Thanks Double Shot for the great info on crush injuries and Gangrene.  I just wanted to share a few thoughts I had while working in the OR here in NYC over the weekend as well as from watching some great footage of surguries in Haiti on CNN.com.

So I was on call for the operating room this weekend at my hospital in NYC, where I did a crush injury case – coincidence!  The patient was an 18-year-old who got his hand crushed in a piece of machinery at his job.  He had a complicated pinky finger fracture as well as nerve and blood vessel rupture to that finger.   A special orthopedic hand specialist was called in to perform the surgery to reconstruct the finger, including repairing the nerves, arteries, and veins in order for the patient to keep his pinky finger.  It was about a 3 hour case in a sophisticated operating room, with an infinitely expensive microscope used to repair the tiny nerves and vessels in the finger.

Compare and contrast that to the videos I watched of the surgeries taking place in Haiti.   Watch this piece below.

Pretty amazing to see that patients in Haiti are being anesthetized without the use of modern monitors. The surgeries are being performed on modular tables, open to the dust and debris carried in the air, with only ambient light – no high-intensity OR lighting to be found.  They are using garden hoses for tourniquets and Black-and-Decker drills intended for home use to perform the procedures, much less a 100K-dollar microscope.  And the goal is not to repair the limb, but to stabilize the patient to prevent further health risk, such as infection.

Just some food for thought…..

Hopefully the surgeons will come back to the US a little humbled by the experience, and maybe a little easier to get along with!!

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Tags: Haiti, injuries/trauma, surgery

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