EMS Physician & JEMS Games Judge Put to the Ultimate Test

When she received a call at her home to respond to a horrific night time scene on the train tracks in Philadelphia, long-time emergency responder and emergency department physician, Melissa Kohn, MD, MS, FACEP, EMT-PHP, never thought that she was going to be thrust into the middle of a chaotic scene and have to perform a field amputation on a 46-year-old man, in 100 degree heat under the train, in the dark, at 2:45 AM.

For a moment however, the longtime JEMS/EMS Today Conference JEMS Games Judge probably thought she was involved in one of the challenging scenarios at the EMS Today Conference’s advanced clinical competition secret finals scenarios.

But she wasn’t.  The skilled EMS responder and seasoned physician from Einstein Medical Center, dispatched from her home and tasked with the field amputation of a man’s ankle that was pinned between the wheel of the train and the rail on the tracks, was thrust into a real scenario that most ED physicians and surgeons will never be called upon to do in their entire career.

With no other options available, Melissa was the man’s only hope to prevent his death from exsanguination and hemorrhagic shock. She and another ED physician (Dr Megan Stobart-Gallagher) from Einstein spent an hour carefully assessing and anesthetizing the man, cutting away tissue, infusing stabilizing IV fluids and using two surgical saws to free the man and save his life. An additional challenge was calming the patient who remained conscious throughout the ordeal.

Melissa and her husband, paramedic Chris Baldini, are a part of the JEMS/EMS Today Conference JEMS Games competition judging staff.

JEMS salutes Dr. Kohn for the use of her advanced prehospital and hospital emergency skills, for remaining calm under intense pressure and her lifesaving efforts in the worst of circumstances.

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