Friday, August 15, 2008

A bottle of whiskey

Male caller, cut arm.
Arrive on scene at a wooden shack, a party shack , with its namesake going strong.
Older male sitting at a table with a blood soaked towel wrapped around his elbow.
"Hey Doc, wanna look?"
OK, just a minute and let me get some dressings ready.
He removes the towel and shows me a three inch gash near his elbow.
How did you do this?
My brother and I were arguing and he threw a bottle of whiskey at me.
I could picture the Hollywood version, as the two square off, one grabs the bottle by the neck and smashes the bottom off of it to produce a jagged weapon.
As I'm cleaning up the wound, I notice only beer bottles around. I am supposed to be thinking of scene safety and should be getting control over the weapon. Where is the bottle? I asked this more as a reflex and a bit out of curiosity to confirm my vision of the fight.
He's got it he says pointing to a fellow laying on the floor with no obvious signs of life.
Is he OK?
Oh yeah, just can't handle the drink you know.
I'm not sure why but something made me ask if the bottle was broken.
No he says, it hit me on the arm and fell on the table. Good thing too, there was still some left.
I exam the wound further, and with a little movement, a jagged piece of bone comes out.
I had just broken rule number one for a broken limb. Stabilize and splint in position found. But in my defense, I didn't suspect a break from the MOI (mechanism of injury). The bone had broken at a 30 degree angle on impact and then, or sometime later, had cut through the skin. I dress and splint the wound.
I then go and check on the brother, who, although smells quite dead, is in fact just in a restful slumber.
OK, rookie, never assume that you know what the injury is until you do your exam and ask all of the questions that you can think of.

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