Power tool safety

An unfortunate mishap that a coworker had reminded me of a call I did about 2 or 3 years ago.

It was a bright summer day when we were dispatched to a amputation. Arriving on scene, we were met in the patient's driveway by the patient and the fire department. There was blood dripping down the man's hand and his right hand was wrapped in a bloody towel.

He has been using a table saw and the piece of wood he was using got stuck and he tried to get it unstuck without turning it off. The wood kicked back and he ended up amputating his thumb at the first knuckle and split his forefinger length-wise up to his hand.

The poor guy was so pale. The firefighters had searched through all the saw dust and found the tip of his thumb, so we were able to preserve it in hopes of a successful reattachment. We loaded him up and I called medical control for guidance. Shee, I know that he needed to go to the trauma center when they had micro surgery available to try to reattach his thumb but he was severely hypotensive--from shock, I think more than blood loss. He was also in an extreme amount of pain, but our protocols prohibited giving him anything because his BP was too low.

So I consulted with our local ED doc and he said to take him to the trauma center and to bolus him with fluids and titrate Morphine administration to his BP and pain control. We started 2 large bore IVs and gave him 2 mgs of morphine at a time. I so wish we could have given him more, but I didn't want to keep his pressure bottomed out.

It took 2 liters of fluid to get his pressure to 90 systolic. I think we ended up giving him 6 or 8 mgs of Morphine total. He was a lot more comfortable when we dropped him off at the trauma center.

I don't know if they were ever able to reattach his thumb or not but I know that we go him to the best place to take care of him, regardless.

Please remember---TURN OFF the power equipment BEFORE grabbing things when they are stuck. All your parts are precious and deserve to stay where they are--you will miss them when they are gone, I promise!!!

What is the definition of Emergency?

It is not:

A stubbed toe
A sore throat that you've had for 3 weeks
A cough you've had for a month
Anything that you've had for 2 weeks and not seen a doctor for
A dramatic panic attack


I know that sometimes it's hard to know when you're in the middle of something to make a decision whether to call an ambulance or not. So we wouldn't get mad if you try to use good judgment. If you ask, though we'll tell you that your insurance will NOT pay for a trip to the ER via ambulance for a stubbed toe. As unfortunate as it is, you could *gasp* drive yourself, or have someone take you. And in all reality, an isolated stubbed toe doesn't warrant a trip to the ER.

It's not that we don't want you to suffer or not use the 911 system if you need us. After all, that is what we are there for. But know that there is a finite amount of resources in your area and if we are picking up up for your stubbed toe, the person across town having a heart attack may have to wait for another ambulance to get there. And it may be too long.