11 February 2008

I'm so happy I don't work in Buffalo

Nothing against the city, mind you. I've visited. A lovely town, with scenic Niagara Falls right there, some lovely casino resorts across the river in Canada (a whole 'nother country! Who knew?), and no shortage of snow.

But the other night, when they brought in an NHL player with a severed carotid artery suffered in a bizarre on-ice accident, well, I rather suspect the ER doc who was on duty wound up needing a new set of shorts.

Did I mention that it was his Carotid Artery? You know, the one in the neck? (We call it "Big Red.") And it was severed.

Technically, it was only lacerated. The vascular surgeon, Dr Sonya Noor commented that if it was severed, it would have retracted and been technically much more difficult to repair. They had his common carotid cross-clamped for fifteen minutes or so (thank god for a patent circle of willis in a young non-atherosclerotic patient!). Either way, it bled a damn lot.

I've seen my share of vascular injuries. They can be pretty scary. Multiply the stress level by a factor of ten when it's in the neck, and another factor of ten when it's a pro athlete, a celebrity of sorts. If I don't misread the AP report, did he get a trach? I would hope not, but with neck injuries you never know. He's a lucky guy.

The surgeon commented that the artery was "a normal, beautiful artery," which might mean that, unlike most of the vessels she sees, it wasn't crusted with cholesterol and calcium, but also brings to mind the last couple of sharp, penetrating vascular injuries I have seen -- both of them femoral. In both cases the surgeon commented, marveling, that the kitchen knife (or whatever) used to cut the vessel created a cleaner, nicer edge than he was ever able to get using a scalpel in surgery. I guess the soft tissues around the artery bolster it enough to produce that nice crisp cut. Funny.

Man, not the sort of injury you associate with pro sports (even hockey!). Nice job by the ER and surgical team.

And I'm still glad it wasn't me!

11 comments:

Anonymous said...

Today I just happened to see and buy the consumer version of QuikClot that has seen so much successful military use over the last five years. It was in the first aid section at REI for
$10 (a single 3.5"x3.5" sponge). A Google search shows that it is widely available now. I wonder if the trainers and team physicians will make it a point to have QuikClot immediately available now? Are folks seeing it in EMS now? What about in the ER or OR?

Christine-Megan said...

Yeah, that injury was nuts. The people I've talked to were there said it was like nothing they've ever seen before. And then to watch him skate off the ice! And to think of how high his HR must have been from all the skating already. *shudder*

We've actually had plenty of lack for snow this year. Like none. It bites.

docheidrich1 said...

to anon, re quikclot

Im a US military medic, been to Iraq a couple of times, played with quikclot a bit.

Its not a magic cure, but when used appropriately could help with this patient.

Quikclot causes a lot of problems when used inappropriately. It generates a *LOT* of heat as it absorbs blood to form clots. too much can cause more damage then its worth.

Id advise you to seek some good training before you grab this stuff off the shelf at REI.

jz-md said...

A related case to consider: spontaneous suture rupture in a fresh carotid endarterectomy.

Matt Dick said...

Another reason an accidental severing of an artery could be cleaner is simply speed. I'm sure bolstering the area is part of it, but I would imagine you wield a scalpel a lot slower than you'd have to swing a kitchen knife in order to get through the femoral artery...

txmzqf

Anonymous said...

I actually saw a similar injury several years ago - at a high school hockey game, of all things. The injured kid was 16 or 17, IIRC. He survived but it was damn scary for the spectators, not to mention his parents who witnessed the whole thing.

ladyk73 said...

It is actually the second time this happened in buffalo.
In 1989 Clint Malarchuk had a similar accident. He nearly died on the ice.

I am from Buffalo, and we have our own casinos now!

Jen Taurus said...

I was in high school at that time.

I saw where the wind chills are below 30 - I do not miss that here in breezy carolina.

Christine-Megan said...

Lady- "we" don't have our own casinos. The Native Americans do!

PE Mommy said...

I live outside Buffalo and it was all over the news. They said an ER staff member had been in the lounge and witnessed it. He then ran out and said that there was a devestating arterial bleed coming in. They got everything ready for him before he rolled in. The hospital is very close to the arena (a few blocks). He is still a very lucky man! I believe the last that I heard was that he was doing very well.

Anonymous said...

Yes, PE Mommy, he's doing quite well and is going to play in the upcoming season that starts in October (can you imagine the guts it takes to go back on the ice? I bet you his coach won't give him much ice time whenever his team plays in Buffalo)