHHH, geyser erupts from the sewer system shooting this pt >20 feet in the air, he lands 100 ft away and is now a quad (sad I know). last i heard the city was getting sued for neglect of citizen complaints.

Two words: silage wagon.

I've pulled two people from them, both lived to the ED to die on the table. They were both new circles from Dante's Hell.

- H

I read about this one in NYU Physician.

Man fall of a building, onto a bus.

Man falls of the bus, onto the ground.

They end up giving him over 100 units of blood.

He left the hospital 1 month later.

http://www.med.nyu.edu/communications/publications/nyuphysician/assets/Trauma30-35.pdf
(last page)

The worst trauma I get to see are the demented GOMERS, or the ETOH intoxications bolting from the bed without first putting their feet down.

*splat* on their face.


Occasionally we get a walk in GSW or stab wound, but we quickly transfer them like a hot potato.

This is one was one my instructor told me about.. .A teenage girl was riding her dirtbike, didnt see a barbed wire fence and ran straight into it. The barbed wire transected her trachea but didnt cause any damage to the carotid arteries. She was fully conscious while EMT personnel came and she was nasotracheally intubated. In the OR, when they were going to switch her to the OR table, someone didnt secure the tube and it came out and the already transected trachea got severely displaced ...so there was no airway. They ended up cracking the chest open as soon as they could. PT survived!

The most messed up trauma I have ever seen was someone I took care of on my second night of trauma call. We had a 30's y/o white trash female who was sick of people speeding down the road in front of her house. She and her husband and 6 kids all were standing near the road waving and yelling at people who they thought were going too fast. A group of about 10 crotch-rockets went by, and she didn't really like them. She swung her PITCHFORK at the last one, connecting with his front of his helemt. (he was patient #1 with minor injuries). The bike then took a turn and ran into her, giving her a pretty significant head injury. She was trached and in the SICU long enough for me to take care of her 3 months later when I rotated there. All of this for a bike that the police reconstruction showed that they were going 5 miles UNDER the speed limit.....

Ive seen a bunch of crazy ones so far, but the most disturbing was a 50 y/o m who laid his motorcycle down and slid into the guard rail with his wife. The motorcycle was ok c/ only minor damage. His wife was decapitated and declared at the scene so I never saw her. The man in question was partially decapitated. Meaning that the top of his head, everything above (and including) his eyes was cut clean off. Brain matter all exposed of course. He was still breathing on his own and had a strong pulse. He was kept alive in the ICU for over 24 hours, so that he could become an organ donor. Donated heart, lungs, liver, and kidneys. I got to assist on the procurement which was cool. It was just gruesome taking care of someone in that condition for over a day.

JobsFan said:

umm... no - he was dead.

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You know, despite my error I think a few of the readers were still able to understand what I meant. Thank you for taking the time to point out my mistake

Shot in the head point blank, then thrown off a 70ft bridge onto train tracks and then ran over by train. Everything reattached and still a alive and doing well; 80-90% overall recovery.

Me? Of course, I'll probably turn my head the wrong way and transect both vertebrals or something and die that way.

Old lady, got drunk.

Falls asleep on bed.

Two small dogs proceed to eat her face.

She wakes up, calls 911, then continues drinking.

Her left eye, eaten. Her entire face, chewed off nearly to the bone.

One of the creepiest things I have ever seen.

Q

DrQuinn said:

Old lady, got drunk.

Falls asleep on bed.

Two small dogs proceed to eat her face.

She wakes up, calls 911, then continues drinking.

Her left eye, eaten. Her entire face, chewed off nearly to the bone.

One of the creepiest things I have ever seen.

Q

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The real question is, though, does she still have the dogs?

*shudders*

I had an elderly lady, victim of dog mauling, came in with multiple lacs (which you might expect), pneumothorax (long teeth eh?) and a liver lac. Not bad huh.

MGG1848 said:

Saw a guy after accidently falling off a boat and happened to straddle the motor. Had a destroyed perineum and inner thighs. Awful.

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This is quite terrible...is he still alive? I think those that live through injuries like this win the top award.

I saw a pt with attempted suicide (jumped off bridge and changed mind). Open tib-fib fractures bilaterally. Then was told to leave the trauma room, so I don't know the rest of the story.

Heard of a pt who attempted suicide 3 times over 3 day period...with a gun. Shot self in head, woke up next day, shot self in head again, woke up next day, shot self in head again, woke up next day, called EMS. Decided after 3 failed attempts he should go to hospital. I know one bullet got stopped by the hard palate. One missed most brain matter (was a lateral shot) and don't know about the last. All I can say is that this guy had to have the worst aim I have ever heard about.

USCDiver said:

Yes, I'm sure someone, somewhere had a Troponin of 0.7

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BRB, I'm going to shave, too!

EM2BE said:

Heard of a pt who attempted suicide 3 times over 3 day period...with a gun. Shot self in head, woke up next day, shot self in head again, woke up next day, shot self in head again, woke up next day,

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Sounds like groundhog day. I had a cancer patient who shot himself 4 or 5 times in the head. Should have used something bigger than a .22.

bump

Faze2 said:

Ah good bump. This one happened a while ago, but still worth mentioning. 40 year old male was brought in for attempted suicide. Apparantly the pt stuck some sort of serrated hook tool in his trachea and proceeded to move it in and out in an attempt to bleed to death, or so he says. While he was doing doing this, the pt's girlfriend walked in on him and immediately passed out at the sight. On the way down, she smacked her head on the side of thier marble table, spiltting her head open. She was also a level 1. During the examination the patient kept asking if she was okay. When we answered "yes", he said disappointingly, "That's a shame, it would have been beautiful if we both died together." I guess he is a Shakespeare fan.

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I can't even begin to picture what he was doing.

VonKarolinas said:

I can't even begin to picture what he was doing.

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I don't even want to try to begin to picture what he was doing.

http://i275.photobucket.com/albums/jj303/zmedic04/DSC_0088.jpg

this was the helmet of a 40s female biking along the highway, hit by a bus at aprox 60mph. Had bilateral leg fractures, flail chest, open book pelvic fracture. Our scene time was 5min, transport time about 5min. Pt ended up getting an external pelvic fixation in the ED, got about 10 L of NS, about 4 of blood and then flown to level one center. Pt. survived with no neuro deficits, was discharged to home for rehab several weeks later.

18 y/o motorcylist crashed into pole, took off whole leg and genitals, pt lived.

40 y/o driving to work, tar covered object came through windsield and cleanly took off calvarium and whole cerebrum came out with it, still breathing for a couple minutes. Looked like an anatomy lesson...

Egon said:

18 y/o motorcylist crashed into pole, took off whole leg and genitals, pt lived.

40 y/o driving to work, tar covered object came through windsield and cleanly took off calvarium and whole cerebrum came out with it, still breathing for a couple minutes. Looked like an anatomy lesson...

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Holy hell to both of these especially the latter. What a freak way to die.

Two of them for you.

1. Man decides to commit suicide by stopping his car in front of a coming train. Horrible head and chest injuries. Running blood in as fast as they can and doing CPR. Did I mention every time they pumped on the chest that blood would squirt out of his ears. Not very forceful, but noticeable.

2. The other one was a guy who was working for a house moving company. For some unknown reason he was riding on the front of the house, fell off and was then run over by the trailer. The first time I saw him was in the OR when they brought him in for a washout. I am not squeamish and am rarely suprised, but when they moved him to the OR table, OH MY GOD! There was the open abdominal cavity, no hips, no legs. He was literally cut in half and was still alive. You could already smell the pseudomonas. Corn tortillas anyone?

Cleaning attic, fell through ceiling, landing on upright vacuum impaling handle through rectum into the diaphragm.

Drunk vs. train. Split leg longitudinally to just below pelvis. Found by cops ~3hrs later drinking with buddies. Cop asks "Where's your leg?". Wino casually points to severed limb lying 10 ft away.

Leg vs. power-take off of a combine. Very difficult to fit into the helicopter.

Thanks for the laughs everyone. Keep up the good works and keep the stories coming.

ccfccp said:

Hi everyone, I'm an MS3 and a new poster. I've lurked for a while, and I thought it was about time I joined the party.

This one is a little less gruesome, but I still thought it was pretty cool. I was at in the ED not too long ago and this guy was flown in from a reported MVC. It turns out a semi kicked up a 5 ft long solid steel crowbar-looking-thing that was about 3/4" in diameter on one side and 1.5" on the other. The thing probably weighed 100lbs. Anyway, it goes through this guys windshield and the 1.5" side went straight through his upper arm somehow sparing all the major nerves. He still had full sensation and movement of his hand. The removed it and he's recovering.

The best part was that the guy wasn't freaking out at all. He was pretty cool about the whole situation.

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This happened once in my hometown except the piece of re-bar pinned an 11 year old girl to the car seat. The firemen unbolted the seat from the car and brought her in still pinned.