FacebookTwitterLinkedInGoogle+RSS Feed
Fire EMSEMS TodayEMS Insider

Call to Action: Snowmobile Trauma


JEMS.com Editor's Note: Grab a copy of the April 2008 issue of JEMS for Images B-E„from this incident.

On a snow-covered rural road, two men were attempting to fix a stationary snowmobile. While one held up the rear of the vehicle, the other revved the engine. Suddenly, one man slipped under the snowmobile, and the free-spinning track caught his left pant leg. His lower leg was quickly torn off, and he also sustained an injury to his left arm (Images A and B). Another friend, a veterinary assistant, witnessed the accident and immediately applied a belt as a tourniquet to control the exsanguinating hemorrhage from his leg. EMS was activated, and Dexter (Maine)„EMS was on scene in 11 minutes.„

The rapid trauma assessment revealed the amputation and an apparent open fracture of the left humerus. Both injuries were immediately stabilized and dressed. When LifeFlight of Maine arrived, the crew recognized the potential for life-threatening internal injuries, and the patient and the amputated limb were immediately flown to Eastern Maine Medical Center (EMMC).

On arrival at EMMC, it was clear from the amount of tissue loss and destruction that the patient was not a candidate for limb reimplantation. The focus changed to salvage and„to maximizing the patient_s function. In the relative calm of the trauma bay, it was noted that the bone protruding from the forearm was triangular (the humerus is round), the wound„margins were pushed in and pieces of the patient_s coat were lodged in the wound. These findings suggested that the bone protruding from the forearm was actually a portion of the patient_s tibia, and that the arm itself was not fractured.„

X-rays confirmed this suspicion (Image C), as well as the fact that the bone amputation in the leg was just below the level of the knee, much higher than initially suspected due to the large amount of remaining soft tissue (Image D). The patient was taken to the OR for management of both wounds. Approximately 18 cm of tibia was removed from the arm (Image E). The puncture wound was cleaned and closed, and healed very well.

Thanks to the quick and skillful action of bystanders, local EMS, the flight team and the trauma center, the patient recovered quickly from this potentially devastating injuries, and within two weeks, he was not only back home but was active in the community. He appreciates how lucky he is to have done so well with his leg amputation and "open fracture impaled in the arm."


A First Responder's Guide to Ebola

There are several things to think about when considering the treatment of an Ebola patient in the back of an ambulance in the traditional EMS setting.

Cardiac Arrest Registry to Enhance Survival to Begin Collecting Data to Measure CPR Quality

Data will assist in providing uniform reporting metrics back to agencies to assist with their internal quality improvement efforts.

A Multidisciplinary Approach to Urgent Care for Long Distance Runners

Pittsburgh’s rapid response team provides marathon runners with immediate care.

A Scientific Look at START and Our Ability to Do It

Do we correctly categorize patients or are there limitations to how we triage?

Early Clinical Trials Suggests Hydroxocobalamin Beneficial for Hemorrhagic Shock

Medically facilitated hemorrhage control study yields good results, more questions.

Epileptic Effect: The Aftermath of a Seizure isn’t Always What it Seems

You and your partner are dispatched to a 60ish-year-old female with signs and symptoms of a possible stroke.

Features by Topic

Featured Careers




Learn about new products and innovations featured at EMS Today 2015


JEMS Connect




Blogger Browser

Today's Featured Posts