What would YOU do?

[Sniper-T]

Obviously, there is no 'right' or 'wrong' answers. The question is "what would YOU do"? Each of us has a different skill set, and different set of supplies. The question is just designed to make us think of a possible activity, and the consequences should an accident happen.

That said, from the first part, where it just looked like a bunch of dislocated fingers and a broken hand without serious laceration, I would have given my wife one of my good painkillers (they make her sleep almost immediately), then gently but firmly reset the bones, and stitch or glue the laceration after a good cleansing. I would then make a slip on cast to help immobilize the hand, but still be able to slide it off to change the dressings. And then start a round of antibiotics.

The second part, with the completely mangled hand, I would knock her out as above, and then slowly start cutting away the damaged tissue and bone. I would try to keep any decent sized chunks of skin attached (near the wrist), and then separate the hand from the arm at the wrist. If I was able to keep enough skin to cover the stump I would, or I think I would slice a patch off her butt to cover the end. I would cauterize all of the blood vessels as I came across. Naturally, clean clean clean, and then antibiotics.

And prayer.

[Sniper-T]

Anyone who wishes to still answer the previous questions please do so... but here is another scenario:

You are with your group, minus any medical people that may be on their way, when you are confronted with several 'questionable' individuals. You are ready to defend, but you are talking amicably and exchanging information. Talk turns to trading some stuff, when out of the blue; one of the guys takes a swing at you with a tire iron. You get your arm up to defend, and draw and fire. The hooligans are quickly dispatched by your group, but the damage is done.

The tire iron blow landed squarely on your arm (which saved your head!), and you look down and see this:



Same scenario (no hospitals, no doctors); same question, What would YOU do??

[Brownwater Riverrat 13]

Well, I'm FUBAR, and it smarts! Sooooo, anybody got a couple of sticks, a knife, gimme your shirt so I can cut it up into strips and tie these sticks around my forearm. I do all this while I place my bad hand (left) on a rock palm down about knee high, place right foot on the back of my left hand and pull....... setting what little bones that will fall into place. I use my right shin and calf to press up against my broken forearm to hold the sticks while tying them around my forearm. While my group stand around in awe......................... Chuck Norris weeps.


Be safe.............the night is your friend.

[realist]

Scenario one:
1. Anesthetize
2. Debride the wound
3. remove whatever is not salvageable
4. Bandage
5. Administer antibiotics
6. Watch for infection

Scenario #2
That b broke Batman........
Step 1
1. Check for circulation
2. Elevate
3. pain meds
4. Ice to help reduce pain and swelling

The best thing about this is that it is a closed fracture. It will probably have to put into traction to straighten it out. If so then important to make sure circulation is not cut off.

[Brownwater Riverrat 13]

Scenario one:
1. Anesthetize
2. Debride the wound
3. remove whatever is not salvageable
4. Bandage
5. Administer antibiotics
6. Watch for infection

Scenario #2
That b broke Batman........
Step 1
1. Check for circulation
2. Elevate
3. pain meds
4. Ice to help reduce pain and swelling

The best thing about this is that it is a closed fracture. It will probably have to put into traction to straighten it out. If so then important to make sure circulation is not cut off.

Remember........this happened to you, not being a smart ass, ok? But all your procedures are on target IMO, easy on pain meds. Depends on individuals, just a note. If you could take said person on a stretcher back to base camp or where ever, do it! Best way of keeping them calm, treating for shock and elevating such a wound. If not, this person will not last long on foot with such a trauma. Sure you could sling it after all the preps but due to the freshness of the wound and not know whether there was any serious internal damage/arterial/venus there's no knowing of internal bleeding from crepidation from such a fraction and their movements over time in transit. Seeings I also have an open window with a group, I would have them carry me back to base camp for further treatment.



Be safe.............the night is your friend.

[Echo2]

Get my bud to get me to the nurse.....while the rest go on patrol to ensure that any threats are dealt with.

I want my ass sedated well....I DO NOT want to wake up during the setting of the bone/fragments....hope for best...monitor for infection......

Thanks god it was left hand.

[realist]

My bad I was thinking that we were a base camp. So guys you now need to carry me. Can you get me a drink while you are at it......

[Brownwater Riverrat 13]

Well, it's just what I would have them do. Just my experience with fractures that serious and having to wait for looooong periods of time before any type of treatment can be obtained. PAIN is usually what's embedded in between points A and B. "Immobilize" is what's most important in this situation, if they freak out, "incapacitate the victim" that's how I was trained. Nobody ever sees what happens underwater anyway during a water rescue (different scenario of course).


Be safe.............the night is your friend.

[apssbc]

Well I would consider that fracture open due to blood on the dressing. I am unable to see the wound on my phone so I'm calling it open.

I would clean the outside after sedating the pt or giving them some pain killer. The sterilize myself and get my tool kit and give the wound a good probing looking for damage to tendons, muscles, and blood vessels. Then sew up best I can what I find inside. Then it's bone setting time, do that and reexamine for more damage inside, again fix what may be there. Place a cast or splint and start healing. Leave the wound open but covered untill I'm comfortable with no infection. Stitch it up when it's ready to be closed. Change dressings keep clean and do antibiotics.

I realized I wrote this as if I was doing it to myself. I would have to direct someone to do these things. I keep a copy of emergency War surgery just in case.

[mitunnelrat]

Though it would be somewhat interesting to run around as a real life cousin to Captain Hook. I should contribute a more serious response to this.

Given the parameters for scenario 1, I know I could treat the shock well, though I'm not confident I'd recognize it as quickly as I'd like. However, I'd probably be saved her falling out before she got off her feet because I'd have her lie down for the hand alone, being afraid she'd pass out as I attempted to reset it. I'm running pretty lean on pain killers right now; I haven't gotten new scripts for a while. A dowel and an ultram probably won't help much.
Anyway, I'd have her lie down, put pressure on the wound herself as I get equipment prepped and talk to her.

Dose her up, clean the wound, have her bit (Evolver will get it) the dowel, and reset. I can't sew wounds, so I'd have to rely on compression/ pressure bandages to get the bleeding stopped, and changing them daily.

If the serious laceration is bad enough I feel like I'd probably seal it with. Quikclot after thorough irrigation, and hope it doesn't get infected.

Then its time to scrounge for antibiotics.

Fireworks hand? Pretty much the same except for adding the amputation. I'd be inclined to try a flame sterilized filet knife while its still hot, since my undereducated self thinks it'd be sharp enough to get through cartilage, sensitive/ flexible enough to feel/ avoid bone, thin enough to make clean lines on the skin left to cover the wound, hot enough to cauterize as I go, and long enough I might not need to stop to sharpen it mid process...

Lacking suture skills and materials, I'd probably try super glue to seal the arm and finish the procedure.

If I ran my hand through a pulley like that I'd cuss like a soldier, then take a knee, a motrin, and a swallow of water...

... Or I'd cuss like a soldier, check for lacerations, responsiveness, and strength. Further response would be dictated by how it looks/ works, up to (and including) wishing it had been my left hand that got wrecked, rather than my dominant right hand.

In the final scenario, I'd almost be relaxed, as I'm almosy guaranteed to be under the care of far more capable people than myself. In this scenario I'd just have to follow orders.